I thank Mr. Devane for his presentation. I have a number of specific questions about what has occurred over the past four to five years and how the chairman sees it going forward from now. I refer to employment in the HSE. The number of people employed in the HSE has gone up by 15,954 people since December 2014. That is a 15.48% increase. I am concerned about such a large increase in staff in any organisation because one would imagine that there would have to be a strategy around what needed to be prioritised, what needed to be planned for and how this could be funded into the future.

I am concerned about the increase in managerial and administration staff. There has been a 15% increase overall in the entire HSE staffing levels over the past four years and three months but the number of staff employed in administration and management has increased by 24%. It has gone up from 15,112 to 18,751. That is an increase of 3,639 in four years and three months. The increase in front-line staff such as nursing has only been 11%. To me, that suggests there is no strategy. I do not understand why there has to be an increase of 24% over four years and three months in administration and management. Will the board set out a strategy to look at the issue of employment within the HSE to examine where we have a surplus and excess numbers and where we have shortages? It appears that whoever shouted the loudest got the staff and I am concerned about that. If one looks at those 15,954 extra staff, that costs €650 million a year at a rough estimate. That will not disappear in the morning; it will be an ongoing cost into the future. What will be the board's role in setting targets and achievements?

The second issue I have with the HSE is with no one wanting to take responsibility for decisions. I have learned of an incident where a particular issue arose in a particular HSE facility. The person who was in charge of the incident reported it to the person who was overall manager and the overall manager felt it was necessary to go up the line in the HSE, almost all the way to the top, for a situation that was well under control. About three or four other people from the administration side got involved in decisions being made on the medical side. It does not make sense to me that even though the person who was the overall manager of the particular unit was in charge, that person felt that they did not have the capacity to oversee the process that was ongoing. That sounded to me as though the big problem within the HSE is that no one seems to be able to make a decision and that it must go up along the line all the time. That is causing huge delays and frustrations in making decisions. How can Mr. Devane focus on trying to change that type of approach to dealing with issues?