Dr. Philip Crowley:

I would like to open up by initially apologising to the families - the families present and the families not present - who suffered harm in Portlaoise hospital. I was personally very distressed and sad at the testimonies they have given in various settings, including here today, not only about the failures in care, but clearly fundamentally about the lack of compassion, the poor response to the adverse situation of the death of a baby and people covering things up, hiding for whatever reason.

I have practised for 30 years as a family doctor. I have worked in Central America, in the NHS and here, always trying to work with patient groups to ensure that their voices are heard and that we are responsive to what people who use our services have to say. I have worked all through that period of time to try to improve services for patients and service users. One can only be deeply upset when care breaks down in this way and particularly care in its fundamental sense - in compassion.

Some of the questions relate to that sense of upset. One question from Deputy Kelleher related to open disclosure. We have developed a policy on open disclosure, as he is probably aware. We have an unprecedented implementation programme around it because we understand from the testimonies of the families here today and from other instances of harm to people that the harm is so compounded by how people react after the event that we know we do not have a culture of open disclosure in our health service.

That is why we carefully developed our policy. I commend it to the committee; it is available on our website. It is a very clear policy. It gives very clear guidance to staff on how to behave, how to respond, how to react immediately. We have run 150 workshops around the country to try to train people in truly adopting this approach, which I recognise represents a culture shift in our health service.