Terence Flanagan (Dublin North East, Independent) | Oireachtas source

I welcome the opportunity to contribute to this debate. This Bill will improve the experience by patients of the health care system by introducing a unique identifier for every person in Ireland. The measures contained in the Bill will help to ensure quality and safety of care and correct patient identification. These provisions will reduce administration costs and, in the long term, prevent instances of unnecessary care, thereby avoiding the types of medical cock-ups that have resulted in legal cases being taken against the State in respect of patient misidentification and errors in regard to records.

The Bill proposes the introduction of two types of identifiers, namely, individual health identifiers for every patient and health service provider identifiers for the health professions and organisations. The Health Information and Quality Authority has highlighted the necessity of introducing a unique health identifier for patients and drawn attention to the very low proportion of health care funding that is spent on IT services relative to other European countries. Identifiers will not contain any personal or clinical data at the initial stage. Their introduction will ultimately lead to a more pleasant experience for patients, who will not have to give their details more than once, on their first admission to hospital.

The current system of storing patient records is antiquated and disjointed. Some documentation is stored in electronic format but the vast majority is held in files in various locations.

Obviously, this can result in files being mislaid. It can present difficulties for health care professionals who need the complete picture with all the relevant information if they are to make informed decisions and judgments. We often hear about health professionals who are not able to see the complete global history of a patient, but are instead confined to what are called "islands of information". The introduction of health identifiers is a step forward in that regard as it will make it easier for the movement of patients within the health system to be traced. The health providers register will be open to everyone to access. That will not be the case with individual records, obviously, but the issue of data protection arises nevertheless. People have relevant concerns about who will have access to the individual patient identifiers, as distinct from the health providers register.

Responsibility for this work has been allocated to the primary care reimbursement service. Does it have the resources and the capability to carry out the duties it is being given? Like other Deputies, I have had difficulties dealing with the medical cards office in Finglas. It has lost information, for example. One of my constituents had to send in the same information in support of a medical card application on three occasions. It was only when the office was challenged - a receipt was submitted to prove that the information had been sent by registered post - that the primary care reimbursement service accepted that it had received the application. That undermines the work of the service and underlines why there is genuine concern about the quality of its computer systems. Why does the service not scan these documents when they are received to safeguard the sensitive information contained in medical letters and payslips, etc.? I am concerned that the primary care reimbursement service does not act in a clever manner that ensures information is retained and stored safely. Can the Minister of State outline in his response what role the service will have in the implementation and roll-out of this system? Will training be provided to the staff of the service to ensure people's files and records are retained correctly?

No detailed costing or funding information regarding the implementation of the various systems is being given. Perhaps the Minister of State can give Deputies some information about how much it is estimated that this will cost to implement. Is it planned to upgrade the various information technology systems in the health service in due course to ensure the new system can be accessed in a timely fashion? Genuine issues have been raised regarding the decision to introduce a completely new identifier system when the PPS number system is already in operation. I understand the PPS system has been discounted on the basis that the necessary capability does not exist within it. Why is that the case? Are we incurring unnecessary additional costs in this instance? As I mentioned earlier, there are genuine data protection concerns about who will be able to access the individual health identifiers. Ultimately, this is a good system. An electronic health care system is the Government's end goal in this regard. I welcome the Bill and the Minister of State's initiative in this regard.

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