Mr. Mark O'Donnell:

It goes back to the Cathaoirleach's original question regarding why we do not have a plan or strategy. I am not sure of the answer to that specific question but I very much agree with the point made by Mr. Macey that there is a tendency to generate strategies but then there is a gap in implementation. The implementation happens and there may or may not be a review process thereafter. We need to treat that whole life cycle as one process. The strategy should be prepared with input from all stakeholders and include a clear implementation plan. Rather than an implementation plan following on some time down the road, it should be part of the same process. It is important to have ongoing monitoring and evaluation throughout the life cycle such that by the end of one strategy period, there should be substantive input into the next strategy from the experience of the first. We are not tightening up that cycle enough in terms of the actual implementation, resourcing and delivery and the ongoing review. For the national stroke strategy and any new national cardiovascular health strategy, there has to be an end-to-end closed-loop process that we work through.