Ireland was hit hard by the global financial crunch of 2007 and 2008. It was the first of the EU member states to slip into recession immediately following the bursting of the economic bubble.
As the economy contracted, banks faced default and government debt increased, with Ireland eventually taking an €67.5bn loan from the European Commission, European Central Bank (ECB) and the International Monetary Fund (IMF)
Falling tax income and the need to bail out banks saw the Irish government spending in other areas of public life.
The government had introduced the Public Sector Recruitment Embargo in 2009, which stopped hiring of all civil servants across government and cut pay and pensions – in return for a promise of no compulsory redundancies. Not that this was entirely adhered to.
"If you modernised in one area that released people, you had to move those people into other places..."
What that embargo did achieve, however, was to leave ICT as one of the few ways to change how government worked, according to Bill McCluggage, the Irish government’s chief information officer in 2013-14 and now a consultant.
Ireland introduced shared services, starting with human resources, along with a national network service for the public sector.
But the embargo caused its own problems. “If you modernised in one area that released people, you had to move those people into other places,” says McCluggage. “The scale and capability to realise efficiencies was I believe constrained by that agreement.”
GDS-alike? I don't think so
It also made it difficult to set up new ways to do ICT. McCluggage rejected the option of forming a small Irish equivalent of the UK’s Government Digital Service: “The capability to pull people in quickly the way that [GDS co-founder] Mike Bracken and GDS did was completely constrained because of the process you had to go through to justify people and positions,” he says.
Jim Friars, chief executive of the Irish Computer Society, says this was frustrating for suppliers as it stopped both spending and strategic thinking. “What they were talking about was: ‘We can save money here if we implement some of this stuff, but you have to spend money before you save money’,” he says.
One exception was the Office of the Revenue Commissioners, Ireland’s tax office, not least because it could potentially help in the raising of much-needed revenue for the state.
The office developed a range of digital and online services and created a brand-new system to collect Ireland’s Local Property Tax, introduced in 2013, in a year. “They are probably at the head in the whole of Europe in being one of the most efficient revenue-collecting organisations,” according to McCluggage.
The financial crisis is slowly turning into a memory. The Irish economy is now expected to grow at 3.6 times the Eurozone average, with a 3.5 per cent increase in GDP. That ban on government staff hires officially ended some time ago.
Ireland’s financial recovery leading up to this point is letting it become more forward thinking on IT projects, too. One area where this is being felt is in the national health service.
“There were pockets of absolute excellence in localities, but no national healthcare IT function,” says Richard Corbridge, chief information officer of the Health Service Executive, which co-ordinates public sector health and social care. “We believe the Irish healthcare technology system is around 15 years behind the NHS.”
The UK’s National Health Service organisations spent billions on ICT in the 2000s, while Ireland cut healthcare spending to essentials – meaning technology was not updated. Corbridge says one Irish patient administration system was more than 33 years old and ran on Mumps, the US-developed, health-centric programming language dating from 1966, with others using Cobol and Vax.
"There were pockets of absolute excellence in localities, but no national healthcare IT function"
The last 18 months has seen Europe’s biggest Microsoft replacement project, with 47,000 new machines running Windows 7 and 10 over the last year allowing for the scrappage of ones running Windows XP, NT and even 98. “Having said that, there are still 10,000 people working in primary care, delivering care, without any technology in their hands,” adds Corbridge.
The executive is introducing national healthcare systems. CSC is implementing a single patient administration system, McKesson has installed a national picture archiving and communication systems which lets users see medical images across the country and Cerner is providing maternity, new-born and laboratory software.
Ireland has gone live with a national electronic referral system from primary care to hospitals. It is in the process of planning an overarching national electronic health record service which will use several suppliers, and will not only let patients see their own records but also which professionals have viewed them.
Much of this work draws on England’s problematic NHS National Programme for IT. Corbridge, a Briton who worked on that programme, says Ireland has learnt from England’s mistakes. “It gives us a great opportunity. There are an awful lot of positive and negative lessons to be learnt, and we can take those, apply them to Ireland and make sure that we get these sorts of things right.” This includes getting clinicians to lead projects and focusing them on changing processes rather than ICT.
Corbridge reckons Ireland can catch up with UK healthcare IT in five to six years. “Clinical engagement in Ireland is much easier,” he says. This is partly due to the smaller size of the country, but also “the enthusiasm for what technology can do in healthcare is huge amongst clinicians in Ireland”.
Tough time economic times forced the Republic to adapt and tech was the answer. With its economic prospects looking brighter, however, the State's tech is gearing up for something a little more strategic. ®