Ossian Smyth (Dún Laoghaire, Green Party) | Oireachtas source

I will answer this from the point of view of e-government. I am responsible for e-government policy and making sure that people can access their records online. Of course it is up to the Minister and the Department of Health to deliver on that. Health is an incredibly important part and that question is very good and very fair. As people move through their lives they see a variety of different healthcare professionals. They see GPs who are privatised and they see people who are in the public health service - for example, they attend a HSE hospital, a voluntary hospital like St. Vincent's or the Mater and may be in community healthcare as well.

Traditionally in Ireland, those different sections of the healthcare system allocate a different number to each patient and those numbers are not joined up. Let us take a hypothetical example, a person is in an accident, knocked down by a car in the west of Ireland. Somebody needs to assemble the person's healthcare record. It is not actually in one place at all. To get all that data together, just to get a simple history of what has happened to a person in their life. Gathering information on their diagnoses, procedures they have had, illnesses and allergies and so on, would be a research project. All those different bodies would have to be contacted. It makes sense that everybody should use one ID number and, in fact, we have a social security number in Ireland, the PPS number. The Health and Information Bill 2023 intends to legislate for that and to say that healthcare operators can all use the PPS number and can all join up their records.

One of the questions is how are we doing in this regard and what can we bring together. During the pandemic, for one of the first times ever in Ireland there was a healthcare system that applied to the entire population. For example, everybody had to get a vaccination. To do so, there had to be a record of everybody in the State in one place, not split between different healthcare providers. Of course, the vaccinations were delivered by a range of different people, pharmacists, GPs and hospitals and so on. However, we all had to keep track of who had had their first dose or their second one. There had to be a centralised system and that was built extremely quickly. Because the healthcare system was under stress and because there was no shortage of motivation to deliver the project, it did not run into organisational challenges or consenting problems. It simply delivered in a few months a system which was way better than what would have been delivered in normal times over a period of years.

A system was delivered that was able to schedule vaccinations, run contact tracing, the testing service and everything else that was needed to manage the pandemic. This is a model for how things should work. There should be a centralised record of every person's healthcare and so on. That is being built at the moment. I have worked with people in the HSE on this. The HSE's budget for IT has doubled. It is now €200 million per year. The number of staff has also greatly increased. Its IT section now has 820 people working there. The HSE is working on an app. This is a normal thing that happens in other European countries. People can use the app on their phone. It will show a person's prescription, they can book a doctor's appointment and so on. Everything is centralised so a person can see a history of the tests they have had carried out and what the results are. Doing this empowers the patient to know what is going on. In the traditional authoritarian or patriarchal way the health service worked in Ireland in the past, a person went to hospital and things were done to them. No real explanation was given as to what happened. The doctor treating the person would then send a letter to the person's GP telling that person about it. People were often dispensed drugs or injected with drugs without even being told what was going on. The person's role was merely to submit and to accept all this.

This is a different philosophy in which the patient is involved in their episode of care. Their information is shared with them and actually belongs to them. With the consent of the patient, the information is shared among all healthcare professionals and their health records are kept in one place.

I will give some examples of what is going on. For the most part, the maternity hospitals have electronic healthcare records. The new children's hospital will have electronic healthcare records. As I said, the app which I expect will be the type of app that will be installed by the vast majority of people in the country, will allow people to see online their healthcare records as they happen, as happens in other European countries. I am looking forward to seeing that later this year and I am glad that the HSE is using an agile approach to this. It is not doing a giant project.