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One small change: A hospital systems manager on how to make Ireland’s health system better

Gina Naughton: HSE cyberattack identified the absence of this fundamental cornerstone in our health service

As our health system begins to return to normal activity levels following the Covid-19 pandemic, we would like to hear from doctors, nurses, paramedics, medical secretaries, hospital porters, canteen staff and others about one change they would like to see in our health system.

It can be something simple that annoys you, day in, day out, that is easily fixed, or it can be a small change in practice or attitude that would make life easier for everyone.

If you are interested in sharing your idea, you can email (put "One Small Change" in the subject line), or fill in the online box below. Thank you.

Gina Naughton

(Systems manager, Galway University Hospital)


“My suggestion for one small change is to roll out the national unique health identifer [Health ID number] for every citizen in the country. This number would be used across all health services, both public and private. The patient should be encouraged to memorise or carry this on their person at all times for verification at point of entry to services. Each citizen should be issued with a card and a QR code with their personal number and again encouraged to present it at all doctor and hospital visits.

“The HSE cyberattack identified the absence of this fundamental cornerstone in the foundations of our health service. We were left without access to patient records, and a unique ID known to the patient would have made it so much easier and safer to retrieve and match up records during the attack and in the aftermath.

“I understand the preparation work on the Health ID has been done and the majority of citizens now actually have a Health ID assigned, but there have been delays in rolling this out. It is beyond time.

“You cannot open a bank account, lodge money in a bank or withdraw money or gain entry to some places without showing official photographic identification, yet you can walk into any public hospital emergency department, give a name and address and a new medical record can be created for you. There is no mandatory requirement to show proof of identification. Referrals from GPs to acute hospital outpatients, radiology and laboratories without a unique patient identifier listed is another example of entry point to health services where duplicate patient records can be created in error, often due to absence of information. The clinical risks associated with duplication and indeed multiplication of patient records are many, yet unmeasured. This issue is widespread in all Irish public hospitals.

“It is a small change that would make a huge difference ensuring that all relevant historic and current clinical data is available to a clinician at the point of care.”