Alex White (Dublin South, Labour) | Oireachtas source

I thank Deputies for their contributions to the debate on the Health Identifiers Bill and welcome their support for what is proposed.

This Government is committed to a very ambitious programme of reform, at the heart of which is the care and safety of the patient. The focus of this debate is the Health Identifiers Bill which, as the Minister set out in his statement, is an initiative that has the potential to support health reform goals and bring a range of benefits across the health system in a number of areas. The principal benefit of the identifier system will be in individual patient care and safety and ensuring the right information is associated with the right individual at the point of care.

I propose to address briefly some general and specific points made by Deputies in their contributions. Speakers raised the matter of the Bill and patient information. Deputy Kelleher read into the record an e-mail he received from persons with concerns regarding the disclosure of personal health data for research and other purposes and recording their apprehension or fear about access to centralised medical records. It is important to clarify that while the Bill introduces a framework for using the individual health identifier or IHI, it does not change the existing law on the collection, use, sharing or disclosure of personal health data or the creation of medical records databases.

I am aware there is some controversy in England about the establishment of a national medical records database by the National Health Service, the uses to which the data involved can be put and the persons to whom the data can be disclosed. This Bill is not about such databases. The only national registers created under the Bill are the registers to hold the individual health identifiers and provider identifiers and the appropriate related identifying particulars, such as name, address and date of birth. The Bill specifically provides that the identifying particulars relating to an individual's health identifier cannot contain clinical data relating to the individual.

The law on the sharing of personal health data continues to be governed by the Data Protection Acts. The Health Identifiers Bill, which has been discussed with the Office of the Data Protection Commission, is designed to ensure the individual health identifier is associated with an individual's medical records and related medical correspondence. This will help ensure the individual can be uniquely and quickly identified during each engagement with the health system. Furthermore, the persons who can access the IHI register and the purposes for which they can access it and use the IHI and the identifying particulars in the register are set out fully in the Bill, as are the persons to whom they can disclose such information.

Deputies mentioned access by individuals to their medical records. The Data Protection Acts and freedom of information legislation provide a statutory framework for an individual to seek access to his or her personal health data. The requirement under the Bill to associate the individual health identifier with a patient's medical record and related correspondence should facilitate such access, as it will ensure that records associated with the individual can be identified more readily and made available to the individual concerned where he or she seeks them.

As I stated, the Bill was discussed with the Office of the Data Protection Commissioner. This reflects our concern to address privacy considerations fully in the governance structure. In that regard, it is important to make clear that the Bill gives an express role to the commissioner in a number of areas, for example, where the Minister proposes to add to the number of specified persons or the identifying particulars for the individual health identifier. This is in addition to the Data Protection Commissioner's general role, under the Data Protection Acts, in regulating the processing of personal data.

I note Deputy Ó Caoláin's views on section 5(3). This subsection is included in the Bill to make clear that the assigning of an individual health identifier to an individual shall not be regarded in any way as indicating in itself an entitlement to, or eligibility for, the provision of a health service to the individual. As stated by the Minister in his opening speech, the main purpose of the Health Identifiers Bill 2013 is to put in place a legislative framework for individual health identifiers. Eligibility for health services is a separate issue. While it has been canvassed by Deputy Ó Caoláin as issue for this legislation, it is provided for in other legislation. In so far as there is necessity for a debate in that regard, that ought to happen in the context of that other legislation or new legislation that a Deputy might wish to propose for introduction to the House.

I agree with Deputy Kelleher's remarks in the earlier part of this debate in regard to the potential of e-medicine and e-health for Ireland. The scope of the potential of e-health includes improving the health and quality of life of our population and better quality health services at lower cost. It also extends beyond the health sector to improving the economic health of the nation through its potential for job creation.

The Minister published the e-health strategy for Ireland last December. It identifies a series of high level actions to achieve these objectives. It will bring all stakeholders together, including Government, industry, health care providers and academia, under the umbrella of e-Health Ireland, which will be established initially in the HSE to move Ireland towards the vanguard of e-enabled health care. Health identifiers will be another enabler of e-health. I am sure Deputies will agree that the assurances the new identifier system will bring to theidentification of patients will be of considerable importance in enhancing patient safety in the excellent potential real world examples of e-health applications, as described by Deputy Kelleher in his contribution to the debate on the Bill.

Health care in Ireland is changing radically and future health care systems will need to be radically different to respond efficiently and effectively to forecasted demand. A unique identifier system is an essential element underpinning the changes that are being, and will continue to be, introduced to address those challenges and to ensure the patient stays where he or she belongs, which is at the centre of the health system. The Bill before the House is about making that happen.

See this speech in context