Thomas Pringle (Donegal, Independent) | Oireachtas source

Overall, I welcome this Bill and the intention to introduce digital health records to our healthcare service. There is no doubt that we lag miles behind other EU and OECD countries with respect to digital healthcare. Ireland is currently ranked lowest of all OECD countries in digital health readiness and is one of just four member states that does not provide its citizens with access to electronic health records through a centralised access service. People should have access to their medical records. The creation of a digital health record will help to ensure that they have access to important information that relates to them.

We can all agree that the healthcare system in this country is broken and in desperate need of serious upgrade and overhaul. Nearly a year ago, 78 GPs from Donegal wrote a letter to Minister for Health, Deputy Donnelly, stating that they also believe the system is broken and that they no longer have "faith that the current system can be fixed and appropriately managed without outside intervention, support and resources". They highlighted their concerns regarding timely access to care for their patients in Letterkenny University Hospital and I have no doubt that improvements in our digital health and an introduction of a digital health record will improve access to care given that it has the potential to provide accurate, up-to-date information about patients and would significantly reduce the administrative burden on hospitals and other healthcare providers.

It has been reported that fewer than two in five people in Ireland are satisfied with the public health system and it is not hard to see why. I have a few issues with this legislation, however - and very serious ones - so I hope that the Minister takes these into consideration when progressing it.

First, it is hard to see how we would have the resources and infrastructure to actually deliver on this legislation once it is enacted. I am sure it is going to require significant funding to deliver digital health in Ireland and if that is the case then it is vital that we make sure that public money is spent wisely. Unfortunately, this Government has a very poor track record of spending wisely or sensibly. The €2.2 billion for the children’s hospital comes to mind, as well as the €336,000 for the bike shed and the €1.4 million for the copper-roofed security hut at the Merrion Square entrance at the back of Leinster House, details relating to which were just revealed at today’s meeting of the finance committee. I am also reminded of the time and money we wasted on trying to introduce electronic voting 20 years ago. Some €54 million was spent on faulty electronic voting machines, only for them to be scrapped almost as quickly as they were introduced.

Put simply, I do not trust this Government’s ability to handle the level of investment that digitising the health service would require and I do not doubt that it would take this opportunity to once again look after friends and private contractors at a ridiculous price. I am certain the public feels the same way.

This legislation is designed to bring us into line with our obligations under the European health data space regulation, which was due to enter into force this autumn. That is interesting in and of itself because with most European regulations, it is about nine or ten years after they have been introduced that we actually look at implementing them. What is the big rush to ensure that this is implemented now? I question whether we have the infrastructure and systems in place to ensure that what is envisioned will be put in place in such a short timeframe.

In regard to the European health data space regulation, I echo the concerns of the Irish Council for Civil Liberties. The regulation in question creates the possibility to use health data for secondary purposes beyond providing health services to individuals. This opens up the opportunity to use health data in the public interest, such as development of public policy but also perhaps for sale to private interest or, as the Government of Ireland works, to give the private interest the information for free. However, the wording in this regard is not precise and allows for a broad range of uses that risk fundamental rights. The Minister needs to ensure that this is adequately addressed before this legislation is allowed to progress. I urge him to engage fully on Committee Stage and ensure that the relevant organisations are given the opportunity to contribute.

The Minister must also ensure both compliance with data protection regulations and that our citizens’ health data is as protected and secure as possible. This means ensuring that apps are not required for people to access their digital health records either. Apps are not a safe or secure way for people to access such private and sensitive information and I would oppose this suggestion completely.

I also have concerns regarding reciprocal arrangements with other jurisdictions. I understand the need to share information to healthcare providers in the North, for example. I have many constituents in Donegal who would benefit greatly from their medical records being accessible to healthcare providers in the North, given that we are a Border county. However, we must be strict on our terms and the purposes for which this information could be used should be extremely limited.

Obviously, the 2021 HSE cyberattack is still a matter of concern. I do not wish to scaremonger in any way. Ireland is leading in terms of cybersecurity practice, but we know health is a prime target for cybercriminals. Cyberattacks are not only extremely costly, they can also make our citizens feel violated and vulnerable.

This is something that needs to be fleshed out and to receive serious consideration going forward.

Lastly, I wonder if we have sufficient Internet connectivity for a national digital health system. The truth is that we do not in Donegal. I have raised this many times, but there are large parts of Donegal that are still without fibre broadband. It is one of the many ways that we remain the forgotten county. The sad reality is that Donegal will continue to be a laggard if significant investment into communications infrastructure and healthcare are not prioritised.

I suggest again that there need to be strong protections in this legislation. I can see that the information that is gathered through this legislation will be wide open to abuse. Unfortunately, history has shown that this will happen. We need to be careful to make sure that does not happen and protections need to be in place.

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