David Cullinane (Waterford, Sinn Fein) | Oireachtas source

I wish to make another point, because this is an important discussion on accountability and we probably will not get a chance to discuss those issues again in this Bill. I realise we are talking about accountability in respect of mandatory open disclosure, but I will outline my experience of the HSE. When the Minister was in the Opposition and on this committee, he had to deal with a lot of scandals and crises in health. Many people who have come before this committee have had to testify to failures at management level, clinical governance management, standards, quality care and so forth. There is a sense that nobody is held to account at management level. We have reviews and processes, but at the end of it people do not see that there has been accountability at senior management level. Obviously, we will have separate conversations on the wider areas in that regard when the Minister comes forward with his plans for regional health areas. We have all sorts of concerns in that regard as well, to which we will return. Everybody on the committee wants that to be right. However, to get accountability right, there must be accountability at senior level at the core of an organisation. If there are very senior clinical failures, nobody is ever held to account that I can see. I will not attempt to talk the Minister through all the incidents. I referenced some of the most recent ones but we could go back over many years.

Can the Minister talk through - people will want to hear this to better understand from the Minister's perspective how this is going to work - what the sanction is if a senior relevant clinician does not report something that the authorities then deem should have been reported and there was an obligation on the clinician to report it? Separate from that, the Minister might take the opportunity to talk about his view on accountability at management level. When I deal with organisations such as the Irish Association of Social Workers, Safeguarding Ireland and others, the one issue they continually come back to is that if one does not deal with cultural problems where there is a lack of accountability at senior level in the HSE, we will have these incidents happening repeatedly. I know that it is a tricky area and I appreciate it is not an easy area to resolve, but it is one we have to start addressing. We can start to do it in this Bill, certainly when it relates to mandatory open disclosure. Can the Minister outline exactly what the sanctions would be for somebody who fails to report and who should have reported?