Mr. Tony O'Brien:

I was asked why I did not provided a written statement. The reason is that essentially I found it almost impossible to write one. Each of my statements I make are written by myself, but when we have our quarterly meeting, there is much input from many colleagues. When I sat down to write a statement for today's meeting, I was able to identify the areas I wanted to talk about, but not to write it. I wanted to appear before the committee and speak on the issues without reading from a script as I would have felt uncomfortable reading from a script in the circumstances. It is not the case that I had a script but did not provide it to the committee. I did not have one. I gave the committee the headings. For myself, I had written down the key words to remind myself of things that I thought were important to mention.

I regret that Senator Gilroy does not feel in any way enlightened, that is unfortunate and suggests we failed somewhat in our task today. We will reflect on that. He asked whether I had considered how families might feel in the context of the discussion I have had with HIQA. It never entered my radar to expect that within 24 hours of having had the meeting with HIQA, having agreed a way forward, being provided with additional information and having been given a timeline within which we could respond, that it would find its way into the public domain and be presented in the way that it was. I had no expectation that would occur. I think it is reasonable that I would not expect that to occur. I would expect to be able to engage in discourse with any regulator and for that process not to result in the type of thing that went on. Inevitably that has caused all sorts of concern among those who are at the centre of this investigation. It was suggested that we were attempting to ensure that there would be no report. That was never the case. All I wanted to do was to be facilitated to deal with what was asked of me, which was to make a submission that would be part of the normal process.

There are things in the report that would not be there if the submission had not been possible. I have already outlined some areas in the report where I think there is room for further improvement. We have already covered that ground. I agree with members that it would have been better in the years from 2008 to 2012, inclusive, if training budgets had not been cut. When I became effectively the acting chief executive officer after being designated as the future director general, my first action was to begin to restore training budgets. What we experienced in those years was unavoidable.

The situation the country faced meant that emergency measures had to be taken. There is no question about that. However, they had quite a corrosive effect on the relationship between managers and staff at all levels in the service. A significant amount of talented managers and leaders left the organisation. Others had to assume their roles without the benefit of enhanced training to facilitate them.

One of the things I reflected to HIQA and previously in this committee is spelled out in the service plan for 2014. All that focus in public discourse on budget overruns, deficits, staff head counts and too many administrators - all those headlines we have all seen - drove many levels of the HSE and the organisations it worked with to become excessively concerned about those issues, often to the detriment of being able to spend time focusing more on other issues such as access, quality and safety. The committee will find a reference to comments I made in the report that are also reinforced by HIQA's reading of correspondence I had with the Department where I said back in 2013 that we needed to renew the focus completely on quality and patient safety. I cannot tell the committee the page number. I think it is in the final chapter. I made that reference to the investigation team as part of seeking to secure its understanding of what I was about, that five years of that does not get turned around terribly quickly and that I am in the process of doing that. I wanted the team to understand by giving it the letters of determination and the head count reduction targets, none of which has ever been met while I have been director general because I have not really prioritised the head count reductions. I do not think they are sensible. They often increase costs and reduce safety. I have always told everyone that across the four factors performance is measured by, one of which is the use of human resources, achieving arbitrary head counts is the least important. As the Chairman is aware, I have often got myself into some trouble for the stance I have taken on some of those things.

In response to Deputy Regina Doherty-----