Mr. Bernard Gloster:

I thank the Deputy. I do not propose to disagree with his observation that we are so far behind the curve on this, and have been for many years. There is no point in me attempting to dispute that. We could go into lots of analysis as to why that is. I am sure it would cross everything from culture to resistance to money and lots of things. We all, as healthcare professionals and providers of State services, share a responsibility in that.

We have some increasing advances, thankfully. The new digital framework for healthcare, which the Government agreed this year, is credible and comprehensive. Rather than expect the country to wait for the entire full EHR to be everywhere, which is really something that will take several years, we have committed to producing the first nationwide patient app at the end of this year and from that start to build a patient summary record. It will take a bit of time to build up all of the records that are potentially available for somebody.

We also have some discrete projects going on, about which I previously advised the committee. The new children's hospital, despite all of its challenges, will be the first completely all-digital hospital. St. James's Hospital has a good EHR system. The Mater has one but it is coming to end of life; we will focus on the priority of that. We will go by the six regions to build up the EHR but, as I said, rather than waiting for a big bang, four of the maternity hospitals, for example, are now completing the implementation of EHR. All of the maternity network will be done next year. All of the palliative care network will be done after that. We are building it.

The GPs' own systems are quite good and the interfaces with ours are not bad. I will not convince the Deputy that they are anywhere near where we want them to be. We have previously done very good records on the introduction of the national imaging system, which is quite successful. I do not want to be disparaging of anybody, but our problem in the past was that we allowed for too much opt-in or opt-out of what are and should be national mandated positions. I really feel, as a health system on behalf of the people, that whoever we fund, whether it is our own hospitals or section 38 hospitals, the simple reality is everybody will have to accept decisions will be made and implemented consistently or we will not continue to fund them. That is the approach that will be taken to it.

As I said, the critical thing for me was not to wait for the big bang at the end, which will probably outlive my career, but to start with real, nationwide, comprehensive measures. The patient app is a very good start to that. I look forward to people seeing that in the coming weeks.