Dr. Tom Ryan:

I wish to make a comment from personal experience. Perhaps it is also the experience of my colleagues. When something has gone wrong, openness and speed are key. It is important not to wait until the morning and for the administrative staff to come to work. It is important not to wait for a formal meeting to be held. It is important for the doctors concerned to tell the truth on a one-to-one basis. Personally, I show the patient the chart and walk him or her through it, sometimes in the middle of the night. That is the only way to do it. If there is a delay, the patient or relatives immediately see it as an attempt to hide things. It must be done as soon as possible after the event and in as open a manner as possible, with full and free access to as many of the medical notes and much of the information as is available to show the patient or relatives on a confidential basis. One cannot wait for the administration staff to come to work. If something goes wrong on a Friday night, one cannot wait until the Monday. It must be done there and then; one must start the process oneself. As a consultant working in an Irish hospital, one must take ownership of the process. It is the consultant's patient. Perhaps the consultant advised the patient to undergo the procedure or perhaps he or she performed it. It is the consultant's problem and he or she must take ownership of it. It is nobody else's problem.

We cannot have a situation where administration staff are attempting to control the process.