Professor David Keegan:

Let me be clear; we really welcome the regional health authority structure coming in. We believe the model will slip across and will be transferable. As part of that, we did go into a huge amount of detail. We included the responsible approval support information table on who we are responsible to, who we are accountable to, who we communicate with and who we inform. We are obviously accountable to the CEO of the Ireland East Hospital Group, and, ultimately, all the way up the chain to the head of the HSE and the Department of Health. We all have this accountability but we have different sorts of lines. We bring everyone on board but, ultimately, responsibility for this decision lies with others. We read the media, we read the comments from patients and from politicians in the media about the waiting lists, which is exactly the story Deputy Kenny outlined to us today. We are alive to that.

When I took over as head of department in the Mater hospital in 2018, the greatest stress was how do we tackle this. We cannot tackle this by conventional means. As Ms Ryan stated in respect of the paediatrics group, we must look at it differently. We are trying to present a solution. If it does not get adopted in the end I would like an explanation of what is better. We have said this in our backup. If an alternative comes up and is presented to achieve these goals, we will sidle the machine in behind that. We just ask that it is still true to the purpose pyramid of elimination of preventable blindness. We are trying to provide a solution rather than coming in here and just saying that we are sinking and that we need help. We are sinking, we are struggling and patients are struggling but we believe we have solution on which we have been working for 14 months.