James Reilly (Dublin North, Fine Gael) | Oireachtas source

I thank the Senators for their contributions. The issue of resources was raised, along with the ongoing exercise to estimate costs. My Department has asked the HSE to establish a project team to continue the work of developing high level estimates. Engagement with the market will be needed to determine the final cost but there is no question of another personnel, payroll and related system, PPARS, fiasco. I can guarantee that. The ICT strategy being prepared by the HSE is nearly complete and it will complement the e-health strategy I published last month. Senator Gilroy is quite right in that now there is almost an allergic response to information technology in health services because of the PPARS debacle. We must grasp the nettle and we are doing so. We must act in a way that will minimise the number of systems we must use, as there are approximately 1,700 different IT systems in the health services. They are not necessarily related to finances but they must all be able to interact.

There were some comments about the myriad of people dealing with finance in the HSE who do not have financial experience. That has been corrected through the new chief financial officer and his financial reform board. We have a much greater grip on finances than we ever had before and it is clear to people that, having taken almost €4 billion out of a €16 billion budget over the past number of years, there is no financial black hole in the health sector any more.

Senator Burke raised the issue of the Swedish health system, and the e-health strategy has had regard to the best practices in both Sweden, Denmark and other countries. Senator Crown spoke of cultural change, which is necessary, and this Bill and the e-health strategy is a step in the direction we want to go in order to kick-start that change. Senator Gilroy also raised the matter of security and access to the individual health identifier, IHI, register. It will be an offence to inappropriately access the IHI register, and it is intended that the implementation process will record who has accessed the system. We will be able to track those who access the system in that way. Senator Crown asked what would be available in the IHI. The identifier is used to identify a person, and access to medical records, etc., is another matter entirely, which would be based on clinical need and the level of clinician involved. The identifier will help significantly in that process.

I thank Senators for their input.

We all share the view that the introduction of a unique system of identification for patients and providers would be a very positive and welcome development. It has taken an inordinate length of time. While its principle purpose relates to patient care and safety - that must be our absolute priority - an identifier system could bring a range of benefits across the health system in areas such as better and more reliable data quality, system efficiency in information collection and management, supporting desirable initiatives such as the money follows the patient model, and facilitating the whole e-health agenda. In short, a unique health identifier is regarded internationally as essential to underpin a modern, integrated health system, and in framing the Bill we have had regard to international experience and best practice, as well as input from HIQA and others who have contributed much to the Bill.

It is critically important that as we reform, we learn. Underpinning our approach to the health service has been the aim of making it patient-centred and improving outcomes for patients while learning from the reforms we have introduced - reform, learn and reform again. In planning the health service, in observing how reform is operating and evaluating what we are doing, we need a unique health care identifier for patients to have much more accurate information. In a broader sense, we also need much better IT systems. We are looking at that as well.

The Bill provides the appropriate enabling framework to implement a unique identifier system in a structured and planned way that will best suit the needs of the health system as we meet challenges in the future. I look forward to debating the issue further with Senators on Committee Stage. I am open to suggestions Senators might have to improve the Bill. I again thank Senators for their contribution.