Mr. Paul Reid:

If I can, I will quickly respond on the cancer screening services. I was making the extra focus, not the distinction, that we have also in terms of rapid access clinics. Positively, we have seen our rapid access clinics restored to a much stronger level and part of our winter investment is to support them again. There is €2.3 million for our rapid access clinics.

Separate to that are four major screening programmes. The Senator was pitching on one of them there, namely the diabetic retina screening. The others, BreastCheck, BowelCheck and CervicalCheck, have all been restored. Obviously, some are more challenged than others. For instance, BreastCheck, because we must put in place many infection prevention and control measures, is not as efficient as it would have been, but we are providing extra resources in order that we get back to the reasonable levels we desire and can sustain. Obviously, our key message to the public in this regard is that if someone has symptoms, he or she should please come forward. I would separate that out from the screening programmes, which are, in essence, testing healthy populations to get early signals.

Specifically, on the learnings from the first phase, we in the HSE have been very open, and so we should be, to what learnings can we take from each phase. From me, here are a few brief reflections on the first phase. Obviously, in the nursing homes and long-term care for older people, we all have to stand back and ask what could have been done differently. There have been many learnings on that. One certainly is that as the virus presented itself and affected people who were asymptomatic, once it got in it caused a huge risk across the nursing home setting. That is one that we built some more protections on in this phase. Certainly, that had to be a huge learning for all of us.

There was a second learning from nursing homes.

Congregated settings are not ideal and not the solution for the future in terms of long-term care, particularly for vulnerable groups and older people. Ultimately, that is a long process of change but it is not the way we would organise for a pandemic because one is at higher risk.

The third point from my perspective is that as we look into the utilisation of private hospitals, this time we will do it in a very different way. That is not to say it was wrong. We all watched what was happening in Bergamo, to which some members referred. We just had to get capacity into the Irish hospital system. Thankfully, the way the Irish public responded we did not utilise that to the extent we thought we may need it. Looking back now, we will do it very differently in this phase, which will be very targeted in terms of procurement and some phases. We have had learnings and we are very open to more.