Mr. Paul Reid:

We have provided answers to the questions posed by Senator Dolan and will make sure they go directly to him as soon as possible. We have some detail on the responses and I am happy to pick them up with him. Regarding finances and the memorandum referenced by the Senator in terms of my own communications, as I said in my opening statements, it was not my only message on day one but I appreciate that it will get wider attention. There were three messages. The first one very strongly focused on patient safety and care, in particular valuing the work across the health service and the people who work in it, what they do and their commitment to that, but it also focused on strengthening controls and governance issues that have been highlighted and that we must address. The second issue, on which the Senator touched, concerned the reform agenda to which I wish to return. The third one was a wider message around building trust and confidence, one aspect of which will be moving to managing within budget. That will build trust and confidence not just on the part of our funders - the public, the Oireachtas and the Government - but on the part of our patients and in terms of our capacity to invest in the future.

Regarding the comment about the perception that someone from the Department of Public Expenditure and Reform is in the seat, I have worked full time since I was 16 for 39 years. I spent less than three years in the Department of Public Expenditure and Reform. I have had a very successful career in the private sector, the not-for-profit sector, central government and local government so my career has spanned a wide range of sectors. I am a committed and passionate public servant. That is why I want to be in this role. As I said in my opening statement, one can make no greater impact in the public service than in the sector that is committed to people's lives and safety. That summarises who I am and I hope it provides a more rounded context. The Minister touched on my next point. I know I have two very clear mandates, one of which concerns what the Minister touched on, namely, an agreed Sláintecare strategy. The appetite for that within the service is very strong. A lot of organisations talk about reform and restructuring a lot and one can get weary saying the same thing but since the announcement of my appointment six weeks ago and since I took it up, I have spent a lot of time talking to people in the service. There is passion and appetite to move to a new model of service. The fact that we have a model approved by the Oireachtas into which staff buy is a great factor. Staff need support and help in terms of change management and how we get to implement that but I sense a strong desire for people to move to a new model.

There are two mandates. One relates to the Sláintecare change plan while the second is our overall service plan and budget. At the start of 2018, the national service plan had €14.5 billion and the outturn was €15.2 billion. We have €16 billion this year so we are up €2 billion overall on the original national service plan for 2018. That is the budget within which I must manage. In doing so, I must deliver quality services and deliver on our commitments in the national service plan. Like many of the other sectors that are under pressure such as justice, education and local government, from which I have come, I feel the wider pressures for us, particularly given that it impacts on people's lives. It is a challenging issue. I have a mandate, budget and change plan and must work towards all of them. No public servant, myself included, has a mandate to spend overall above what is committed to him or her. That is my challenge. I am committed to public services, want to get value for money for them and want to deliver quality services. I may have referenced Dr. Colm Henry as the chief medical officer. My apologies if I did. The chief clinical officer and the team are working very closely on this as we work through in terms of delivering to the budget. How do we do it in a manner that delivers services and provides good-quality care and safety? That is a very strong driver as we work through this process. Ultimately, I am clear and as a public servant, I know the funds that have been committed to me. I do not have a mandate to spend beyond them. I want to bring the whole organisation along with me. Long before I arrived, the team here, including Ms Anne O'Connor, who has been interim director general, took some very good actions in the first quarter that I recognise. They took some really good actions that I hope are beginning to constrain the overrun we saw throughout last year and set us on a way forward for the rest of the year to make some decisions and difficult choices we will have to make to work through that process. We will do so in a balanced way and that is the message I want to communicate clearly.