Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

The witnesses are welcome. I thank them for coming in. I agree that we have to have the Secretary General of the Department of Health before us to answer for both what that Department is doing and for the position the Department of Public Expenditure and Reform took in 2018. We should aim to do that soon because this is so fundamental to everything else in the health service. The Chair suggested asking the Department of Public Expenditure and Reform for a written response. I propose that we also ask officials to send us a copy of the 2018 letter with its response to the strategy. Reference was made to Richard Corbridge. I remember him well from the health service. He was regarded as quite exceptional in terms of his vision for the future and the need to digitalise the entire health service. He was largely responsible for drawing up that 2015 strategy. Regrettably, after the response from the Department of Public Expenditure and Reform, he just decided to walk away because it was quite clear there was no appetite for this at either a political level or within the two Departments. Nobody was serious about this. We are seeing this over and over again. We saw it just last year when Laura Magahy and Professor Tom Keane walked away because there was no will to modernise the health service or to do those blindingly obvious things that need to be done. Why are they being blocked? We have to get to the root of that. It is no surprise that Richard Corbridge is now in a very senior role with Boots. He had fantastic ability and it is an utter shame that he was driven out of the health service.

As has been referenced, we have to have data-driven policy and decision-making within the health service. We all know the difficulty in accessing data through parliamentary questions. Even when I was in the Department of Health for a short period, I wanted to know where the health and social care staff were, how many we had and where they were employed. It took four or five months for the HSE to be able to give me those data about its own employees. That is the level of need. It is so completely basic. We know nothing about the prevalence of disease around the country and whether there are particular pockets or anything like that. It is fundamental stuff. The idea of the RHAs is that decisions would be taken on the allocation of budgets based on local need within each of those areas but we do not have those data on local need. It takes forever to get any kind of basic profile of different areas. This is critical. The other thing about that is not only having needs-based budget allocation but having accountability for performance. How can that be done unless what the needs are and what the response is can be measured? There is no accountability right down through the system because we cannot measure these basic things. The witnesses have strong support from the committee. We are keen to accelerate those fundamental reforms or at least get them moving.

I ask them to fill us in from a research perspective. We know the huge benefits for patients of an EHR and all the other aspects of that. From a research perspective, what are the huge obstacles to carrying out meaningful research and the data gaps that are there? Maybe they could fill us in on some of those key areas that they cannot properly do because of the lack of data.