Mr. Damien McCallion:

I agree. Deputy Louise O'Reilly raised one other point that I have not addressed, which relates to critical incident management and emergency management. One of my areas of responsibility is emergency management. She was probably referring to two levels: one is the day-to-day basis in the hospital and the management systems around risk that are in place. There are systems, escalation protocols and so on to manage that daily in terms of making decisions when hospitals come under pressure.

On the wider perspective, there is an emergency management framework. The HSE works in the same way as the Garda and those in other inter-agency areas. We are constantly running tests in that regard. We just had a discussion at our own leadership team yesterday in terms of running people through it. There is constantly simulation. We were taken through one yesterday in relation to a major road traffic accident in the north west that was simulated live on the road. All of the emergency services were involved that would have an impact on the hospital. The process and framework is constantly tested. Being trained for these events is one thing but to test it and simulate it is another. There is strong evidence that unless we are doing that regularly we will not address it. Therefore, on major emergencies, there is a well-established framework. We have strengthened the resources in that area to work with the hospitals and our community partners as well in terms of community health organisations to do that.