Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I am delighted that this is in process. Is it proposed to roll out open disclosure across all sorts of services within the HSE or will we target a particular area? While I do not want to give false information, I believe that more than 50% of State claims are maternity-related. They are heavily weighted towards events that happen in our maternity hospitals. Has consideration been given to rolling it out there first, seeing how it goes and then moving on to other areas?

Has this process been included in the new national maternity strategy? We hear anecdotal evidence of many doctors and nurses practising open disclosure for many years and it seems to work out fine for them. I have spoken to a number of people about it recently. How can we guarantee a standardised approach to the patient? From my limited experience, working as a cleaner in a hospital for a long time and then as a pharmacist in a hospital and having been there having children for the past few years, it is clear to me that these places are busy. Is it realistic to have a lead clinician available in the hospital in Holles Street of an evening if there is an adverse event? If we are to do this, can we be realistic about who that person would be? Following on from Deputy O'Reilly's point on training, if things are going wrong, there is a sense that if we have a consultant knocking about we will grab him and if not we will get the other person. It is very important to have a standardised approach.

How do the current systems of reporting of adverse events fit into the new proposal? Have they been evaluated? Have we taken anything good from them and used them in this approach?

Deputy O'Reilly spoke about the protection of professionals. As we know, many health-care professionals are regulated by their own professional bodies. It appears that a lead consultant of a team in a hospital does not have much input into who forms part of that team even though the consultant is ultimately responsible for the team. I am very concerned about the protection of people's good names. We often see reports on the television news of a particular doctor in a particular location and the immediate reaction is that I will never go to that hospital or I hope I never meet that lad. However, he may have done nothing wrong at all. It is important to protect our professionals. There is a difference between the management staff and those to whom they are accountable. Having to face Medical Council hearings is a very stressful process for a medical professional. It can be very difficult for their professional and personal lives.

While this may not fall into the scope of today's meeting, how do the professional indemnity insurance companies feel about this proposal? Is there any push-back from them?

When we are talking about providing support where the flowchart ends, we also hear of patients who have adverse events possibly with catastrophic outcomes and they cannot even drive past the hospital anymore; they do not want anything to do with that hospital. Is there any provision to help those people get care in another hospital? That is not to put blame on the place where the adverse event happened, but it is possible to understand from a psychological point of view that they would not want to go back to the place where they experienced an adverse event.