Ms Lucy Nugent:

Regarding the governance structures, like any new CEO, I have come in and reviewed them, notwithstanding the HIQA report recommendations. Those structures were put in place at a time when the new children's hospital was imminent. However, we have corrected the issue, for example, of the site responsibility for the clinical directors. They no longer have that. I have changed that. We have enhanced the supports they have. In addition, we have clinical specialty leads and we have revised their job descriptions. They now take on more of a management role as well as a leadership role. This will be of great help to the clinical directors.

In relation to the executive management team, since my appointment, I have appointed a permanent director of people and culture. Obviously, this is a huge focus for us. The director took up his permanent role on 7 April. The director of operations started on 9 June and the deputy CEO will be starting on 7 July. I have two other posts on the executive management team that were temporary and I am now progressing to permanent. This is important to stabilise the executive management structures, to ensure that we are fit for purpose. A lot of work has been done in regard to that.

I fully accept that it is a systems process response. It is never about one individual. Regarding the medical device management process, we now have a clinical ethics committee in place. This is important because in paediatrics, unfortunately, manufacturers do not always manufacture paediatric-specific devices, etc. We have a clinical ethics process in place for any off-label use of a particular device, in other words, using it for a different purpose than that for which it was originally designed. Any non-CE marked devices are also brought through that committee.