We move now to the Regional Group and Deputy Matt Shanahan.

Unlike the Tánaiste, I am not medically qualified although I spent a number of years in the healthcare area working around medical devices and medicines. I am not an expert so I talk to experts to try to inform myself of what is happening on the ground. When I say experts, I mean those who are at the front line of medicine, working with cutting edge medicines and dealing with Covid patients.

On 4 April 2020 I issued a national statement calling for the use of face masks but this was not supported by NPHET until August 2020, when it mandated the use of masks in shops and indoor settings. On 23 April I asked NPHET to consider allowing senior nursing staff in residential care settings to take nasal swabs rather than sending in National Ambulance Service personnel in full PPE, which was terrorising dementia patients. I asked for that in April but it did not become policy until the end of May, again waiting for NPHET approval. In May 2020 I raised the issue of antigen testing by a world-leading pharmaceutical company with NPHET but this was dismissed out of hand, within two days. I pushed the issue with the Tánaiste's office, the Taoiseach's office and the Department of Health and asked that pilot studies be done with the Construction Industry Federation, CIF. I engaged with Professor Paddy Mallon on this and to be fair to the Tánaiste, he looked to get Professor Mark Ferguson on board because he saw the resistance to antigen testing. Now we are talking about the roll-out of some pilot studies in August or September of this year but this is not acceptable. Antigen testing is being used in the US and we are using it as a Brexit mediator in the context of haulage. We are still trying to roll it out and this is retarding our Covid-19 response.

In recent weeks the Oireachtas Joint Committee on Health produced a very fine report on the use and possible benefits of vitamin D supplements. There is overwhelming evidence supporting this but it has not been adopted by NPHET or even properly looked at. Vitamin D is a very benign prophylaxis that could be used and I cannot understand why we are not doing it. NPHET still refuses to take seriously the views of underlings in the healthcare service. Who is making the decisions? It is people who are earning many times the average industrial wage in this country and who are not furloughed from their jobs or businesses.

I also ask the Tánaiste to look at the issue of e-health. We do not have a patient identifier number. There is the farcical situation with healthcare where there are two systems, one in the acute hospitals and one in community health, that do not talk to each other, which leads to double booking of people coming in for vaccinations. This is not Ireland in 2021, nor should it be. We must consider what Slovakia, Denmark and Hungary are doing and send people there to find out what e-health systems they use and bring this into our Covid-19 response.

The Deputy made some very good points. However, while Denmark has had a very good response to the pandemic and is one of the few countries in Europe, or the world, with a lower mortality rate than us, we would not follow Slovakia's or Hungary's response to the pandemic because their mortality rates, sadly, are among the highest in the European Union.

Deputy Shanahan is spot on in relation to e-health. A lack of an individual health identifier is a real deficiency in our health service. We have a really good PPS system and public service card which, for many reasons, have not been extended or replicated for health. One of the outcomes or dividends from this pandemic must be universal patient registration with a health ID for everyone so that we can do vaccination programmes and screening programmes much better and identify people through disease registers and so on. What the Deputy said in relation to that was spot on and will have to be part of the legacy of and dividend from this pandemic.

I referred to Denmark's and Hungary's e-health systems rather than their mortality rates.

The Tánaiste referenced PPS numbers. We have up to 20% more PPS numbers than population, which behoves us to come up with a new identifier number to manage our systems.

As the Tánaiste is well aware, there have been issues for years in terms of hospital inpatient data, the hospital inpatient enquiry, HIPE, system. For years, University Hospital Waterford suffered from the under-reporting of cardiac activity in terms of the national HIPE system. I ask that as part of this exercise we seriously consider integrating technologies and communications systems to provide a better response in our hospitals and primary care settings and for our patients. As the Tánaiste said, we will have spent a considerable amount of money and we must have something at the end of this. I hope the Government will deliver initiatives on new health ICT systems shortly.

The Taoiseach and I feel strongly about this, not least, because we are former health Ministers and understand the problems facing health administration. We are both keen to use a decent chunk of the European recovery fund - we have approximately €800 million to €900 million coming to us - on e-health, to do some of what Deputy Shanahan suggested.

However, much has happened in our health service in terms of e-health that has worked well. Our patient record in maternity care is good. Something is starting in pediatrics. The medical laboratory information system, MedLIS, means people do not have to take the same blood test twice. Our radiology system is good, having moved from a picture archiving and communication system, PACS, to a national integrated medical imaging system, NIMIS. I would not like the impression being created that nothing has happened in this space, but it is true not enough has happened. I concur with the Deputy's view we must up our game and invest in e-health.

While people may have been scared by the experience of personnel, payroll and related systems, PPARS, the very expensive health service system which went horribly wrong ten to 15 years ago, we should not make the mistake of not investing in e-health when we need to.