Dr. Tony Holohan:

As the Minister mentioned, an open disclosure policy has been developed between the State Claims Agency and the HSE, and Mr. O’Brien might say something further about its implementation. It is a very good policy, and stands up to the standard of policies around open disclosure to be found anywhere. The question that arises is the extent to which any additional benefit arises from mandating open disclosure. Our expectations should be that, through the open disclosure policies, staff will always deal in an appropriate way with patients and be honest and open when things go wrong. Patient safety depends on creating the kind of environment in which professionals will be honest and open with patients in the first instance when things go wrong, explain it to them and deal with them appropriately. It does not always happen. Part of this is creating an environment in which health professionals can feel supported in participating in a range of activities that can improve quality and patient safety, including clinical audit, other quality assurance arrangements, adverse event reporting and open disclosure. We intend to build into our health information Bill, which is part of our set of proposals, when it is published shortly, protections from access to this kind of information through freedom of information and data protection that will give health professionals an assurance that if they participate honestly and openly in these processes, the information will not be used against them in freedom of information. It is about creating the sense of a culture which is not about imposing requirements on professionals and mandating them to do things but giving them a sense that they are supported in doing the right thing, which in this case is being set out in the open disclosure policy in the HSE.