Cathal Crowe (Clare, Fianna Fail) | Oireachtas source

A Cheann Comhairle, 80602 is a seven-year-old Hereford cow I have on my farm. Her entire health record is on the Agfood website from the moment she was born up to the current time, including every vaccination withdrawal period and her annual BVD test. Everything is there. I drive a Honda car. Every detail about my car, including every NCT report setting out the percentage performance of the brakes and the wear of tyres, is recorded electronically. Everything is there for my car and the herd of cattle I have at home. It is not the Minister's fault, but it is a crying shame that over many years, we have allowed impressive databases to be built up about the national fleet of vehicles and about cattle and other livestock; yet we have no database that is shareable and digital for patient records for the human species in our hospital systems.

This is good legislation. I am glad that in the programme for Government our party is leading this and trying to have, finally, a digital database of patient records that is transferable and useful when people get to the hospital environment. I am someone who lives in the mid-west and has been through the accident and emergency department there. There have been many debates about its shortcomings. One of the first things that people who arrive in the emergency department interface with is the triage room. They meet a nurse and a team and some basic questions are asked. Those basic questions are fine and essential but not all of them necessarily need to be asked. There are some details no one knows. For example, I do not know my blood type and many people do not. The answers to many questions should be and are available in a litany of paperwork, journals and files that are not collated and brought to a central point. We also have to factor in the patients who are not in a good state when they arrive into accident and emergency departments and are incapable of answering due to concussion, the inability to recall facts or the consumption of alcohol since the start of the evening. There are many reasons that people might not be able to be triaged effectively and passed on to colleagues in the accident and emergency department. To have a digital record for that patient would be invaluable.

At the moment the files are paper and they do not transfer within hospital groups. Any hospital stay I have ever had has been in the mid-west region. There is some semblance of records with some detail of when I was last in hospital, my appointments and so forth. However, if people were to move down from other parts of the country or if I were to move to Dublin, there would not be any exchange of records. That is a flaw to begin with. At a minimum, before we get to a digital base of records, we should at least have some way of transferring files. If a person's habitual address changes, all files relating to that person should be moved to a different health district. A team is leading the digital transformation in the Department of Health and the HSE at the moment. Some of that work should involve assessing whether patients have moved beyond a certain CHO area or health district and whether some of their paper files could be moved as well.

Today is my uncle's first anniversary. He passed away last year from cancer. His name was Tom Crowe and he sat above me here on the first day I sat in Dáil Éireann. He had a wonderful life. He died in his 80th year. Like many people, cancer caught him in the end. It was devastating to hear at some of the hospital visits I accompanied him to that his patient history and the fact that he had been checked out for other forms of cancer were not known. It was just said casually to him. As he was 79 and a casual laid-back person, he mentioned it once when he was being discharged from hospital. He said "Aren't I some man? I already went through this three years ago". Every jaw in the place dropped because nowhere in his patient file was that this man had been investigated for cancer in the past. That is wrong. That is fundamentally wrong. There are a lot of people like my uncle who do not reveal every scintilla of their health information when they go into hospital and for many, that vital information is found out when it is far too late.

I will turn to a point Deputy Shortall mentioned a moment ago: the need to have more resilient data protection and the whole online security base for this. I have no doubt that it will be well managed in the HSE mothership and the Department of Health. However, there are many outposts of the Department. I was a primary school teacher before becoming a TD. I was in a little classroom in Parteen which was an outpost of the larger Department of Education. We were a little spoke in a huge wheel. The desktop computer in the classroom ran on Windows XP, which is software that is probably 16 or 18 years old. Over the years, various teachers, including me, had downloaded software packages. The computer was probably riddled with viruses. On that computer, alongside worksheets and all the nice stuff teachers print out for children during the day, were sensitive records relating to children. That is typical of any classroom in the country. I am not so worried about HSE HQ, the Minister's offices or the mothership of the organisation. I am worried about its outposts because there are many old laptops and personal computers, PCs, that hold very sensitive information and are potentially prone to being hacked or data getting to places we do not want them to go to.

I hope this has changed. I have been to maternity hospitals a few times with my wife. I do not quite know what are the reams of paper records that keep printing out throughout the night. The midwife takes notes on an almost ten-minute basis about how labour is progressing. All those notes are handwritten. A computer churns out a template sheet. The midwife catches those sheets before they hit the ground, because they keep coming out and she or he fills out all the details with a biro. I saw that happen just five years ago. I hope to God it is not still the case. If we are digitising - of course we have to digitise records - surely such practices are from yesteryear and these highly skilled, highly trained and highly valued nurses and midwives should not be spending their entire working day trying to catch the record before it hits the floor to fill in patients' temperature, the time, how many contractions per minute and so on. That kind of detail should also be digitised. It is not only patient records; the diagnostic information also needs to be digitised.

This is good work. Mo cheol thú, a Aire. I hope this progresses and that we get to this point before 2030. The Minister is welcome to look at Herdwatch and all the apps that already work. The Ceann Comhairle has some knowledge of how animal records are quite adept in this country already.

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