HSE’s IT quagmire must be tackled

Responsibility lies with politicians, senior civil servants and vested interests

Sir, – The reaction of Government to what is merely the latest scandal in the Child and Adolescent Mental Health Services (Camhs) was predictable: to express shock and horror and haul in the recently appointed head of operations of the HSE, Damien McCallion, before a Dáil committee to question him. Minister for Health Stephen Donnelly promised a raft of ad hoc fixes, including more reviews, a new deputy director of mental health services, a new way of hiring consultants and lots of “discussions” with Minister of State for Mental Health Mary Butler. Tánaiste Michael Martin denounced the Camhs failings as “unacceptable”.

Hundreds of children were “lost” in Camhs, not only because of the undoubted shortage of psychiatrist or social workers, but primarily because they were relying on hand-written, chaotic paper records, which don’t provide automatic prompts and reminders you get from the most basic IT system.

In 1983, then-minister for health Barry Desmond invited tenders for IT systems to improve efficiency in the health service, and the brief included the creation of an electronic patient record system. Now, 40 years on and umpteen ministers for health, including Mr Martin, Leo Varadkar and Simon Harris, we are once again told that the creation of an IT system, with individual patient identifiers, is a Government priority, but, regrettably, that it will take seven years to materialise.

Handwringing, blame shifting, and sticking-plaster fixes are what is unacceptable. It is unacceptable that it will take many, if we’re lucky (consider the over-runs at the National Children’s Hospital), before we have the kind of IT infrastructure that is absolutely essential for patient safety, continuity and quality of care, value for the €23 billion spent and, crucially, provides an accurate basis for personal accountability and good governance at all levels of the HSE and the Department of Health.


This quagmire is a damning indictment of successive governments, senior civil servants and vested interests who, through incompetence, inertia and self-interested obstruction have stymied attempts to install modern IT systems and implement other reforms. The same forces were at the root of the Ppars IT health payroll fiasco and recently drove Dr Martin Curley, an expert of high international standing in the field of digital innovation, to walk away from his role as HSE director of digital transformation, expressing deep frustration at the “extreme resistance” to change and among “bad actors”.

When Prof Tom Keane, who stood down as Chairman of the Sláintecare Implementation Advisory Council (SIAC) for similar reasons not long ago, yet whose integrity and expertise we drew upon once again to assist Dr Susan Finnerty in her review of Camhs, was asked what could be done to remedy the situation, he hesitated and then sighed: “It all comes down to governance and accountability”.

Déjà vu. – Yours, etc,


(Member of the defunct Sláintecare Implementation Advisory Council and

campaigner for reform of mental health services),


Dublin 6.