Mr. Richard Corbridge:

On the question regarding data protection and legislation relating to it, other jurisdictions have ultimately failed to deliver technology into health for multiple years because they have fallen down in the context of data protection. We go into this with our eyes wide open and having learned those lessons. One of the principles we have adopted, particularly in terms of the electronic health record, is that data protection and the ability to govern who has looked at information to do with health will be placed in the hands of the patient. We will enable a patient to log-on to see who, from a clinical point of view, has looked at his or her records and be able to do something about that. That has been proven, particularly in Estonia, as a way of taking away many of the concerns around data protection. The concept of a legitimate relationship to access information, I personally believe, is something in respect of which there is a need to change legislation in order that it might be contemplated. We must also consider how we do that so that we have health information legislation around accessing health information is important to the success of our programme. We have seen, even in the past six months, issues in the NHS where large programmes, after quite a significant spend, have been stopped because of data protection concerns. We work with the Department of Health to ensure that we address our data protections and keep striving to deliver in that space. Something called the privacy impact assessment was completely around the individual health identifier before that was made capable and live. That was done in the public domain, with comments from the public, to try to ensure that we bring people on the same journey that we ourselves are on in that space.

As Ms Goff said in respect of the big-bang solution, the ten-year strategy and the ambition we have in that space, our rate-limiting factor on the delivery of technology in Ireland is probably not technologist, it actually relates to clinical capacity. The Cork hospital example is a prime one, where 8,000 hours of training were needed in a hospital before a system could go live. That cannot be fulfilled by putting IT staff into that place. Business change is what drives efficiency and benefits from digital, and business change cannot be done to people. It is clinical time that is most needed as opposed to IT staff. That is one of the asks in the opening statement - to consider how, at some point, the digital health budget could also include capacity to do business change. Currently, my budget does not allow me to spend money on business change. It only allows me to spend money on technology. I must then seek assistance from the system itself to spend its own clinical budget on business change and that makes it somewhat challenging sometimes to ensure that business change can happen.

On the question around leadership and how to keep it in place, we have built a strong team across eHealth Ireland. Throughout the whole function, as small as it is, we have a team of passionate people who believe strongly in what they are trying to deliver. There is the ability to move that team and flex it to reflect the Health Service Executive itself and how we change our structures and what we deliver. Having 200 clinicians and a chief clinical information officer who is considered to be the deputy CIO is hugely important to me personally because that means that we are clinically led and have clinicians involved in where we are going. We are striving to ensure we combat any issues around changes in leadership, changes in styles and changes in structures. We have created a national structure in the past 18 months. Previously, we had lots of local IT teams. That also has been crucial in ensuring that we deliver a single vision for where we go.