Mr. John Hennessy:

I thank the Chairman and members of the committee for the invitation to attend this meeting to discuss HSE Brexit preparedness. I am joined by my colleagues, Mr. John Swords, national director for procurement, and Ms Paula Keon, assistant national director for the HSE North-South unit.

The HSE has been preparing for Brexit for some time on the basis of a central-case scenario and for a potential worst-case scenario, while at all times aware that negotiations are ongoing to help ensure that the necessary transition arrangements are in place to maintain continuity of health services.

A HSE Brexit planning group has been in place since 2017 and has been working closely with our departmental colleagues on a wide range of Brexit contingency planning and mitigating actions. The focus of this work has been on Brexit implications across key work streams, including the continuity of patient and client health services; cross-Border and frontier arrangements, including co-operation and working together, CAWT; emergency healthcare, including the ambulance service; public health matters; environmental health; workforce issues and recognition of qualifications; and continuity of supply of goods and services including procurement.

The focus of the mitigation measures relating to continuity of care is on ensuring that service level agreements and memoranda of understanding are in place where necessary. This applies to specific service areas such as emergency cross-Border arrangements, cardiac and cancer services, treatment abroad placements and CAWT arrangements. The EU North-South unit is working to ensure that services currently available to people living in Border areas continue to be available post Brexit. Examples of those, as I mentioned, include cardiology and radiotherapy services at Altnagelvin and the specialist cardiac services provided on an all-island basis for children at Our Lady's Children's Hospital, Crumlin.

Arrangements in respect of other specific areas of healthcare, such as paediatric organ transplant services, are progressing and agreements are being finalised with the relevant UK hospitals to ensure continuity of service post Brexit. That includes Great Ormond Street Hospital.

The national ambulance services, here and in Northern Ireland, are liaising closely to ensure service continuity and agreement with regard to operating procedures. There are two key memoranda of understanding in place between the respective ambulance services. The first is a memorandum of understanding on the provision of assistance in the management and resourcing of emergency and urgent calls. The second covers mutual aid for declared major incidents. These join the two jurisdictions in their responses to emergency situations.

The environmental health service is engaged in ongoing discussions with the Departments of Health and Agriculture, Food and the Marine about the import and export of foodstuffs and the possible divergence of food regulations and controls over time. As Mr. Breslin mentioned, additional resources have been made available in 2019 to strengthen the environmental health service capacity in this regard, and those additional posts are being recruited at present.

The wider workforce implications of Brexit have been examined in detail by human resources department of the HSE and the key risks such as mutual recognition of qualifications and training for professional staff have been analysed in detail in the context of the movement of healthcare workers. The HSE is liaising closely with the respective professional bodies and the regulators with a view to facilitating the continuation of existing recognition arrangements.

The key risks for the provision of goods and services, such as medical and surgical supplies and medicines, in the short term relate to potential disruption and delay to supply chains. As Mr. Breslin mentioned earlier, a joint working group comprised of staff from the HSE, the Department and the HPRA has been engaged in intensive work that involves the identification of suppliers of critical medicines and detailed follow-up with regard to specific product lines. The key supply chain challenges in the short term are likely to be related to medicines with a short shelf life, those reliant on refrigerated supply chains, compounded products and time-critical logistics. The HSE-HPRA group is liaising closely with hospitals and community pharmacists to identify short, medium and longer-term concerns regarding the continued supply of drugs and any risks to such supply and the proposed mitigation of those risks. This work is being done in close collaboration with the pharmaceutical industry and both hospital and community pharmacy stakeholders.

There is currently a two-month stock of vaccines held in the HSE national cold chain service which, along with the stock held by companies in Ireland, gives approximately a six-month supply on the island to ensure the continuation of service delivery. My colleague, Mr. John Swords, can provide the committee with further details about the continuity of supply of goods and services post Brexit.

In terms of next steps, the HSE is continuing to work closely with service providers, suppliers and patient groups in relation to Brexit preparations. This involves identifying, assessing and addressing the necessary contingency measures and actions required to maintain service continuity in the event of both an orderly and a disorderly Brexit.

The HSE is also continuing to work on awareness of Brexit implications among HSE and health service staff generally along with our colleagues in the HPRA and the FSAI, key suppliers, and with patients and the public in consultation with the Department of Health. This concludes my opening statement. I and my colleagues we will endeavour to answer any questions the committee may have.