Mr. Dean Sullivan:

I want to build on Mr. McGrane's contribution, and return to Deputy O'Connell's earlier point around structures and the comments the director general has made. Ireland is a relatively small country of 5 million people, which is equivalent to Manchester in England. It is apparent, within Ireland and other jurisdictions, that the idea that a set of measures or indicators can be put in place from the centre that will wave a red flag to tell us when something has gone passed tipping point at a particular service or particular site is bonkers.

No one in the world has designed anything like that. The only way of getting to the place to which we would all like to get, where we minimise levels of risk - one can never eliminate risk as this is a human-delivered service - where staff at the front line are empowered to manage the service and where appropriate governance arrangements are in place at the front line is to have a culture that encourages the sharing of issues when they occur at a local level, that learns from them at a local level and that, as appropriate, escalates them through systematised arrangements to national level where there is national learning to be had. We are on a journey in this regard, and it is the same journey that many other countries are on.