Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I thank the witnesses for their presentations. A lot has been asked and answered. To bring it back to the practicalities of the delivery of health care in general, if we look at the various policies that have been outlined by the Department of Health, the HSE and various Governments, and probably by this committee in its final deliberations, without setting that it stone, primary care and community care will be where most health services are delivered in the years ahead. This will be for many reasons, in particular cost efficiency, but it is also the obvious place to deliver health care as opposed to acute hospital settings.

To put it into a practical example, a public health nurse calls out to a patient in some part of the country, he or she makes an assessment of the patient and, given he or she may or may not be prescribing nurse, it may be necessary to refer back to the GP to prescribe. The GP should then, in theory, be able to prescribe through electronic means to the pharmacy, and all of that should be centralised under the individual health identifier code. The question is how far we are away from this happening. I visited a GP practice recently where the staff have to put the mobile phones into a car and drive to the top of a hill to download messages before driving back to the surgery. That is happening as we speak in rural parts of this country. While we are trying to move to this model, do we have the infrastructure in place and has this been considered in terms of the ability to roll out e-health across the country?

To follow on from a question asked by Deputy Barry, there is the issue of the support and training that would be required. While come clinicians are technologically advanced and want to embrace technology, others may be resistant or may not feel confident in engaging in that process. The witnesses mentioned a figure of 40%. In general, it is those who are interested who will step up to the plate first and it then gets harder and harder to encourage or, possibly, force people. In that context, how much is being put aside in the HSE budget for training and support in moving people to e-health?

Reference was made to 47,000 new digital identities and 10,000 staff being given access to a digital device by December 2016. Is that digital device an iPad or a tablet? What type of device will they have access to? With the continuous advances in technology, how flexible will contracts and tendering processes be in terms of ensuring we are not burdened with out-of-date equipment, given tendering processes can be very slow in this State?

How compatible will our system be with other jurisdictions? For example, there is an EU directive whereby people can access treatment abroad if it is not provided for in this State. This is one area where I wonder whether information can be transferred electronically to clinicians in other jurisdictions who are taking on an Irish patient.

On the issue of collating data, the Scottish did a lot of analysis of prescribing by individual GPs and GP practices. Would e-health make that more efficient or do we already have systems in place to do that?