Alex White (Dublin South, Labour) | Oireachtas source

I want to endorse absolutely what the Minister has just said. It captures the point very well. There is no doubt in my mind that Deputy Ó Caoláin's amendments are very well motivated. I do not say that in a condescending way. No citizens - politicians or otherwise - would regard delay in clinical practice as acceptable. It horrifies us all. In some cases, it has the most dreadful outcomes. We can all understand and see that.

It comes back to what we think we can do and what our responsibility is as legislators. As the Minister has said, when we are setting out the law as politicians, that does not involve us stepping into the clinical environment. It cannot involve us stepping into the clinical environment for the exact same reasons I gave when we were debating Deputy Mulherin's query about why we cannot include in the legislation a requirement to exercise best practice. I made the point that such a provision would involve including in the legislation a further definition of what best practice entails, and that would take us into a whole new area of legislating in detail for what constitutes best practice. Best practice is set out, supervised and changed when necessary by the professional bodies, including the Medical Council. There is a statutory basis for that. We do not step into the clinical environment. There must always be an arm's length between the Government and the Oireachtas, on the one hand, and the actual clinical practice, on the other hand. That must be the case even in these really very difficult and delicate areas. There needs to be a high level of trust.

I would like to comment on the issue of delay, which has come up again. I believe that acting in a timely fashion, quickly and expeditiously is a fundamental aspect of professional medical practice. I am reminded of what we were saying last night. I would regard all doctors as having a requirement to act in accordance with best medical practice, without that needing to be included in legislation by means of the use of certain words. All doctors have to apply best medical practice and all doctors have to act in an expeditious manner. Time is of the essence in clinical practice. It seems to me that if we include this in legislation, we would risk it having the opposite effect. It would almost raise - I am trying to put this in a way that does not misrepresent what I want to say - the possibility that the Legislature has a doubt in some way as to the likelihood of best medical practice, or acting in an expeditious manner, actually occurring. I think that would be unfortunate and wrong.

I agree with what Deputy Ó Cuív said. He is absolutely right about the very high standards of care that exist throughout our hospital system. It is not the case that the Oireachtas has prescribed a certain method or rule that a doctor should follow. We have a statutory regime, through the Medical Council. We have reliable professional bodies that uphold these standards. We also have laws. People have the option of bringing cases to court. Medical negligence cases are brought when things unfortunately go wrong. We have a very strong legislative and statutory infrastructure. We have other ways for people to vindicate their rights if things go wrong, as they unfortunately do in a small number of cases.