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

We are back down to two sides. We all want to end up in the same place. There is no dispute or disagreement. The Minister is committed to evaluating the approach that is proposed. He suggests that we need to allow it to bed down and give it a chance to work. We all agree that voluntary open disclosure, if it works, will be the best outcome. We propose to start with the best outcome, which is voluntary open disclosure. The current open disclosure situation was referred to, but there is no protection for staff at present if someone makes a voluntary open disclosure. If someone says he or she did something, there is no protection. One could argue that is one of the reasons it is not happening to the extent it should. The Bill sets a clear standard for open disclosure, so it is not just a matter of mandatory disclosure, but there is a whole package here and it is all linked together. It provides for a written statement to patients, which is not now current practice. That is also part of it.

I would like Deputies to look at the Bill in the round and to take in the cultural shift we want to get here. If anything mandatory is brought in, it goes against the thrust of this Bill. As it happens, open disclosure is HSE policy anyway, but we want to improve it and encourage it because we want more of it. The medical ethics code, as I understand it, obliges disclosure too. This whole Bill is a package. It is not just one thing. By having voluntary open disclosure, we are not forcing people to do anything. People want to do it because it is the right thing to do. They are protected in doing it as well, and we are building up the relationship between patients, service providers and doctors. We are building trust there and that is important. If one thinks of it in the round and if we can get to voluntary open disclosure as a practice, as we are beginning to see happen anyway, and I think people want to go there, it will be a win-win for everyone. It would be better than if we made it mandatory and forced people to do things which should be voluntary. I think we agree that, ideally, they should be voluntary, and if we put in place the necessary protections for people in order that they feel safe in having the candid and open conversations they need to have with their patients, it is a win-win.

The Minister is committed to evaluating this if it does not work and looking at it again. He asks that we give this a chance because we believe, given the evidence, that this is the best approach. Let us encourage it, give it a chance, put it in place and evaluate it as it goes on. If it does not work to the extent we hope it will, we will move back from there. The Health Information and Patient Safety Bill mandates reporting of serious incidents. That is on the way.