Mr. Tony O'Brien:

I thought I had said last week that I was not at all happy for multiple reasons. The Deputy asked a multilayered question and I will try to give a multilayered answer. The first thing is that I believe that had I been aware of this case in all of its magnitude, it would have been possible for me to put in place a number of steps which, while not taking away from the case itself, would have meant that the organisation was far better prepared to deal with the fall out of it. In other words, if I had become aware in advance that the matters disclosed as a result of discovery indicated that it was far from certain that all the women the programme had set out to tell had been told, it would clearly have been greatly beneficial if all of that communication had been completed so that by the time this came into the public domain, there would have been no woman out there wondering whether she was one of those who should have had that communication. In fact, that is the most important aspect because that is probably the single thing that has damaged confidence in the programme and led to all the calls to the helpline. Had I known and had I been made aware of all of the implications of this - had I been given the information, I would have figured out the implications for myself - I would certainly have put in place a different approach to how the whole thing should have been dealt with. That is the first point.

The second point, and the Deputy asks a fair question, is whether the culture I have attempted to create encourages people to tell these things. Yes, it is. The Minister tells this story sometimes. On the wall in my office is a sign that says "speak truth to power". I put it up the second day I was in the job back in 2012. The reason is because, by statute, the HSE is one of the most hierarchical organisations possible. The role of director general is quite a powerful one in that sense. After a round of meetings and briefings on my very first day, it appeared to me that people were reluctant to tell me stuff so I put this sign up, brought everyone back into the room and had a repeat set of discussions encouraging that this would be a place where everyone could tell me whatever they needed to regardless of whether they thought I would like it. It is not dissimilar to a process that Pat Lamb introduced when he was manager of Connacht - the safe zone. I have encouraged a process of people telling me stuff. Why was I not told about this one? At the moment, it appears that those who should have told me did not see the significance of it but this does form part of the inquiry. Yes, I should have been told and I have sought to create a culture in which I should be told these things and, by and large, I am told about these key issues. I was not told about this issue and I am very concerned about that. The Deputy knows I am on the record as supporting mandatory open disclosure or duty of candour, as it is typically referred in the states that have legislated for it. It would not necessarily change the way people make their judgments but it would bring a sharper edge to the judgments they would make and I would hope that if such a duty existed, I would have known about this case.