Mr. Paul Reid:

Normality is always relative in health systems. I thank the Deputy for his comments. I worked in the private sector for 30 years and the public sector for 12 years. I have never seen any organisation implement so much change over such a short time, with so many people and such a great impact. That is what happened by the response of our health teams. I recognise that publicly and thank the Deputy for doing so. Having said that, we know the challenges we still face. We were able to track during Covid that the public's trust and confidence in the health service strengthened, though it could be said to have started from a low base. We know it is always fragile and could collapse quickly, but we want to build on it. A key issue for our board is continuing to build trust and confidence.

We spoke about some of the challenges that are ahead of us already. Sláintecare is the right direction for the health system. It is about relieving the legacy pressures on the acute system by doing things differently in the community service and increasing capacity regionally. The other issues arising for me as CEO, which I set out at the start and which we have made progress on, include accountability. We want to strengthen accountability in the health service. Things will go wrong and we should support people when things go wrong, but equally, we have to have an accountable system that has open disclosure and holds systems to account where things should not have gone wrong. That is something we want to strengthen, and that involves performance management, which we are rolling out and has not been rolled out fully across the health service to date. It involves another range of strands concerning management accountability and clear lines of responsibility. Those are some of the issues, as are waiting lists and Sláintecare, which we spoke about. Value for money and the best use of taxpayer funds committed to us by the Government form a key issue. We want to give confidence to our funders, the public, that we are providing the best value for money in return.

A big challenge we have had and which I set out when I came in is engagement with our stakeholders who work with us. There was a great example of that during Covid, with trade unions, representative bodies, Government and Oireachtas Members. The public heard a much-strengthened voice from the health service. That is good for us for the future. We will all have different challenges and disagreements at times, but the health system needs to have a more unified voice. The public has told us that is what they trust.