Mr. Sean Egan:

I thank the Deputy very much for his questions. I agree with him that it is important, through our work, to identify what we find - good and bad. There is certainly learning that can be applied. If we take, for example, the recent inspections we conducted at University Hospital Waterford and Beaumont Hospital in Dublin, reports on which we published recently, we can see that two hospitals which have had significant problems with overcrowding historically have definitely turned the ship around. There is a sustained improvement at both of those hospitals. There were very clear examples of measures they had introduced which are directly applicable to other services. They have changed much of the way they do their business when it comes to processes. They have streamlined the way they manage patients, they have ensured their staffing levels are correct, and, in both instances, they have increased the amount of capacity available, both with regard to inpatient services and in the community.

The Deputy asked about the level of engagement at senior level within the HSE. We regularly engage at all levels within the HSE. It is fair to say that improvement is often within the gift of local management. In some instances, it is not and requires a more concerted report at senior level. One of the key things we need to try to differentiate in our work is to discover where is the appropriate way and place to engage within the HSE in order to ensure that we have the maximum impact. We publish all of our work. All of our inspection reports are in the public domain which we believe is important with regard to public scrutiny but is also important with regard to driving learning across the system.

With regard to our experience-----