Colm Burke (Fine Gael) | Oireachtas source

I thank our guests for their presentation. The first issue I wish to raise is open disclosure and the Medical Council. Where will practitioners stand with regard to when a complaint is filed with the Medical Council and the information given in that open disclosure? It does not appear to be mentioned in the legislation. What is the clinician's situation where that occurs? What information is there from that open disclosure? Likewise, Dr. Holohan mentioned, in the context of the clinical audit, that it cannot be used in any proceedings. What about matters that come before the Medical Council where there is a clinical audit? Will that information be made available to the Medical Council?

The second issue relates to where a death occurs in a hospital and the medical and nursing staff are upfront that they are unsure as to what actually occurred, they want to have a review of the procedure the patient went through and there are delays in carrying out that review. What process will be put in place? One of the problems that occurs is that the family of the patient who has died believe that because there is a delay something is being hidden. This arises time and again. What process is being put in place to ensure a review is carried out in a timely manner when the practitioners and the nursing staff cannot give an explanation for what has occurred?

The third issue is inquests. I have raised this with Ministers previously. There is no legal duty on a coroner to hold an inquest within a specific period, and sometimes information relating to the autopsy might not be available until the inquest is held. I am aware of a case where a person died in a hospital and 18 months later an inquest had still not been held. What process is being put in place in that regard? Are we going to amend legislation to require coroners to hold inquests? In fairness, the vast majority of coroners will carry them out in a timely manner once all the information becomes available to them, but there is still no legislative requirement on them to hold an inquest within a particular period of time. When there is a death families can be convinced that some information is deliberatively being withheld from them. That must be clarified.

The other issue I wish to raise is accountability. We talk about medical practitioners and nursing staff being accountable but there is no process in place for accountability by management in the hospital structure. For example, when was the last time a senior official in a hospital structure or agency was brought before an inquiry? I have never heard of it happening. In some of the issues that arise medical practitioners and nurses identify to management that there is a shortfall in the support they require to provide a service. It is in writing and is sent repeatedly, yet 12 or 18 months or two or three years later nothing has changed. Nobody is held accountable for that. Portlaoise was mentioned earlier. One of the issues there was that the number of deliveries doubled in a short period, but additional staff were not provided even though the medical and nursing staff requested them. I did not hear of any management personnel suffering the consequences in any way of not taking action.

I very much welcome this Bill but there has to be a quid pro quoin respect of the accountability of management, and I do not see that happening in the HSE. I am aware of an incident in the last two weeks where 12 people were to meet to make a decision on one person. This issue has been ongoing for over three years. Then an individual in the HSE sent an email two days before the meeting to say that the person was now moving to a new job in the HSE and would not be at the meeting. The meeting had to be cancelled. The family ended up having to face a battle to resolve an issue relating to one person. I support this legislation but I also want a quid pro quoof accountability by management because I do not believe we are getting it.