Mr. Muiris O'Connor:

I thank Senator Byrne. It is nice to see him again. I will take those questions. The import of medicines and medical devices was very close to our top concern in our preparations for Brexit and in our review of the implications of Brexit for the continuity of health and social care in Ireland. We did enormous work in the years leading up to Brexit. As the Senator knows, there were a number of cliff edges and we were ready for each of them.

Regarding the supply of medicines to Ireland, as the island beyond the island, an awful lot of our medicines came either from or through the UK. It was mostly the latter and came through in the form of the land bridge. We worked with our suppliers and the pharmaceutical industry in Ireland in the past while to look at the vulnerabilities that arose in that regard. Many of these were evident earlier this year. Thankfully, there was buffering of stock. We have never used the word "stockpiling" and we never advised stockpiling on the part of citizens, but we ensured there was a high amount of buffering in the pharmaceutical supply chains. That still stands to us. I believe there were approximately 12 weeks of supply for most medicines. We have monitored very closely the ability of the companies in question to maintain their stock levels and all is going well.

The products we were really worried about were the short shelf-life medicines that were not amenable to buffering. Those are radiopharmaceuticals that fuel the chemotherapy X-ray machines around our services. Compounded food products were the other area for which we had specific contingency arrangements in place. The radioisotopes are sourced from mainland Europe but come through an airport in the UK. We have watched those supplies. They have been completely unaffected by Brexit and the supply of radioisotopes has been unproblematic.

Compounded chemotherapy products, that is, nutritious medicine or food for very ill patients who may not be capable of eating, go off very fast because they are so high in nutrients. We had a dependence on the UK for those so we have watched that very closely.

We have worked closely with the Revenue Commissioners. I pay tribute to our colleagues in Revenue, who have been absolutely fantastic in responding to any issues and where anything got stuck. They worked with our medicines regulator and their counterparts in the UK to ensure no products were gravely affected. We were dealing with them on an almost case-by-case basis through January and February. As well as resolving the immediate issue, we were going back on each case to understand whether the logistical supplier, the pharmaceutical company or some aspect of the paperwork gave rise to the trouble. We have found that we are ironing out those issues.

We are feeling much better about medicines now. There has been significant rerouting of medicines, as has been the case with many other goods. Many of our shelf medicines are coming direct from Europe now.

This is much more secure and bureaucratically tidier for suppliers. We are also looking at our own capabilities in compounded goods. This is important and a matter on which we are working and building up capability with the HSE.

On data, we are all holding our breath. The data adequacy agreement, in my assessment, is absolutely vital for the UK in terms of its ability to interface with Europe as neighbours. I would absolutely hope for a data adequacy decision whereby the European Union would deem the standards of data protection in the UK to be equivalent as they are now. Much of it depends on the UK's inclination to maintain that equivalence. Medicine is a very serious example of where deviation from regulations would give rise to difficulties in the future and give us real headaches. We await hopefully the adequacy decision on data, as well as the longer-term inclinations of the UK - it should be remembered that it is a major pharmaceutical exporter - to maintain alignment with European regulations and standards for medicines. We are watching this very closely. I will be able to give a fuller response as it unfolds.