Dr. Colm Henry:

There are two forms of harm. One is the harm associated with overcrowding. Studies carried out in England and Australia show that certain levels of overcrowding over certain increments of hours are associated with increased harm. That was studied in the context of retrospective cases. Then there are the cases the Deputy alluded to, that is, individual cases where harm is suspected in the course of giving treatment and providing care. Such cases cross a certain threshold and we set that threshold low. We instigate what is called a serious incident management team under the policy of 2018. That does not necessarily mean harm was done in the course of care. However, there are certain trigger incidents, such as a sudden deterioration in somebody in an emergency department while waiting to be seen, or maternity incidents, which automatically trigger an event and an investigation. During the course of that investigation of course the family would be informed or fully briefed at the end as to the outcome.