Professor John Higgins:

On research and innovation, I could not agree more with Deputy Kelleher. A key element of the hospital groups was to embed that in the system. In terms of the value of manufactured goods and exports, health care is responsible for almost two-thirds in value terms of what we produce as a country. We must be a place where not just manufacturing but research and innovation in health care are a central element of what we do. The health care system up to now has not accepted that as a responsibility. If the Deputy reads the report on the hospital groups, he will see a key change in policy where that is now accepted as part of the mission. It is very important. Cork has probably the biggest concentration of pharmaceuticals in the world bar none. As evidence of that, the demonstrator site for the national health innovation hub, which is a joint interdepartmental initiative, was based in Cork. It was part of the work we were doing. I am fairly sure that the national hub to be announced shortly will be headquartered in our region because of the fact that we joined the dots between clinical service, training, research, innovation and job creation.

I have a final comment about retention. We have had a long tradition of our specialists going to the world's best hospitals, becoming the best people there and then coming home to spend their working lives in Ireland. There is a grave danger of that long tradition coming to an end. What will keep them here? There is certainly an issue with salary, which has been mentioned and discussed previously, but there is also an issue with the culture within the Irish hospital system, which must be changed. A key element in that change, not the universal element, is that we have a system that is open to innovation, is ambitious and fosters enthusiasm and excellence. That is a different culture from the one we have at present. The young trainees are in hospitals overseas where that is part of the mix, and we must get them back here again. A key element in making the hospital groups a success is the link to the academic partner.