Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

We need such an informed debate. At the moment, what we have is, as I have described, an internal row within this coalition Government, with the people and the people's representatives in these Houses of the Oireachtas excluded. That is unacceptable.

As I said in the context of another health Bill recently, the Bill before us today may be part of a bigger picture, but I have yet to see that picture. I have to judge it on its own merits, not as part of a process or a package of measures that will result in a reformed health system.

The Bill provides for what I believe is a positive and useful development in our health services. Most of us have had the experience of the difficulties caused by the disconnection between the different elements of our health services. There is little co­ordination between the records of patients kept by GPs and other providers of primary care, including the HSE, and between them and acute hospitals and other providers at secondary and tertiary levels. Even within hospitals, there are often difficulties because of the absence of a single patient number for each patient. Many of us have experienced the repeated filling out of forms with basic patient information even during the course of one hospital visit and even when the hospital already has our records.

The purpose of the Bill is to assign a unique number - the individual health identifier - to each individual to whom a health service is being, has been or may be provided. The focus needs to be kept on that simple and straightforward aim. We need to ensure that maximum benefit from this change is assured for all users of our health services and for health service providers. That said, we need to put this major change in place very carefully to protect people's personal data and to prevent abuse of what will be a very important and valuable database on our population. We have seen in recent years how certain state agencies - notably US agencies - have grossly abused people's right to have their personal data protected. The current controversy in this State regarding surveillance provides another reminder of the need for robust data protection.

The introduction of the individual health identifier will require wide public consultation and information to ensure it can work effectively and that all necessary safeguards are put in place. I strongly urge the Minister to ensure this is done and that people are informed in a clear and coherent manner about this new development in our health system. I also urge the Minister to ensure constructive suggestions and contributions, both by way of amendments to the Bill from Members and by way of relevant comment in the public domain, are taken on board. Too often it has been the experience of the Opposition that little attention is paid to important observations and to key amendments.

This Bill will require careful scrutiny on Committee Stage. I wish to notify my intention to object to section 5(3) which reads: "The assigning of an individual health identifier shall not be regarded in any way as indicating, in and of itself, an entitlement to, or eligibility for, the provision of a health service to the individual." I can understand some of the arguments for the inclusion of such a provision in the Bill. However, the reality is that while this provision states that the individual health identifier shall not be regarded as indicating entitlement to health services, there is a consequential lack of clarity in the overall body of health legislation about exactly what health services people are entitled to. We just do not know. The allocation of an identifier number for each of us does not of itself underscore entitlement, according to this section of the Bill. I think it is offensive for that very reason.

The Minister will recall that in the previous Dáil - I think it even went further back than that - the eligibility for health and personal social services Bill was repeatedly promised year after year, but it never appeared. The current Minister and I probably competed at various stages to pose the question to a former Taoiseach and the Minister for Health of the day on the progress of that Bill. We all know what happened to that Bill. It was allowed to fall off the promised legislative list, yet its importance was clear in its stated intent. The Bill was supposed to clarify and update current provisions relating to eligibility for health and personal social services. That was and is a very important Bill. That affirmation of our right and entitlement to specified health services and personal social services should have been progressed in legislation. I again ask the Minister of State to re-examine all that and inform himself as to why it was allowed to fall off the table, so to speak.

This brings me back to my opening points on the Government's health programme now being in a shambles. One would expect that legislation along the lines of the Bill that never saw the light of day might form part of the Government's reform programme. It does not. I contend that it should and I ask that the Minister of State enlighten us on the conclusion of Second Stage. In the absence of explicit legislation setting out what people are entitled to, we are all in limbo with great uncertainty. I hope he accepts the arguments I have made for why I will oppose section 5(3) of the Bill when we get the opportunity on Committee Stage and Report Stage, if it still survives at that point. I urge the deletion of section 5(3), but I record my support for the passage of the Bill.

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