Ms Martina Harkin-Kelly:

As regards there being a lack of support, I have to agree with Senator Colm Burke. There is an entity within the HSE or, from a public service perspective, the employer, of which the union is the organiser and in which the preparation of statements is part of the role of the union. Staff working within hospitals are left to their own devices, with minimal support, and there is minimal guidance for managers on how to access support. The same support systems are not operated in all areas. The occupational health service is overwhelmed because of the current financial crisis in terms of retention and recruitment. Staffing levels have dropped because there has been no replacement of the quantified number of medical professionals required to man these departments. There is another very lonely entity which comprises carers. We work in a caring organisation but minimal care is provided for carers, which is a worry.

Speaking from an organisational perspective, there are good structures in place. Our members are regularly updated on the services we provide at our annual delegate conference, branch meetings, section meetings and on our website. There are also structures that are regularly advertised on the HSE's website. However, I caution that they do not always operate on a 24/7 or 7/7 basis. As the representative body of members, in the past we have occasionally had to deal with very stressed employees at perhaps 8 p.m. or 10 p.m. in a call which could have lasted for an hour and a half or two hours. Post-traumatic stress disorder is associated with it.

The initial pilot training on open disclosure consisted of an half an hour information session followed by three and a half hours of role play. However, the mechanism used in the roll-out of that training worries me because a system in which the trainer is trained is not the proper one to cascade information down to all employees. It is important that information on open disclosure be available much more widely and incorporated into the induction programme for medical staff, including nurses and midwives. The general public also needs information on open disclosure.

The Senator is correct that the delays are a problem. Timeliness is important. The information needs to get out, as Dr. Duddy mentioned. When information is not timely, there is the mindset that the HSE is hiding something. Therefore, timing is key. The information must be made available within 24 or 48 hours, or even immediately. We talk about the golden rule in treating myocardial infarction, MI, or heart attack patients. It is equally important when an adverse event occurs that that golden rule also be instigated as it keeps the wolf from the door which is vitally important.

That is all I want to say. My colleague Mr. Edward Mathews might like to say something.