Martin Kenny (Sligo-Leitrim, Sinn Fein) | Oireachtas source

I welcome the opportunity to speak to the Bill. I will speak to the various sections, starting with the overarching agenda of the Bill setting out the legislative framework for reporting notifiable patient safety incidents.

Mandatory open disclosure has been a significant public concern for some time, not least since the CervicalCheck scandal. A policy of mandatory open disclosure of specified serious patient safety incidents should form the cornerstone of our health service. We need a clear and consistent approach to open disclosure for health service providers, for those working in our health service and for patients. Sinn Féin has always been in favour of mandatory open disclosure and has argued in the Chamber and in the committee rooms for legislating for mandatory open disclosure.

In recent years, we have had many instances that have reinforced the need for open disclosure. It is unfortunate that these instances have been the catalyst for this part of the Bill. The CervicalCheck scandal showed the limitations of a process of voluntary open disclosure. Telling the truth where there is a patient safety incident should be mandatory and legislatively underpinned. Nobody believes the health service can be run without error or risk but people demand that it show compassion and be truthful and honest. Oftentimes in the health service this has not happened. It did not happen in the cases of Vicky Phelan, Emma Mhic Mhathúna and others affected in the past. It did not happen in the case of Alison McCormack when she had her breast cancer misdiagnosed. It did not happen when there were errors leading to baby deaths and injury in Portiuncula Hospital and it did not happen when errors led to the deaths of babies in Portlaoise hospital.

In order for open disclosure to work it must be mandatory and it must be legally underpinned. In the past few decades there has been recognition throughout the world of the importance of open disclosure in medical incidents. Medicine has evolved and so too must the way in which we report harm or error. It can no longer be an act of goodwill, it must become a system of meeting the expectations of transparency and accountability.

In one case of which I am aware, a couple whose baby did not survive had at least a dozen meetings with personnel from the HSE to try to get answers. In the end, they met with what they felt was such stonewalling that they went to a solicitor, who told them the only way to ever get answers is to go the legal route. This is a very poor reflection of the health service. These people were not interested in that. They just wanted to know why there had been no 20-week scan and why the woman was not treated appropriately when she was sent to a Dublin hospital. They just wanted answers but those answers were never given. The only way they could try to get answers was to go down the legal route. This is a very unfortunate reflection. This is what has been happening in the past 12 months. We do not have to go back years to find such a case. It is here and now and we must recognise this.

In the British system, driven by events such as those which occurred at the Mid-Staffordshire NHS Foundation Trust from 2013, new standard NHS contracts require all NHS and non-NHS providers of services to NHS patients to comply with a duty of candour in reporting patient safety incidents. In 2007, New South Wales Health in Australia defined open disclosure as the process of providing an open, consistent approach to communicating with the patient and the patient's support person following a patient-related incident.

While the Bill will see mandatory open disclosure, it is important that we reinforce or help cultivate a culture in the health service where admitting something has gone wrong is not considered a sign of weakness or an admission of guilt. This is the most important part. Human beings make mistakes. The biggest problem we have is that every time there is a small incident there is an immediate rush to cover it up, then a rush to cover up the cover up and then to cover up that cover up with another cover up. This has been the systemic problem we have had not just in our health services but our justice system. It is in so many places and in so many parts of our Government structures throughout the State. A notion almost prevails in all professions that we are better off ignoring or denying our mistakes or errors and living in the hope that no one notices. This belief, if such a culture exits in our health services, needs to be countered right now. This is not about admitting guilt or weakness, it is about doing the right thing.

The amendment to the Health Act 2007 to extend HIQA's remit to private hospitals is eminently sensible, and like all sensible matters in our health service it should have been done long ago. HIQA's healthcare team already does a great deal of work in promoting quality in healthcare services in our public and voluntary hospitals. Private hospitals provide a significant amount of healthcare in the State and, therefore, it is important that HIQA can inspect them to ensure they meet the same national standards.

There are aspects of the Bill that will have to be teased out and will need further work and some amendments on Committee Stage. We hope the Minister will attend and work constructively with all members of the committee when that time comes. I am sure he will, as will all members.

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