Dr. Tony Holohan:

They will be professional bodies and the Medical Council.

The context regarding doctors is still clear as it stands. We heard reference earlier to the 2016 guidelines. The obligation on each individual medical practitioner is set out clearly and unambiguously and makes it clear their absolute obligation regarding open disclosure. What we are seeking to do is to reinforce both the implementation of that and the open disclosure policy of the HSE with something we know will tackle the pervasive culture which exists internationally in terms of fear of litigation. This will help to support the creation of the right kind of space. We want to ensure that when things go wrong, rather than retreating from patients, doctors will support patients actively through that without fear that an apology and engaging with patients will create risks for them.

Our experience has been of patient safety incidents. These have been written up and described by us in the Department. We found that at that very moment of harm, doctors, sometimes through fear, step away from patients at the very moment they need help and support. Accordingly, trust and confidence in the service and practitioner is lost. The purpose of this is to create and maintain that safe space. Open disclosure is not the ticking of a box or the filling of a form. It is supporting a patient through a journey of beginning to understand what happened, maintenance of confidence in that service and beginning to adjust to what in some situations could be life-altering or life-limiting findings. It cannot be just a tick-box culture.