Mr. John Hennessy:

I will be delighted to pass on those positive comments to the staff and I am sure that they will appreciate the comments.

With regard to Deputy Ó Caoláin's question on national performance indicators, I shall not repeat what Ms O'Dowd has said. She has covered most of the questions on the issue. The indicators that crop up on the HSE's routine performance monitoring system are the 48-hour visit performance; the immunisation and child development check metrics which involves the percentage uptake achieved in each of the areas around the country; and the performance and delivery of child developmental checks within the prescribed period. The monthly performance metrics reach the management team's table where they are monitored extremely carefully and variances that emerge get escalated to the national management team. I am aware of some particular variances that are of concern.

With regard to future of the service, I do not disagree with the point made by Ms O'Dowd that a task needs to be done. As the incoming primary care director I will engage with the various stakeholders in the system, including the patients and users of the service, in order to discover the appropriate performance measures and metrics for the public health nursing service. The ones that we use are useful and provide a good picture of how the system performs. The performance measures are probably inadequate and not comprehensive enough so we must do more. That will be a priority for me. The consultation process with stakeholders in the system, including the institute, will assist in developing a more robust set of performance indicators for the public health nursing service.

I will briefly mention dental health and answer the question on oral dental health. Dental health does not arise in public health nursing but forms part of the primary care dimension which has performance metrics that are monitored on a very regular basis. The latter entails the delivery of dental checks at primary school takes place at the commencement and end of the primary school term and the follow on treatment, including orthodontics, that ensues from those oral health checks. Children are monitored. If there are delivery problems in local areas due to staff shortages, etc., then they are addressed in the monitoring process. We publish the details in our monthly performance review which can be found on the HSE's website.

I shall ask my colleague, Dr. Shannon, to comment on child health records. A record is very important and the scheme is a great opportunity. There have been pilot schemes in the past five to ten years and I am sure that there will be questions on why it did not progress into a national system. I will be happy to explore that issue as the incoming primary care director and it will be a major priority for me. Dr. Shannon will comment more on the subject at the end of my contribution.

Senator Crown raised the issue of numbers per head of population. Do we have the numbers, Dr. Shannon?

Dr. Michael Shannon: Yes.