Mr. Paul Reid:

I might clarify my perspective on a couple of issues, including when I referred to the concept of "tight and loose". I have worked in change management throughout my career. I have worked in centralisation and decentralisation, in nationalisation and decentralisation, in every kind of model and in very large organisations. There is a concept of "tight and loose", whereby the issues that need to be controlled centrally are kept “tight”, which for me, in this case, relate to patient safety and clinical consistency, while the "loose" refers to devolvement and creating that empowered culture of innovation. It is not a derogatory process at all; rather, it is about reinforcement. One lesson we have learned in the HSE throughout Covid has related to being less in control at the centre and letting the CHOs and the acute hospital systems work together, and that is what has worked-----