John Dolan (Independent) | Oireachtas source

I have a number of observations first before I get into the detail of the submission we received. I very much welcome the opportunity to get this report. It is more than timely for us to begin such an engagement.

What is important now is how the committee, the Department and the HSE – indeed the whole of Government – proceeds with the issue and that we do not just behave in a way that we are all very busy but that we are thoughtful and strategic in our approach. We must include a risk analysis. I suspect we will not be able to cover all the possibilities as if there were no clock ticking down. We need to do the risk analysis and ensure we are strongly working on areas.

That leads me to another observation, namely, that I suspect we all woke up the morning after the Brexit referendum and uttered a similar two or three words. Let us be honest about that. None of us were expecting it in any real sense. I do not mean just those present in the committee room but people in general. In effect, what we had was an intent to fire a starting gun, Article 50, and we are all finding it difficult to come to grips with it.

We can talk about Brexit but almost as if it is just another thing that is going to happen and we will have to get up afterwards. It is difficult to marshal ourselves. I am also thinking about the various interest groups, whether disability or broader civil society groups. We all need to help each other to get to grips with this and just get on with it because it is a live action now. We can do the analysis when it is over.

The opening statement provided by Mr. O'Connor and his team refers to the whole-of-Government task. We - not just the health committee - need to have a greater sense of the matrix of what is going on between different Departments and the system as a whole. One of the points made in the opening statement is "It is worth remembering that we are at an early stage in the Brexit process." We are, but it will clock on in ways that may not suit us. Therefore, the question - I do not particularly expect to given a full answer to it today, but perhaps a framework of one might be outlined - is how we are best placed to work this process as best we can. This relates to risk analysis. Members have raised many very interesting matters that all need to be put into the mix. One of the final points under the heading "General Context" in Mr. O'Connor's statement reads:

This context of uncertainty makes conducting work to examine and address the implications of Brexit challenging. It also means that a definitive analysis is not possible at this stage. Nevertheless, our preparations are ongoing.

This is a hard space to be in because we do not know what will come up against us and we are caught between whether to wait to see what comes up against us or do some general scenario planning. I would like to get some sense from the Department of its key approach or framework to this kind of never-never land in which it finds itself. It does not know exactly what it is facing but it knows it will face any number of issues of greater or lesser intensity.

Further on in the statement, under the heading "Principal health sector impacts", the third bullet point states, "All our work relating to Brexit is informed by the following key priorities: to ensure continuity in the provision of health services and to avoid any changes to the current situation that would have a negative impact on human health." I do not say this with any disrespect, but anyone could have written that. They are very solid first principles. Going back to my previous question, what I am getting at is the question as to what the next piece is. What are the next few paragraphs that would come after these two principles? What is the evidence behind them and the analysis for moving on? That needs to come on fairly sharply.

Regarding free movement, if one goes out onto the street and asks anybody, he or she will name a few very important hospitals in the UK that have saved people's lives. I would consider the area of disability. Deputy Kelleher talked about rare diseases. Ireland is a small country. Even if one adds Northern Ireland, it is still a small outfit. We are dependent on expertise from the UK. Granted, it comes from other places too, but the UK has been very strong and world class on a range of the issues at hand. That is a real worry for people. The disability movement and other groups also need to play a part in trying to work through this, which is a point to which it would be useful to return. How will the Department, the HSE and others engage with civil society or the patient groups or whatever one wants to call them? We are all in this together. We will face the same problem after it.

Further on, the statement reads, "It is important to remember that there are other issues that will affect the health system but which may not be necessarily led by the Department of Health." This is critical. We are the health committee. The determinants of health is a module I would like to hear more about and one that needs to be worked on. Even the points that have been raised by example - products, free movement, the speed or slowness of borders - are outside health but impact on health.

Another quote from the statement is, "The strength of the relationships between Ireland and Northern Ireland and the UK will be of benefit as we work to find solutions to any problems that arise." Is this an overly hopeful in nature? Sometimes, we all hope things will work out well. When push comes to shove, how good will good relationships need to be to deliver the goods? That is the question. They may still be very good relationships, but people may be hamstrung because they are on one side of the line now rather than on the other.

I wish to raise a very practical matter. I am not criticising anyone but I am bamboozled by the fact, referred to in the opening statement, that we have the Brexit Cabinet committee chaired by the Taoiseach, the senior officials group, the interdepartmental group, the working groups - sooner rather than later we will need a map or a matrix. Some of these matters are beyond the witnesses and are the business of others. Perhaps some of the matters I am talking about are about helping all of us to help others to start in a meaningful way to deal with this.

Those are my few points. I again thank the officials from the Department for being here.