David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I am sharing time with my colleagues. Sinn Féin will support the Bill. This legislation provides, in the main, for digital health records. Digital transformation is essential to improve patient safety, bring the health service into the 21st century, improve productivity, efficiency and value for money, and to properly hold the system to account. Accessible patient records are at the core of enabling better healthcare. Late in the day, at the end of the Dáil term, the Government has arrived with legislation that was needed ten years ago. It is amazing that still in 2024 we operate a largely pen and paper-based health service with poor connectivity between hospitals, GPs and community services. Data systems and physical hardware are outdated and behind the curve. Members see that when we table parliamentary questions and often the response is the HSE does not capture or hold the data or the systems do not speak to each other. The Government is only reaching the starting gate. Bizarrely, the HSE was at the starting gate in 2015 when it launched the ehealth strategy for Ireland but it was never funded, as the Minister knows, or implemented. The Department of Health is now on its second digital health strategy but has little to show for the first.

A business case for electronic health records was submitted in 2016 but the Government did not sanction funding for it. Part of the rationale for delaying full investment in electronic health records was to see how it worked in the new children's hospital. One might agree how daft that was given all of the delays with the children's hospital. There has been a five-year delay in the project. The hospital is not built and we do not know how the electronic system in the hospital will work. The Government still has no timeline for delivering a full, comprehensive electronic health record system.

While I acknowledge that what the Minister proposes is important, it is a much watered-down version of basic shared care records which we are told will be built up into a full EHR system in the future. We are far from where we need to be and two decades behind our European peers. Without proper digital systems, we cannot collect proper data, hold services to account or even ensure value for money in the healthcare system. That includes an integrated financial management system and other technology reforms outside the scope of this Bill which have not been delivered on time either. Without these systems, patient databases or disease registries cannot be created to ensure services operate optimally. The real work is only starting now at the end of the Minister's term in office, 13 years after Fine Gael came into office, and we are at the starting gate of transforming the health services digitally. The Minister for Health has two important questions to answer following this Bill. What is the plan to fund and deliver it? How will he connect, integrate and support community providers like GPs?

My party will deliver an unprecedented investment in digital transformation. I will launch our five-year plan on health in a few weeks. This will be a key component of that plan because we must bring the health service into the 21st century and be brave enough to make the decision to invest in this area. I spoke at a number of conferences which were also addressed by the Secretary General and other officials from the Department of Health. There was a sense that the PPARS controversy is somewhat responsible for reluctance in the Department of public expenditure and reform and, at times, even in the Department of Health to move on some of these issues. We must put that behind us, however. We must invest, provide the funding and make sure we have the ability to deliver the necessary systems. It is not just a paper and pen healthcare system; we do not have interoperability even in healthcare systems. Some hospitals, such as voluntary hospitals compared with HSE hospitals, for example, operate different systems. No all of the information is captured. I am one of those who for many years complained about waiting lists for children with disabilities. I was made aware about 15 months ago that there was a problem with the system whereby the software was out of date and the company that had provided it in the first place had gone out of business so a whole new system had to be created. In the meantime, basic information was not being captured. It was not known how many people were on the list, which is part of the problem.

We know data is rich in a healthcare system. If data is presented to healthcare professionals and clinicians, it almost removes any argument in respect of different opinions because data underpins everything. If it is not being collected, shared or stored, however, that is a real problem. It is also the case that if staff in many hospitals are still using pen and paper, with all of the difficulties and challenges that represents, and the madness of it in the 21st century, that is not the best way to deliver the best healthcare. It does not make sense that GPs, community services and hospitals cannot join up and integrate patients' care, access their records or see and get a full capture of their healthcare needs. Clinicians have told me this is important because if they have access to that information, they are in a much better position to pass judgment and see in the round what might be wrong with a patient. Some things can be missed and they have to wait for information to come from elsewhere. It will be transformative when we have full electronic health records. That is an important part of the journey to where we need to go in terms of digital transformation but it is not the only part.

Primary and community care, about which the Minister spoke, are also important. Like hospitals, we are light years behind other European countries when it comes to electronic systems in this space as well. There is a long way to go. Very little has been done over the past five years. The Minister said an app is ready to go live. I do not know if that will be next week or next month; we still do not know what that app will do exactly. I was briefed by an official from the Minister's Department and I accept that it looks to be of value. I await the app going live. It is all baby steps which are far too late, however, coming at the tail end of the Minister's term as Minister for Health. He has come forward today with a Bill, with respect, possibly weeks and certainly months before a general election, promising to do things in the future. He may not even be the Minister for Health after the general election. It is too little too late. Part of the blame rests with the Minister but a bigger part rests with the Government, which did not properly invest in the health service on the capital side to ensure there is funding to deliver. It also lies with the Department of public expenditure and reform, which simply does not get it when it comes to the need to invest in our health service in order that we can have a 21st-century service that provides safe, accessible and modern health services with the digital systems needed.

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