John Dolan (Independent)
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I thank the officials from the Department for coming before the committee and for the work they are doing on this. I will start by referring back to the engagement we had last March. One thing I mentioned at that stage was the risk that we would be all over the place or very busy and that everyone would be doing a lot but not actually steadying up and doing an up-to-date risk analysis. I wish to come back to that now because there is that old adage that one measures twice and cuts once. We only have one go at this. Perhaps my comments are very old-fashioned, but we need to go over the ground assiduously a number of times in order to double-check and to involve others in that double-checking. That can be difficult for us to do at times. Mr. O'Connor placed some emphasis on the good news of the agreement in December. Then there is talk of moving to the next phase. Would it be possible to set out in a sort of matrix or graphic, rather than a narrative, what those key risk areas are and what kinds of actions are being taken to mitigate them? It is a matter of moving from talking about certain groups being set up. We can easily keep talking about things. That is just human nature. That is one question to the witnesses.

Another key point I wish to raise is that there are two parties here. The EU is involved in this as well, but north, south, east and west are very much about Ireland and the UK and Northern Ireland. In that context, there are two entities, namely, the Irish and UK Governments. It strikes me that Ireland is quite clear about and united in its objectives in respect of this project. I do not have the sense that the entity with which we are negotiating has the same top-level unity of understanding or purpose. One is better off negotiating with someone when one knows that that person knows what he or she wants. One might not like what that person wants, but at least one knows. That is, to some extent, an issue in this. It is important to raise it here but it is an issue that goes beyond this forum. At the same time, Mr. O'Connor mentioned, for instance, the issue of the regulation of medicines. It would seem to make sense that the UK would not want to be in a different regulatory regime from that of the rest of Europe.

It would be useful to have a list of what would be the fairly strong interests of the UK. What would be less so? Knowing this would help us to do the risk analysis and marshal our work and activity. There may be matters about which they are a little more indifferent and which might not be the big issues. It is important for us to know those factors. It is about getting down and dirty. Perhaps I should not say "dirty" but rather down and detailed and forensic.

I come from the area of disability and people with chronic conditions. This is not foreign to any of us and people have been talking about such matters. There is a two-way street. Ireland, and even the island of Ireland, is small in a population sense when compared with the UK. Mr. O'Connor mentioned one area where Northern Ireland requires services that we have here. In the polio area, people come from Northern Ireland to Beaumont Hospital. All that makes sense. On the other hand, we have in cases traditionally gone to the UK for all sorts of supports. Senator Burke mentioned looking at other locations or, as I would describe it, flying over the UK. It was correctly mentioned that we are entitled to all the European Union, EU, health facilities. There is a sort of cultural and language issue coming into play. It is soft but other countries are foreign to us in a way the UK is not. We can rhyme off parts of London and Manchester and we have kith and kin. We share a language. It might seem a soft issue but it is an issue nonetheless. How would one get used to going to Sweden or elsewhere? This will affect a small number of people but these are practical matters for people and families. It is critical they are able to do this. We find it hard enough to make it easy for people to go to the UK. This could be a very different space for people at a terrible time in their lives. It should be examined.

I raised the matter of rare conditions before and others have also raised it. It is a growing area, like so many areas in health. At the start of the Department's presentation last year, the witnesses spoke about the principal impacts of Brexit for the health sector, covering a number of areas, including free movement, rights to health services and regulatory issues. They must all go into breaking down the risk analysis. I am glad the question was raised about the HSE establishment of the steering group. When was that done and what is it getting into?

There has been mention of other Departments dealing with education, foreign affairs and trade etc. Who is minding the determinants of health piece that is not the direct responsibility of the Department of Health? Are there other entities with whom we should have a chat in here? The Department of Health can communicate with others but it may not have a lien on them. It is important as there are elements in other Departments that would have an impact on people's health.