Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

We welcome this Bill, which is very long overdue and the purpose of which is to provide, among other things, a legal basis for the development and deployment of digital health records. The Minister admitted that we have lagged significantly behind the rest of Europe on this. The reality is that our people have not been getting the best care they could due to the paper-based nature of our health records.

We live in a world where technology is rapidly transforming our day-to-day lives, yet in our healthcare system, digital innovation has continued to elude us. What this Bill can provide is the legal basis for a more efficient, safe and patient-centred healthcare system. One of the most important things the digital health record will provide is better continuity of care, particularly for people suffering with long-term illnesses. I have just assisted a constituent through a process of complaint that was based on a misreading of a very large paper-based record in an acute hospital. Luckily, the issue did not have serious impacts on illness or worse, but it could have done. It is minor, but this genuine complaint took up a large amount of administration. These are the kinds of things that could be avoided. This can and should be genuinely transformative for our health system if we deliver a proper electronic health system. It could genuinely save lives. This will not just improve administration, but it will have very tangible health benefits for individuals.

Digital health records will be vital to drive efficiency across our health service. With waiting lists, as long as they are anything that can be provided to our medical staff to make their jobs easier and quicker needs to be prioritised. This is why we welcome this Bill but we are so disappointed that it is long overdue. We know from examples across Europe that digital health records do exactly that. We need to see this Government and that which will succeed it deliver on the digital health records. There is an opportunity here for our healthcare staff to feel like they are being listened to by Government, which is something they feel has been sorely missing for a number of years.

The upside of digital health records being introduced to the Irish context cannot be understated. This can be a real game-changer for our health service. We cannot afford to stay in the last century vis-à-vis medical records. Ask anyone who works in our health service about the sheer amount of paperwork that they have to complete. This is literal paperwork, and it is overwhelming. It is a complete drain on limited resources and specialist resources in our health service who should be at a bedside or patient facing as much as possible, with a minimum amount of time being spent at the desk.

The reality is that the introduction of digital health records is not just important for patients, it is equally important for staff members and for improving the work balance of healthcare workers. We know we have a problem with retention in our health service and much of that is down to the pressure that our workers feel on a daily basis. One of the key integral pressures that we hear back about from speaking to workers and their representatives is the amount of non-patient-facing related work they have to do. Year after year, the jobs of our healthcare staff get harder, instead of being made easier and more efficient. There is a responsibility on all of us in this Chamber to do everything we can to help them and to ensure that once this enabling legislation is passed, that what is envisaged in it is delivered.

In my position as health spokesperson for the Labour Party, I have made it abundantly clear that I and we feel that the Government has thrown in the towel when it comes to fixing the health system. The fraudulent budget of 2024 and the subsequent ongoing recruitment embargo - which still exists even though the Government said it had been lifted - are still wreaking untold damage on the staff and health services across the country. While the Bill, as enabling legislation, is welcome, it must be stated that we are still a long way away from having the real efficiencies and health benefits being delivered to our patients, which is what digital health records can do.

Constant delays are, unfortunately, a theme of this Government in relation to the health service and the delivery of big projects. We, of course, are continuing to deal this week, again, with the omnishambles that has been the children's hospital. Yet, in 2016, a ten-year business plan for the implementation of a national EHR system estimated that it would amount to up to €875 million. That was in 2016. Nearly a decade has passed. Nothing is the same price as it was eight years ago. We do not know what the costs of a digital health system will be, but we have to it bring in and we have to ensure that it does not become another runaway train of health spending. It needs to be delivered. It needs to be delivered professionally. It needs to be delivered responsibly. It needs to be delivered in a way that has real financial accountability.

In 2021, HIQA highlighted what it said were the major deficiencies in the current information system with data on patient health usually being managed on different electronic systems or on paper-based systems. This affects people's health and safety within our health service. I have seen the real-term effects of how far behind we are. Another young man was in my advice clinic last year. Unbeknownst to him, the reason he was not getting the care he needed was due to a missing paper file. This was a serious health issue at the time, which, luckily, we were able to catch. However, he was not receiving the care because of a missing file. It is embarrassing in this or any day and age for any health service.

Serious questions need to be and should be asked about how the implementation of DHR has been delayed thus far. In January 2023, the HSE’s then head of digital transformation, Professor Martin Curley, resigned from the post. He stated that his efforts to introduce new technology solutions were repeatedly blocked by senior administrators. I need to ask the Minister, and I hope he will address this when replying, if is this still a concern for him. Are these blockages still going to be in place? January 2023 is not that long ago. It is unacceptable that there should be any blockages by any senior officials within the HSE in the context of this much-needed transformation.

As it stands, our healthcare system is disjointed and fragmented. We have spoken about this before. There are major issues with siloed care that have impacts throughout our health service. It equals poor care. A modern healthcare system needs to be agile, and information needs to be shared and must flow freely between our healthcare providers, whether those are GPS, doctors, nurses, consultants or specialists.

We have situations where public patients are referred to private hospitals for MRI scans, etc. Will this system ensure that those records are going to be shared between a private hospital and a public hospital? These are the questions that we need to see being answered. We need to be confident that they are going to be delivered.

A duty to share places a statutory duty on health service providers to share personal health data with other health service providers for the purpose of patient care and treatment. What is envisaged in this regard is comprehensive in that it spans public and private use and voluntary settings. It is vital for the continuity of care and for the integrated health system that is envisaged in Sláintecare.

Leaving aside any surplus we already have, we know that in the context of budget 2025, €14 billion is in play following the conclusion of the Apple tax case. We need to see the large majority of this money being invested in housing and infrastructure. Yet, if money is going to be allocated to the area of health - and there are many areas of health which do need direct funding and assistance - and if digital health records are going to be delivered and are going to be delivered as quickly as possible, then this important project could benefit from extra funding at this point to ensure that it gets off to the best possible start and that it is implemented as early and as professionally as possible.

There is no doubt that digital health records are a key missing pillar of our health service. They will, if delivered, help our front-line healthcare professionals provide better healthcare and be patient-facing more often. We need to prioritise it, and I am glad that this enabling Bill has finally come to the floor of the Dáil. I hope to see it passed soon, but the real proof of the pudding would be its implementation and delivery of the electronic health records.

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