Mr. Robert Watt:

I thank the committee for the invitation to appear before it. As the Chairman has mentioned, I am joined by Dr. Tony Holohan, the Chief Medical Officer. While exercises on lessons learned on the pandemic are under way throughout the world, it can be seen from objective data relating to mortality, hospitalisation and vaccination uptake that the response to the pandemic in Ireland was among the best in the world. The Lancetrecently published a major global review of excess mortality during the pandemic with data from countries and subnational regions throughout the world. It found that "some countries ... such as Iceland, Norway, Ireland, and Cyprus had some of the lowest rates [of excess mortality] in the world, at less than 50 deaths per 100,000". As members know, the rate in Ireland was 12.5 per 100,000 of population. The cumulative rate of recorded Covid-19 deaths per million of population in Ireland remained consistently below the EU average throughout the pandemic.

Nonetheless we have seen over 7,000 deaths from Covid-19, as well as high levels of illness.

Both the societal and economic consequences of the past two years are well known to members of the committee, with the pandemic costing the Irish Exchequer circa €20 billion to date. In the context of such costs, it is right that governments and health systems around the world are now investing significantly in public health capacity. In the Department of Health we are working to find new and innovative ways to refocus and to strengthen public health capacity. A clear component of this is to develop leadership capacity in public health in order to strengthen and to prepare in the event of future pandemics. This is set out in the programme for Government.

As I have set out previously, I had initial discussions with the CMO in August 2021 about his future plans, as did the Secretary to the Government. Given the changing disease profile and concerns about emerging variants, those discussions were necessarily paused until earlier this year, when disease indicators confirmed that Ireland was in a much better epidemiological position. At that point, and in the context of Ireland's future pandemic preparedness, the CMO raised with some third level institutions how the Department of Health could, in an innovative and responsive manner, strengthen the knowledge and practice of public health leadership. These engagements had particular regard to public health protection, informing policymaking, understanding the role of public communications and behaviour change and research of relevance to these domains. Over the course of these engagements, the proposal for a professorship emerged. The purpose of this was to ensure that Dr. Holohan's expertise and skill set remained within the public service, with a view to strengthening public health capacity and leadership in Ireland. In this role the Department's intention was for Dr. Holohan to lead the development and activities of collaboration between all universities and the health sector and to develop stronger links with the WHO and agencies of the EU.

On 25 February of this year, the CMO requested my support to progress a secondment to a Dublin university. He indicated that he had informed the Secretary to the Government of this request. In early March the Secretary to the Government spoke to me and I confirmed that I was working on the details of this arrangement, including the proposed research funding element. I was aware that the Government had recently endorsed particular secondment arrangements to the university sector for senior civil servants. Given his long and distinguished service and the crucial knowledge and ability he brought to bear in the pandemic, I felt it was equally important that Dr. Holohan's expertise be retained and utilised in the public sector.

Further discussions took place, and the Department issued a letter of intent to Trinity College on 16 March which set out the main details of the proposals, with further detail on secondment arrangements to be agreed between the relevant HR departments of Trinity College and the Department of Health. As part of these proposed arrangements, the Department considered that the funding of Dr. Holohan's post was something that needed to be worked out but that the Department would support the development of this innovative approach to progressing an important initiative through dedicated additional research funding. It was envisaged that this would involve competitive funding organised appropriately to support the spirit of the initiative outlined above. The letter of intent therefore provided for Dr. Holohan's salary to be paid, in time, as part of a wider fund which, it was envisaged, could be administered by the Health Research Board, with details to be agreed between all three parties, as per the well-established practice of funding of health research in the third level sector.

As the committee will be aware, there are a number of well-recognised steps from the generation of an idea to the funding of a specific project or service that all Departments and Ministers must follow in order to allocate funds. It was clear to me that this proposal was in line with the Government's commitment to investing in public health, as outlined in the programme for Government. As such, and as required, funding of research in this regard by the Department would form part of the normal Estimates process, subject to ministerial and Cabinet approval.

It is a matter of regret to me that what I viewed as an important and innovative proposal for increasing our public health capacity in Ireland is now not going ahead. I believe that this important work would have benefited greatly by being led by Dr. Holohan. I believed when we conceived this proposal that it was essential that we continued to harness Dr. Holohan's knowledge and skills in the public interest, and I regret that that will no longer be possible.

I am happy to answer any questions from committee members.