Dr. Tony Holohan:

I understand. There are provisions, for example, within the consultant contract, in respect of clinical audit. While those are all necessary, they are individually not sufficient to enable us to have the kind of environment we want in terms of having routine clinical audit happening everywhere it should be happening. That is why we are trying to do things through the national clinical effectiveness committee and trying to have a nationally organised system with a set of clear standards, and with this legislation creating a requirement on the Minister to produce standards that we can assess, and we can then mandate and prioritise audit.

If, for example, we have a national stroke audit happening across all our stroke services, we know it is happening to a standard, we can rely on its finding, we have given protections for individuals involved in the way that we have described, we have contractual arrangements that require people to be involved and the implementation levers, if I can put it that way, are all pointing in the same direction, then we can ensure the greatest likelihood of having full participation in a full national stroke audit. I am merely using stroke as an example.