Kate O'Connell (Dublin Bay South, Fine Gael) | Oireachtas source

I am concerned that the audit data will not be subject to freedom of information requests or that it would be usable in court. I understand entirely where we are coming from but I am concerned that the focus is on the professional not on the patient. If everything is all open and accountable why would the information not be admissible in court? It is holding onto the past rather than looking towards the future.

Dr. Holohan referred to the erosion of societal trust. It is worth mentioning that here. I am very much pro-patient safety and open disclosure; the world and Ireland have changed in relation to the relationship between doctor and patient. There was a time when one trusted the doctor down the road implicitly. Such doctors would diagnose a person's pregnancy, weigh the babies when they were brought in and they were part of one's life. That relationship has been destroyed over time for whatever reasons. We are trying to apply open disclosure as though the relationship with the doctor was the same. However, if one considers a doctor with whom a patient may have only dealt once, that patient might be more likely to make a complaint against such a doctor compared with the general practitioner that he or she might have dealt with for 15 years. We must be conscious that the relationships have changed over time. While patient safety is to the fore in this, we must also consider our medical practitioners and that they are not overly exposed as a consequence of the throughput and the transient nature of care now.

To come back to the incidents that happen, I know from working in this area in the UK that there is an idea that an IT system would be the alert system, but I cannot see why it would not be a mobile phone. If an incident happens on one ward - it could easily be a dispensing error by the pharmacy - it would seem logical that the alert would go throughout the hospital in real time. As for the idea that somebody sits down at the end of the day and logs errors into a system, and it sits on this endless list and nothing is done, anything we are doing here has to be in real time.

Following on from that, what sort of person will be in charge of this in an organisation? Will it be a manager or a doctor? Who will be responsible for making sure the list is filled in at the end of the day and whose responsibility will it be to triage what is serious or potentially serious? If that person makes the wrong call and something that is serious is treated as minor or vice versa, whose responsibility is it and is there any protection for the health care professional or doctor in that case?

I have a fear that with seven days to log an error, or potentially longer, we could end up with a list of errors but no actions, no reflection and no change. I know of other jurisdictions which have tried to bring in a regularised form of reporting errors and it has led to an endless list sitting on the system, when it is really only a log and has very little purpose apart from administration. Dr. Holohan might deal with those issues.