Mr. Jim Breslin:

An interesting point, which links back to a question Deputy Dowds asked, is that a very difficult decision is made all the more difficult when there are known individuals whose quality of life is at stake. In this situation there was a very small group of people whose families and communities were, quite rightly, extremely anxious that they get this drug. That is a particularly invidious situation for everybody. I include Mr. O’Brien and the team in the HSE in that. I know how difficult it is for the family, but for any of us to make a decision where known individuals are at stake is really hard. That has resource implications, just as the question about a vaccine for meningitis B has resource implications. The only difference in the case of meningitis B is that we do not know who will be affected by not having that vaccine. It is yet to emerge, if we do not implement that, who will get meningitis B who might not have caught it if we had used the vaccine. It is a more anonymous process, but we have to weigh up its costs and benefits. We make decisions all the time on investment, whether in accident and emergency departments or on home help services, where we do not know the individuals involved. The particular flavour of the recent matter which the committee might consider in its deliberations is how much more difficult it is when it involves a very small, defined group of people. We are trying to avoid playing God in those circumstances. It is a very difficult place for everybody to be.