Mr. Bernard Gloster:

Dr. Henry can talk about the clinical dimension, the epidemiology factors and so on in terms of impact of things like cancer and diagnostics. Regarding the totality of the development of the health service, two fundamental things happened with Covid-19. One was the demographic continued to come against us in terms of the increasing age profile but the development of normal improvements in services and the ramping up of services were essentially put on hold or diverted towards responding to the pandemic so you got a double hit on both ends of that. While the health service worked enormously well and very successfully in terms of mortality during the pandemic, the normal development of and pathway towards things like universal healthcare or individual improvements in community neuro-rehabilitation teams or any other team essentially went into suspended animation so we are playing catch up with the development of normal service, which I said is one of the two parts of the service plan, and we are also trying to fight against what we knew was additional demand that was going to come our way. One of the things we did not see involved what happened since Christmas. The number of new people who have come on to our outpatient waiting lists far exceeded any projections and modelling and that is not unique to Ireland.