Mr. Robert Morton:

I will start and then hand over to Mr. Keeley. Workforce planning is a massive challenge to say the least. Like directions in County Kerry, we would not want to be starting from here. It is where we are starting from, however. Ultimately, we must find a way to work up from where we are.

One of the things we are convinced about is that we need to double our capacity, but even doubling our own educational capacity will eventually reach, if you like, a rate-limiting factor, which is clinical internships within the wider health system. Ultimately, paramedic interns and students require clinical placements. Eventually, people are competing for a fixed volume of clinical placements. I refer to nursing students, health and social care professional students and so on. We need to grow our own capacity. We also need to look at apprenticeships. We have spoken to Solas about that. The support of the committee, for example, with the whole idea of apprenticeships is welcome. We also need to work with more universities. At the moment, we have a formal relationship with University College Cork and we have a growing relationship with the University of Limerick. However, there are other universities we would like to work with in due course to create more opportunities for people to do a bachelor of science in paramedic studies. That creates more avenues for us.

Then there is the international domain and the number of Irish people who are living abroad and who, perhaps, have a desire to come home. How do we make it interesting? How do we incentivise them in doing that? One of the ways of thinking about it, which is clearly beyond the scope of the HSE, is recognition and how we value our workforce. We had a very solid piece of work done in conjunction with our trade union partners that took the form of a review of roles and responsibilities. It basically recommends a change to the professionalisation and workforce model in the National Ambulance Service. It has recommended changes, for example, to remuneration arrangements. That is clearly beyond our scope. The HSE as an employer does not set terms and conditions. Certainly, the HSE supports a very detailed business case, which has been designed in collaboration with the trade unions. That business case is with the Department of Health. I presume it will eventually find its way to the Department of Public Expenditure, National Development Plan Delivery and Reform. It will also probably be taken into consideration in future national pay talks. Obviously, there is a mechanism by which to look at the reward and remuneration of and the recognition arrangements for paramedics, generally speaking, working in the National Ambulance Service. That is obviously beyond our scope, however. That is an important factor in terms of supporting retention but also attracting new people and encouraging and supporting people to move back from abroad.

In terms of the task and finish piece, the Chairman is right; it is really difficult. It has been going on for many years. There have been several attempts to unpick the issues involved but it would certainly be the case, and Mr. Keeley will probably share this view, that the Ministers appear to be focused on achieving an outcome with which they will both be happy. They have tasked us and others in both Departments with achieving that outcome. That is really what we are working towards. The schedule of meetings are likely to be every month. That is what it is shaping up to be. The next meeting has already been scheduled from yesterday. There seems to be a lot of energy behind it at the moment. I will hand over to Mr. Keeley-----