Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I will be as brief as I can.

Reference was made to the full capacity protocol and the figures for this year, which we have obtained. I will offer one example. In Limerick the protocol was in operation 283 times between 1 January and 14 November, that is, 88% of the time. I am happy to share the figures with the committee. We obtained them as part of the freedom of information process.

I am mindful that there seems to be a divergence of views. I am acutely aware that accountability does not and should not mean taking responsibility for systemic failure and systematic and long-term under-funding of the health service, although that is often what happens. I appreciate the point made by Dr. Ryan.

I am keen to hear the views of the deputations on this point. When an adverse incident takes place and the patient or relative is informed at the earliest possible opportunity, the process does not always involve one person. Several people can be involved and they should be all involved. Sometimes it results from a systemic fault that is not easily explainable. It may or may not have something to do with the rules that apply. That brings me to my question. We have had a discussion about it, but I am keen to tease the matter out further. Who should be present when the disclosure is being made or, to put it another way, the chat is taking place? I am keen to get a clearer picture of where we are going. My view is that all of the people involved should be fully trained as they will require protected time. Moreover, it will have to be part of the modus operandiof every hospital and health care facility. Let us suppose there are three people in a room, two of whom are regulated health care professionals and of one of whom is not. The process is over for the person involved in administration. I mean no disrespect to such persons, but the process is over for them once they have the difficult conversation. Unfortunately or fortunately - whatever way we view it - for the regulated health care professional, the discussion might only be the start of a long process in dealing with the relevant regulatory body. There has been some discussion about this matter and I am keen to know whether the suggestion is that the people involved in administration should somehow be regulated statutorily. Is it enough for guidelines to be issued? I have a view about this. I am conscious that there will be three people in the room, two of whom will be accountable to another body outside the hospital and the HSE but the third might not be and the process will be over for that person. I am interested in hearing the views of the deputations on that point.

There was considerable discussion of the adversarial process in place. We also need to be cognisant of the fact that we are dealing with people who for whatever reason have had a bad experience. I am unsure whether education alone will be enough or whether this legislation plus education will be enough to change the culture. I have had experience of this at what is now the Nursing and Midwifery Board of Ireland which used to be known as An Bord Altranais. Often what happens is that people are not satisfied with the answer they have received and pursue the matter. Individuals are held to account for failures that are not within their control. The people who have some of the answers and are responsible for some of the rules and regulations - generally known as the bureaucracy - will never sit in front of a regulatory body. I am conscious that this legislation does not address that point, but do the deputations believe it can or should? Is other legislation required?