Mr. Michael Boylan:

I do not believe a voluntary system will work. It is very much like the speed limit in that people will not comply with good practice unless sanctions are available. The Medical Council changed its code of professional conduct around ten years ago, yet we still have denial of liability and a defend and deny approach. There must be a legal duty to report. We should also take the same approach as has been taken in the United Kingdom in respect of hospital administrators because I detect that much of the problem does not lie with doctors. I have been told by doctors that they wanted to be candid with patients and admit fault but were prevented from doing so by the hospital administration. The United Kingdom has introduced a duty on hospital administrators as well as medical consultants. This approach should be examined.