Professor Frank Keane:

I absolutely take Deputy Nolan’s point, but the programmes which were formed as a joint partnership between the Royal College of Surgeons, as it happens, and the HSE to reform the process, began three years ago because it was realised that the situation had to be expedited and there had to be better knowledge of what was going on.

In terms of what the programmes are doing, they are dealing with a whole lot of issues such as understanding the data, making real time data available to consultants and doctors within hospitals and administration in order that people know what is going on. That connection of trying to understand in a granular manner what individual people and services are doing has only come about since the programmes have started engaging in the whole inquiry into the data so that we have become more familiar with what is going on.

Part of the programmatic activity is not only writing models of care but also interrogating the data of what is going on and visiting hospitals. We visited all the hospitals in the country on a number of occasions, presented their data to them and also showed them how their performance compared with other hospitals and with the best performing hospitals in the country. That is a relatively new process and it has had significant gains in that period, in particular in a time which has been difficult because of financial and staffing cutbacks and other factors.