Dr. Tony Holohan:

I thank the Deputy. She commented very clearly on the adversarial nature of the system and the length of time investigations take to complete. Some of the measures that are proposed, such as this one, and those for the Civil Liability Act are about trying to make that process shorter and more efficient, including the pre-action protocols, periodic payment orders and open disclosure.

As the Deputy is aware, there is a commitment in the programme for Government on this area. The Department of Justice and Equality is taking steps to initiate the process and we will be anxious to engage with it to examine the whole system of medical negligence and whether we continue with the current system which is based around tort, negligence and the adversarial nature and consequences of the process or consider committing to examine the issue and all of the issues that arise in terms of medical negligence and with which we have to deal in terms of the consequences. We will look to engage with the Department of Justice and Equality in regard to that.

I cannot predict or guess what will happen. I have a view on where, ideally, the process would take us. Making the current process more efficient is one legitimate strategy. We can then examine whether, in fundamental terms, we need to change the whole system on which our current system of medical negligence is based, and its adversarial consequences whereby often years elapse before patients can be dealt with. This includes, by extension, the professionals involved, over whom questions might continue that might get answered in the final analysis even where they may never have arisen in the first instance. Justice is not being offered to anybody when long periods of time elapse.

I responded to Senator Burke's question on the number of investigations. I agree with his point regarding the number and frequency. To be clear, we do not think that open disclosure depends on the outcome of an investigation. There should be enough known at the early stages for that information to be passed on to patients as soon as possible. It is not dependent on information being complete. It might well be the case that, in good faith, a doctor or nurse is disclosing something to a patient that he she believes to be the case that on subsequent investigations or examinations turn out not to be true. Again, the principle of open disclosure is that the fact is revealed when it becomes known.