Denis Naughten (Roscommon-South Leitrim, Independent) | Oireachtas source

I welcome the opportunity to speak on this legislation. I will not confine my remarks to the issue of health identifiers. The Department of Health's electronic health initiative offers massive potential to bring services closer to the patient's home and to ramp up community services far more significantly than has been the case in the past. The introduction of this legislation is necessary if that is to happen.

When this Bill was initially published, I was concerned about the approach being taken with regard to PPS numbers. Having gone through the explanation in the briefing, I understand the justification for it. An argument has been made in favour of proceeding on the basis of a unique identifier. Nevertheless, I suggest that the facility could exist for this unique identifier to become the PPS number of the future at some stage. Up to now, we were looking at piggy-backing on the social welfare system. Perhaps the social welfare system should look to piggy-back on this particular identifier.

It is all well and good for people like me or the Minister of State - or even someone as senior as Deputy Mathews - to have to remember a PPS number, PINs for credit and debit cards, online banking numbers, the new IBAN numbers that will kick in at the end of this month, the new postcodes that will be introduced in the next 12 months and medical card numbers. Will one's medical card number be amalgamated into this new system, or will one still have a separate medical card number at the end of this process? Having to remember a series of numbers can cause significant problems for older people who might not be technologically literate.

I would like to refer to one of the issues I have with this unique identifier. It seems that no personal data associated with this number will be held. My understanding is that personal information, such as one's forename and surname, one's date and place of birth, one's sex and one's parents' names, will be associated with this number. Can the Minister of State clarify whether this is the case?

That information can be used to access bank accounts and so forth. However, older people arriving at a casualty department may not know their hospital number but will know their date of birth. If the two are not connected together, it will also cause problems. How do we deal with that double-edged problem?

Now that we are connecting medicine with technology in practical terms for the first time, I hope the Minister of State will be able to work with the Minister for Transport, Tourism and Sport, Deputy Varadkar, and allow for medical data to be held on a driving licence. The only data that can be held on a driving licence is to indicate whether the driver is an organ donor. The technology exists and a chip will be introduced on the credit card-type driving licences pretty soon.

That should contain basic information such as my blood group, my next of kin and if I have any allergies, so that if I am involved in a traffic accident the paramedic with a specific reader can read those data from the credit card-type driving licence and treat me at the scene rather than having to rush me into a casualty department, give me O negative blood because they do not know what my blood group is and gamble regarding the medicines they give me in case I have a particular allergy. That kind of basic connectivity should take place because it will save lives and assist paramedics at the scene of an accident.

There is potential to save significant amounts of money in the health budget by introducing this. HIQA has estimated that 30% of the health budget is being spent on handling data. Even the cost of storing those data must be significant, never mind the associated administrative costs. Streamlining this will make a big difference. However, while we have the legislation, we do not know how much it will cost. A significant amount of the investment will take place this year, but how much investment will be required to ensure this happens?

Significant amounts of money are wasted on diagnostic tests. If I go to my GP with a pain, he will carry out a battery of tests. If I ring him back at the end of the week, he might tell me I have an elevated indicator in my blood and might refer me to the county hospital. When I go to the county hospital, I have another battery of tests, many similar to the ones the GP has already done. If it cannot get to the bottom of the issue, I might be referred on to a specialist in St. Vincent's University Hospital in Dublin. When I go to St. Vincent's University Hospital in Dublin, the same tests are carried out because there is no connectivity between the GP and the local hospitals, and between the local hospitals and the regional centres.

I would have become a pincushion as a result of those three separate sets of tests, which is a relatively minor issue. However, there are significant costs in carrying out those tests. A recent edition of the Irish Medical Journalhighlighted that most medical professionals are unaware of the high costs of these laboratory tests. I accept that the tests need to be carried out, but it is important that we do not carry out the same tests all over again.

I know the Minister of State has a particular problem at the moment - we met representatives of the IMO yesterday - regarding medical cards for children under six. I know there will be challenges in introducing it. I agree with the principle of it and I know the objective is to extend it to encompass the entire population. That will be a big challenge. As an interim measure, I ask the Minister of State to explore the possibility of giving every adult in the country a health check test similar to the NCT for cars. Every four years everybody should have a standard set of cost-effective tests. I am talking about urine analysis, blood analysis, and blood pressure and cholesterol checks. Those can act as an identifier, particularly for chronic diseases. As we all know if a chronic disease, particularly obesity, diabetes and so forth, is identified early, it can be more easily treated at that early stage and at a significant saving to the Exchequer.

At the moment diseases related to over-use of alcohol, smoking, bad diet and so forth are costing our health budget €7 billion per annum. By connecting all this up, we will be able to identify people in risk categories. We will also be able to ensure that when these chronic diseases are diagnosed, people can receive far more of the monitoring and supervision at home rather than continually having to travel to meet GPs or consultants. This can be a big issue for those living in rural areas, particularly in my constituency. For example, one third of pensioners in County Leitrim live on their own; it is just over 30% in County Roscommon; and just under 30% in County Galway. Some very useful technology has been introduced into Wales and England which uses the telephone line and the television screen to communicate directly with people and monitor their blood sugar levels, blood pressure, and deal with conditions such as COPD, at a greatly reduced cost than is the case at present.

I urge the Minister of State to take this technology and piggyback on the existing systems rather than introducing a completely new system. Our recent conference at the RDS was addressed by Mr. Andrew Murphy from Sláinte Healthcare. He is introducing this technology across the world and in some hospitals here. They are building on the existing IT infrastructure, rather than starting from scratch. We need to start with what we have, build on it and use it to create the best type of technology infrastructure we can.

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