Urgent development of systems dealing with patient information is needed, according to the secretary-general of the Department of Health, Mr Jerry O'Dwyer. He was addressing the annual conference of the Irish Medical Organisation.
Mr O'Dwyer said many of the existing information systems were underdeveloped, and those which were developed were not sufficiently integrated. This was an area which required well planned, sustained but urgent development, particularly in relation to the tracking of the individual patient.
He said the Department of Health's agenda for information development, analysis and communication was a daunting one, but its implementation was essential in achieving integrated care. This year, as in 1998, £14 million would be invested in the development of information systems for health agencies. "Despite it being double that of the annual rate of investment a few years ago, it is still not enough."
There had been worthwhile investment in the Cancer Registry and attempts to develop a cardiac register, he said. An information system giving minimum common data of public health was in place, as well as a database on hospital activity.
Addressing the problems facing the healthcare system, Mr O'Dwyer said that in the absence of patient registration the flow of patient information within and between parts of the health system was inadequate and sometimes haphazard. "The essential stimulus to develop integrated information is lacking. Without such integration, outcomes cannot be measured reliably."
Mr O'Dwyer was speaking at the conference's first scientific session, "Cash v Care - Time for an Integrated Approach in Health Service Planning". The session examined the current situation in which health-service planning and budgets operate.
Speaking about health outcomes in Ireland, he said the extent of loss of life among the young had been declining, with premature death having fallen overall by 2 per cent a year between 1960 and 1992 for men and 2.7 per cent for women.
"The health disadvantage in Ireland, compared with other developed countries, is very much concentrated on the elderly. Life expectation for those aged over 65 is the lowest in Europe," he said. Mr O'Dwyer said that in the promotion of healthy lifestyles, aimed at reducing cancer, cardiovascular diseases and accidents, the processes for interdepartmental and inter-agency working together to achieve strategic results was not sufficiently developed to meet the requirements of the Department and the health boards.
The primary healthcare team, he said, was not integrated for treating patients. "If the general practitioner is to be the hub of coordination most are not organised or equipped to fill this role."
Mr O'Dwyer said the emotional attachment to "defending territory" seen as "owned" by a health board, hospital or agency sometimes got in the way of organising services to the best possible patient care.
Quality was no longer an optional extra for any service organisation, he said, and in the health service the patient expected and was entitled to a caring as well as an effective service. "Perhaps if we viewed our service through the eyes of a top hotel manager we would not only get some nasty surprises but a lot of ideas on how the product may be improved without spending a fortune."