Mr. Edward Mathews:

On the number of people who should be present in a room which was Deputy Louise O'Reilly's specific question, my answer is not simple. My colleague has made the point that in some cases they should include the consultant, which is absolutely appropriate. In some cases it might involve a nursing and midwifery issue and they might include the nurse or midwife. When I mentioned an administrator being present, I was referring to nursing administrators. There are administrators available 24/7. I see my colleague's point very clearly. One should not have to wait for the general manager to come in the following morning. Who should be present depends on the circumstances involved. Those who are able to provide adequate explanations should be present. To reflect my colleague's remarks, there is potential initially to have an interim meeting to explain what happened, to be followed perhaps by a follow-up meeting if there has been a systemic error.

I will address the point made by Deputy Bernard J. Durkan. There has absolutely been no suggestion from this side of the room, certainly from my organisation, that staff shortages or anything else are a explanation for everything that goes wrong. Mistakes are made; there are systemic and individual errors. There are things which happen that are not anyone's fault.

On the regulation of managers, there is regulation of health care professionals to protect the public because those who hold a licence to practise have the potential to do great good, but they can also do great harm if they do something wrong. Managers and administrators in the health service have the potential to do great good and also great harm and I have yet to understand why we are regulated and they are not. I cannot make our stance any clearer.

The majority of Deputy Kate O'Connell's questions were directed at my physician colleagues. I will address her questions about the fitness to practise process and the support available in the service. I can tell her that there is perfunctory or zero support for those going through regulatory processes. It is non-existent. It falls to organisations such as the IHCA, the IMO, the INMO or our parallel representative organisations to support them. One will have individual instances in which people are supported by good managers. I do not wish to deny that that happens, but there is no systemic support available.

A point was made about inquests. Our members now have a huge fear of inquests. When they attend, they worry that they will be torn apart in cross-examination. The counsel or representative who is supposed to be present to support them is there to support the institution or the employer and will not even intervene in the most egregious cross-examination.

I am conscious that time is short. The committee is considering the issue of protection in making a disclosure. We have not made the following point. The heads of the Bill are very important in that they extend not only to health services but also to personal and social services.

There is a rider in the definitions included in the Bill which states it only refers to health or personal social services provided to deal with medical issues. Many elderly people or those with a disability receive personal social services provided for them by professionals which do not have a curative or a treatment element. For example, it may involve a social outing. Why should they or their connected persons be excluded from an open disclosure if they fall while on a social outing, for instance? Why should it not be explained because it was not related to treating or preventing an illness? There is a valid proposition to be made that this aspect should be included. If we are talking about service users, say, a person with a disability, an elderly person or connected persons, they will want to know what happened. Why should they be treated less favourably because they are availing of a service not provided for medical reasons? We are supportive of this measure. We request the committee to give serious consideration to the substantive submission we have made in seeking amendments to the definition of "professional regulatory processes", as well as extending the documentary protections to professional regulatory processes.