Stephen Donnelly (Wicklow, Fianna Fail)
Link to this: Individually | In context | Oireachtas source

I also fully agree with the intent of amendment No. 5. The good news is we now have a patient advocacy service that is growing. The Patient Advocacy Service, PAS, was set up to provide exactly what the Deputy is, quite rightly, calling for, which is free and independent advocacy for users in the acute system who intend to make a formal complaint regarding the care they receive. The complaints come through the HSE's Your Service, Your Say process. PAS is also there to help those who have been involved in a patient safety incident, which is obviously the topic of the legislation before us. It was established for public acute hospital users. However, since June of last year, we have extended that to HSE-operated nursing homes as well.

Since its establishment, the service commenced operations nationally. There are hubs in centres with the highest activity, namely, Dublin, Cork, Limerick, the midlands and Galway. The service goes to all locations to meet patients and service users as required. Currently, 20 staff are employed by PAS and recruitment is ongoing. Last year, it received 1,200 new contacts so it is doing an awful lot of work. That is required advocacy arising from more than 3,300 separate complaints. PAS is there, it is very active and it is working around the country.

While I will not accept the amendment, since we already have the service in place, I am happy to commit to asking my officials to engage directly with the HSE to make sure there is a very wide understanding that PAS is there, that it is free and that it is very responsive. I agree entirely that there are many cases where patients need advocates. PAS provides that expert advocacy service.

Section 7 is a very important section. It establishes the obligation of mandatory open disclosure. While amendment No. 4 has been ruled out of order, I will address some of the issues through discussion of the section. The view is that it is very important a clear responsibility and accountability is placed on the service provider and the most relevant senior clinician. That is what this is about.

The Deputy referred to protected disclosure. He is correct. Those protections are afforded under different legislation, namely, the Health Act 2004 which was amended in 2007. The protections for people coming forward are very important and real but covered under separate legislation. I looked at what other countries do. We cannot find any other country where there is an obligation on everybody. There is a concern where there could be someone in a hospital ward, for instance, with no clinical training or not the right level of clinical training who might see something that they are not really qualified to know whether it was a serious incident or whether should it have happened. It might be that it is part of normal care or maybe it is not but it could create anxiety for them that they feel legally obliged to report all of these. That is why Ireland and other countries keep it to the organisation. This would introduce an offence with serious penalties. The legislation lays out who the lead person is and there is back-up for the next person if that person is not available. That is how the section is structured. That is the right way to go rather than putting an obligation on everybody.