Mr. Kevin Duffy:

The decline was across the public service and was a consequence of the economic state the country was in. That was a huge factor, and we are still trying to catch up. That is the reality. The moratorium has been lifted, but that does not mean that people will fall out of the sky to fill the vacant positions. It is going to take some time. The indication we have received in the course of our work is that things are improving. Those findings are set out in the report. Perhaps they are not improving at the pace everyone would want, but they are improving nonetheless. I hope that the situation cannot get worse, but it is true that no one anticipated the factors that caused the problems in the first place. At the minute there are many measures in place which are designed to make sure that the numbers match the needs.

The Deputy is correct to point out that the stressful nature of the job is an almost self-perpetuating cause of decline because people are working under pressure. This came across in surveys and submissions we received. Where a person gets sick and is out of work, this puts more pressure on his or her colleagues. That is a feature of probably every health service. The report makes it clear, and all of the available evidence confirms, that difficulties in recruitment and retention of staff are a feature of practically every health service, no matter the location. To some extent, Ireland is competing internationally to get people to come here. Some people are leaving Ireland and being attracted to other countries that have difficulties. This is an international phenomenon and not by any means confined to Ireland. Our remit is to look at the situation in Ireland and to suggest solutions for the Irish health sector.