Professor Damian McCormack:

It was a mixture of both. There have been policy changes, and Mary Harney sticks out because, at that time, things started changing for the sake of change, to quote her, which created chaos. There were also people, for example, surgeons, retiring and not being replaced by like, that is, by equally skilful surgeons. That creates a problem. For instance, I know the HSE sent money to Galway to fund a paediatric orthopaedic post maybe ten years ago but the surgeons in Galway chose to use that money to hire a spine surgeon. They are autonomous and what they do is not my business, it is their business, but what they did was to hire a spine surgeon, not a paediatric orthopaedic surgeon. Therefore, they had one paediatric orthopaedic surgeon, who then retired and was replaced by a young surgeon, who was not happy and left, and who has come back to Crumlin for various reasons, some of them personal and some of them, I think, professional. To do this job alone in a place like Galway, which is so busy with the whole west coast feeding into Galway, is virtually impossible. This evolution has occurred but it has been a devolution, really, for the past 20 years.

We need one or two really good, solid surgeons working and incentivised for the right reasons, resourced with good quality people around them. We do not need a huge glass building. I am are aware of some really excellent, probably the best, trauma surgeons on the planet who are operating at the moment in a tent in the West Bank. We do not need a huge building. We just need quality people who are motivated in the right fashion, obviously, but the motivation cannot be financial because that does not work. It has to be more. It has to come, from the very beginning, from how these people are educated and taught. They have to be working in good faith, in good spirit and they need to be authentic and honest people. That is not a big ask. Ireland is full of such people but there is interference stopping them from progressing. I think we can clarify that.