Mr. Mark Molloy:

Regarding Deputy Kelleher's first question on whether the HIQA report reflected our experience, it does absolutely. For me, what jumped off the page straight away was the fact that the HSE was aware at local, regional and national level that this was an unsafe unit. Members saw from the schedule that I went through that we had been screaming about this for 18 months through meetings and so on but the HSE did nothing about it.

The HIQA report reflected a dysfunctionality in various management levels, particularly regionally. We met various people who seemed almost unaware of the HSE's policies and procedures in the investigation of an adverse event such as our baby's death. They genuinely seemed not to know how to handle this investigation in accordance with their procedures.

In that regard, the HIQA report reflects exactly our experience during the period from January 2012 until publication of the report.