Oireachtas Joint and Select Committees

Wednesday, 5 December 2018

Select Committee on Health

Estimates for Public Services 2018
Vote 38 - Health (Supplementary)

9:00 am

Photo of Jim DalyJim Daly (Cork South West, Fine Gael) | Oireachtas source

I cannot definitively say that those efficiencies will be brought about in the year ahead. I can definitively say there will be a relentless focus on bringing those efficiencies about. We have a very dysfunctional architecture underpinning our health system and the committee is aware of many of those issues. Integration is key to achieving a more cohesive and coherent health service delivery that works for people.

Someone came to my constituency office a number of weeks ago. They had been in Germany and showed me the new card used there, the equivalent of a driving licence, with a little gold thing in the middle that is the health record for patients. Every interaction a patient has had with the health service since the day he or she was born is recorded on that one little card. We have nothing like that in Ireland. If I go into SouthDoc, then to an accident and emergency department, into acute treatment and back to transitional care, there is shifting of files and paperwork generated and there is a lack of joined-up awareness for prescribing. I can be prescribed the same thing twice or three times. Anomalies arise in the system because of the infrastructure and that is the biggest challenge that I see and I have no monopoly on wisdom on this issue.

My perspective, as the Minister of State at the Department of Health, is to get the IT infrastructure up to scratch and if we can do that, then we can have the integration. It is very difficult to achieve the level of integration desired. Each person has a unique perspective and we want an IT system that will facilitate that. I see that as the single greatest challenge and we must have a relentless focus on trying to get that together. One can achieve so much more with data and information sharing and when everyone can speak to each other from a clinical, medical and management point of view. The information we as parliamentarians seek in order to hold the service to account will be so much more seamless if the IT infrastructure is put in place. That is the single biggest challenge. While I cannot state we will achieve that in the year ahead, there will be a relentless focus on it. We have received €250 million from the European Investment Bank with a view to providing the infrastructure to establish the European electronic health record. That will assist us in taking a significant step towards achieving that but there are many IT challenges in the system.

Currently, integration is ongoing to align the community healthcare organisations, CHOs, and the hospital networks. That will make for improved information gathering, sharing and the provision of health service delivery. Such interaction between CHOs and acute hospitals is crucial to deal with an issue I am very animated about, namely, late discharges. The required level of interaction does not exist currently and never the twain shall meet. They are two separate domains and it is very difficult to try to get them to join up. Thanks to Sláintecare we are very good at recognising and distilling down the key challenges, as well as the optimum ones from which we will get the best results. We must now move Sláintecare along its journey.

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