Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

In terms of open disclosure, has there been full co-operation and an embracing of the open disclosure concept by the professional bodies that oversee the various medical entities in this country? The Minister, who I am sure would agree, was here a number of weeks ago. He said that how we have handled the incidents of adverse effects on patients over the years has been a shameful indictment of the health services and broader society. He said it is something that we need to address very quickly. In the area of maternity services, for example, there have been some sad and tragic episodes and the findings were delayed or not divulged in time. The families have had to go to extraordinary lengths to find out what happened to their loved ones when they were entitled to know what happened early on. As Dr. Holohan has said, very often an apology is given on the steps of a court. Very often, an apology is dragged out of somebody at some stage just outside of the Four Courts. The only people to gain from doing this are those who represent the various bodies. The families are left to endure a traumatic period and then have to endure an apology that has been dragged out of somebody as opposed to being offered. We need to change that concept.

At times the senior management in the HSE has become completely unaccountable. It is always the clinician who is found to be at fault. Even in today's presentation it is the senior clinician who speaks to the patients to make an admission and apologise. It is not always the clinician's fault that something goes wrong and there may be other reasons and factors such as poor infrastructure or equipment. Why has senior management been completely removed from accountability? They are not even accountable half the time when they come in here. Is there a need to ensure that people cannot hide behind clinicians? I would like to hear the Department's views on the matter.

Families often say that there must be a cultural change in the HSE, governing bodies and professional bodies in order for them to embrace the concept of open disclosure. Obviously the Department has looked at other countries where open disclosure is more advanced. What countries have a model of open disclosure that we should aspire to and that has similar legal positions and other similarities?

Dr. Holohan has said in the above context that the apology cannot be interpreted as an admission of liability. An individual is entitled to his or her good name and for his or her professional competency to remain intact until such time as proven otherwise. In terms of reporting and bringing forward legislation, reports are now quickly conducted and disseminated so the laws of libel become irrelevant once the matter reaches social media. Is there any way we can encourage open disclosure? We need to consider this matter in order to ensure people keep their good name even though they have admitted a patient or an entity has experienced an adverse effect while under their watch, without an admission of liability. Many good clinicians could find their names badly damaged without an opportunity for recourse.