Mr. Mark Molloy:

Yes. We live in a locality where there are many health care workers and front-line staff and we have found that most of them will tell us they would embrace open disclosure. It would give them a safe environment to disclose. Many staff will say a certain event happened not because of them but because of the environment in which they work. However, they fear management and they fear recrimination if they tell, almost like whistleblowers, but if open disclosure is in place as the law for all people, it creates a safe environment.

We regularly hear that our doctors and nurses are going to the United Kingdom, Australia, Canada and America. These are the hubs of open disclosure. It is the law in the United Kingdom. The NHS did not break down in 2014 when open disclosure became legal. Doctors and nurses are still entering the NHS. There is no fear on the part of medical staff and no desire to walk away from this. It has been embraced, and this is the direction in which people are going.

I have a fear, which I have mentioned to the Department of Health, that health care workers of a lesser ability may decide to come to Ireland to work because in the United Kingdom one must own up to one's mistakes whereas in Ireland one does not have to do so. Such workers may think they may sail under the radar for a while. It is important to note that when the former Minister for Health, Deputy Leo Varadkar, came to Portlaoise and spoke to families, the same names came up time and again. These were not one-off incidents. Had there been a legal duty of open disclosure, many of those repeat events may not have happened.

Regarding the accountability framework, the HSE is the biggest employer in the State, with 100,000 employees, and it does not have a mechanism to discipline its own staff. It is crazy. One staff member of Áras Attracta served some time in prison but he is still employed by the HSE. The HSE cannot discipline him under its own mechanisms.

Open disclosure comes to the fore in management. Nurses and doctors can appear before their professional bodies but only where a complaint is made, and this is important. We were told Mark's death was just one of those things and were told to go away. Had we done so, nobody would have been put forward to face questions as to whether they were fit to practise. We knew Mark died so we were able to follow up on the matter. What about the people who do not know an adverse event has happened? This regularly happens in the health service. This is the near miss. I work in construction. I am a quantity surveyor. Near misses are so important. They prevent things happening time and again. This is what needs to be reported on and this is why the accountability framework is so important. When these near misses occur, there is a legal duty on people to report them. We have a management investigation ongoing. I have the HSE's open disclosure policy here with me. Two of its signatories are people in front of whom Róisín and I sat before we went to the media. We appealed to them to do something about this. We said it is going on in every regional hospital in the State. They did nothing. Subsequently, when HIQA investigated the matter, they tried to block the investigation, and the investigation which in turn arose from that is ongoing. These are the signatories to the open disclosure document produced by the HSE. This is the top-down management that will introduce this voluntary measure across the board with which people will comply, yet they do not comply with it themselves. It must be on a statutory footing if it is to work.