Gillian Toole (Meath East, Independent)

In this instance, I am not going to duplicate all of the statistics and summaries of the review to date that Members have discussed. I will approach this from the point of view of what may happen next and the human impact. There must be a compassionate approach to supporting the children and families through the review process without sterile communications and an impersonal review process.

Having worked in healthcare, the burning question I have is what happened to "first, do no harm", the very foundation of the Hippocratic oath, throughout all of this? We always say "system failures" and bandy it around here, but in this instance, and very much in healthcare, the system is people. They are the most valuable asset. How do we move forward from here in terms of rebuilding trust and bringing a culture of truthfulness? We must refer to Maslow's hierarchy of needs. We must have a safe work environment where people are valued and where there is esteem, a sense of belonging and self-actualisation. Every team member has to be valued. Teams should be asked for their ideas before external consultants are brought in. We will get better buy-in and a stronger commitment. In terms of culture, high-performance team members can question one another to get the best level of participation from each member and strive to give the best performance possible, whether in the workplace, a healthcare environment, the judicial system or here on the floor of the House. All of this is to rebuild and encourage truthfulness and honesty.

Another area is governance. With responsibility must come accountability and openness. I have several questions on the National Treatment Purchase Fund and the treatment abroad scheme. These are symptoms of system failure. If the costs ploughed into these schemes went into the public system, would we have little or any need for them?

With regard to action, the recruitment of leaders should mean finding the best and most competent person for the job. It may not be necessary to revert CHI back to the HSE. Nine years ago CHI came from the HSE. The best person for the job should be given the job and not just the longest-serving people.

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