Mr. Paul Reid:

Perhaps Mr. Watt will talk about the legislation aspect. I will make a couple of comments on accountability. We are addressing this in a number of ways. I have brought two papers to the board of the HSE about strengthening accountability in the HSE. It is a factor and it comes up after every inquiry or every issue. There are a number of things we will address, the first of which concerns the national incident reporting, NIR, process, which the committee will be familiar with. When we carry out certain clinical reviews, and when we review cases that go wrong, we look at them and we tend to drift into describing what happened, and then we start a process of looking to see who did something that they should not have done. This happens in sequence. We are now making sure, because it is facilitated, that this is done in parallel. It is not a "gotcha" process. It is being done in a parallel process to see what happened, what went wrong, was someone accountable, or did somebody set out to do harm. This will be run as a parallel process.

Separately, in the paper I brought to the board, we addressed the issue of accountability. When we talk about accountability it is sometimes made very simple. While I do not want to say it is complex, it is not that simple. There are a number of factors around addressing accountability. Clinical accountability is one factor, as is open transparency with the Patient Safety (Notifiable Patient Safety Incidents) Bill 2019.

Overall, we must look at performance management. We are not strong enough in that area and it is not fully rolled out across the board. We are in the process of rolling it out across the board. There must be clear lines of responsibility. We have delegated functions. We need to make sure that in all of those delegated functions people are clear on what their role and responsibility is, and what they are delegated to do and not do.

We have brought a number of strands to this, including in the regulatory area to see what professions are regulated and what are not. We are also looking to see what disciplinary process is in place. Some of our disciplinary processes go back to the 1970s and they are not fit for purpose. I would be open to challenge on that, but they are not. Some people can vet who will oversee an investigation. I do not believe this is right. There are a number of strands we want to address in terms of accountability. Perhaps Mr. Watt from the Department will address the Patient Safety (Notifiable Patient Safety Incidents) Bill 2019.