Seán Kyne (Galway West, Fine Gael) | Oireachtas source

I welcome the opportunity to contribute to the debate on the Health Identifiers Bill 2013. We all appreciate that in the past few decades, and with an increasing intensity, technology has revolutionised the way we live and work. Some sectors have been able to adapt and harness the opportunities much more readily than others, a prime example being the difference between new private sector companies and the older more established entities such as Departments. There is a need for some level of "bureaucracy", a word which has long since lost its intended meaning, namely, to confer a formal hierarchical organisation with many levels on which tasks, responsibilities and authority are delegated among individuals, offices and Departments.

The word has evolved. It now has a negative connotation and is used to indicate red tape and excessive routine. Any system, however, requires planning, organising, transparency and clearly developed procedures to ensure the proper delivery of services. In many instances this has occurred in a way which has not put technology to best use and has, therefore, resulted in higher levels of spending on processes and systems at a time when resources are stretched. For example, it is only recently that contacting the Department of Social Protection by e-mail has been possible. Similarly, it is less than five years since one has been able to apply for social welfare schemes online and even then the service is restricted to a small number of schemes. Other examples include the relative infancy of the public services card and the integrated travel card or leap card.

All in all, it seems to take an inordinate amount of time with significant resources to utilise technology in the provision of services in our country. From a different perspective the Health Identifiers Bill is significant in respect of the absolute necessity for every patient in the health system to have a unique identification. The Minister for Health, Deputy Reilly, has emphasised that first and foremost individual health identifiers are about patient safety and ensuring that the right information is associated with the right individual at the point of care. This should be of paramount importance in any system but especially given the reforms under way in the health service. One such reform is the establishment of the new hospital groups, a measure trialled successfully in my area of the west with the Galway Roscommon hospital group. The use of technology, underpinned by health identifiers, will be essential in hospital groups since each hospital will carry out different treatments and procedures. For example, a patient might undergo tests and scans in a hospital in Roscommon but undergo surgery in University Hospital Galway. It is not difficult to appreciate the benefits of having an information technology system in which the health professionals can input a unique identifier and access all the relevant information about a patient, including medical history, allergy information, special care requests and so forth.

Such capability is essential for another key component of the Government's reform strategy, that is, the implementation of the money-follows-the-patient system. Under this system, we will move away from the block grant system which provides a substantial level of public money to a hospital with little in the way of performance indicators or monitoring. Under the new system, once the need for treatment is established hospitals will be funded only for those patients who they treat. This will act as an incentive, patients will receive treatment more speedily and, as long as appropriate safeguards are in place, more readily and more efficiently with regard to standards of care. Within such a system a unique identifier will be critical. The Minister put it best when outlining the case for the health identifier. He suggested it was about better patient safety and care, he noted that the case has been established internationally and he pointed out that it would ensure the right information would be associated with the right person.

As far back as 2008 the report of the Commission on Patient Safety and Quality Assurance recommended this measure, as has the Health Information and Quality Authority, which has advocated that identifiers should be used and provided for health care providers as well as individuals accessing the health care system. This is of great importance. One of the most surprising things is that this measure has not been introduced heretofore or that it is not already part of the system, especially since everyone has a PPS number. It could have been introduced far earlier. Perhaps there is the case for the PPS number to be used as it is, rather than embarking on the initial cost of a new health identifier card. I presume there may be reasons why that is not possible.

I imagine there will be a register which the Minister or the Department of Health will be responsible for maintaining and that it will include all the usual information, including name, address, PPS number, date of birth and so forth as well as a health identifier number. This is most important. The Data Protection Commissioner has been consulted and I emphasise that the lists of identifying information cannot include an individual's clinical information. All in all, this is positive. It will help with patient safety, it will improve the ease of identity of patients and it will ensure that no mistakes are made in terms of their care, which is of paramount importance.

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