David Stanton (Cork East, Fine Gael) | Oireachtas source

I know where Deputies Daly and Wallace are coming from in this set of amendments, which provide for the provision of a mandatory apology. Our goal is to create a safe space where there can and should be full disclosure of the facts surrounding a patient safety incident and the implications, if any, for the patient's care and treatment. Let us put that out there, it is about a safe place. The Ombudsman is clear that many people who have complained to his office say that what they are looking for is for the service provider to acknowledge that something went wrong and to receive a meaningful - I stress meaningful - apology. People say that they want to be listened to and assured that lessons have been learned and that the same mistake will not happen again or that every effort will be made to ensure that. While apologies can be mandatory, I believe that voluntary apologies are far better. I have a number of reasons for thinking that. Is it a real apology if it is forced?

An apology must be a considered expression of regret. It has to come from the heart. It involves building trust, human relationships and human interaction in situations where this is the appropriate thing to do, which depends on the individual circumstances. The Ombudsman outlined that it is important that, when making an apology, the person making an apology understands the other's circumstances and what his or her wishes are in regard to what occurred. That is a good principle. One cannot put together a meaningful apology without understanding what a patient has experienced and how this impacted on his or her individual concerns and requirements. Empathy is a large part of this. The giving of an apology, as Deputy Clare Daly has rightly said, is a human experience for all involved, both doctor or service provider and the patient. It should be borne in mind that it can take time to gather all the information and facts relating to a patient safety incident. It is only once this has been done that a meaningful apology can be given. Otherwise the apology will simply be a box-ticking exercise, which not what members want.

The recent HSE evaluation of open disclosure stressed the importance of making apologies with integrity and compassion, and of having the right people informed and prepared to make an apology in advance of an open disclosure meeting. This Bill will, for the first time in legislation, define an apology in relation to an open disclosure of a patient safety incident as an expression of sympathy or regret. Research indicates that not all patients want an apology but when they do, such an apology needs to be personalised, sincere and honest. This approach is further underpinned by the HSE’s policy on open disclosure and the Medical Council’s new guide to professional conduct and ethics for doctors and other professional codes.

I am mindful of members' concerns on balancing the need to provide for a full understanding of the circumstances of a patient safety incident with the need for meaningful engagement of staff with patients. It reminds me of two children, one of whom has done something to the other, and a parent comes along and tells the guilty child to apologise, which he or she does, but does not mean. He or she had to apologise because it was mandatory. It did not come from the heart. In the next breath, the child tells his or her sibling that revenge is on the way. There needs to be a voluntary, sincere expression of remorse. If it is made mandatory, all of that is taken out from it and it loses what we are trying to build, which is a culture of respect, openness, empathy and feeling. If a person feels he or she is being forced to give an apology because of legislation, it is missing the whole point. I hope members will accept the reasons I have sincerely outlined as to why I have chosen not to accept their amendments.