Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I welcome the witnesses to the committee. It strikes me that the medical negligence claims system in the State serves neither patient nor practitioner well. While I have no doubt that there will be a significant concentration in our toing and froing on the cost, there is without question the fact that there is huge stress and distress involved for all parties, including patients, their dependants and their loved ones, and practitioners.

It is important to share that, in advance of this meeting, we received a significant correspondence from people from throughout the country who had been through this process. The word "inundated" is probably a little strong, but it was significant. Their stories are absolutely harrowing and they have a common experience apart from the tragic incident that changed their lives in almost all cases, which is that it took years to get to a resolution. I can empathise with their cry and their pain and I consider that this is the issue that must addressed. I had, in reading some of the correspondence, images of our television screens through the years.

We would also have seen it in the print media. One would see a family coming out of a court experience following a decision or an award, whatever the case might be. We would all have forgotten what their story was; it may have happened years before. Heaven only knows what such a family will have been through over the intervening time. It is most unsatisfactory.

We are all human beings and it is not only the patient and his or her loved ones who are affected. No practitioner sets out to do some wrong or harm. The protracted process must also take its toll on them. None of us is an automaton. I am deeply concerned that there is a disposition on the part of the State Claims Agency and the Medical Protection Society to approach almost all of the cases that present from a deny-and-defend perspective. There is something very amiss in all of this because we are compounding hurt and pain by that approach.

I am conscious that the British system introduced legislation on the legal duty of candour last November. I recall that the Minister for Health, after the exposé of the series of stillbirths in Portlaoise some 12 months ago or thereabouts, commented that he would commit to the introduction of a statutory legal duty of candour. We met the families involved. They were misled, misinformed and left in the dark, which is unacceptable.

I would like to ask the State Claims Agency and the Medical Protection Society a question. Is it the case that, following an adverse incident in any of our hospital sites, medical practitioners and nurses are obliged to advise the respective organisations of said incidents? Is it the case that they are not obliged to, and generally do not, advise patients and their families? Is it the case that the organisations, in turn, do not advise the parties concerned and do not encourage those whom they may represent to act in an open and forthright way?

I return to my first point, namely, that we are all human beings after all. People put into a position whereby they have to defend their case and know the tragedy of their experience, due to the fact they are challenged, are being put in a very difficult position. The trajectory is one of open conflict. That can be changed through openness, honesty and advising the patient of anything that may not have happened as it should have done or as intended. With that approach, a significant cost factor - protracted legal battles - would be addressed. There are substantial savings to be made in that area. The savings would be not only in terms of the cost of the ultimate settlement and the legal costs associated with years of direct engagement, but also in human, psychological and other related terms by the absence of stress over long years of embattlement. I ask the State Claims Agency and the Medical Protection Society to address with candour at this committee the question of whether they would favour the introduction of a duty of candour for all practitioners and would honour and respect said legislation if it were to be introduced.