Timmy Dooley (Clare, Fianna Fail)

I welcome the opportunity to contribute to this significant Bill and to recognise the considerable work that Deputy Reilly has done in putting it together. It will no doubt lead to legislation. Like my colleagues I am happy to recognise his input, professionalism and experience. He is well positioned to do this type of work. It shows that while we often cross swords in this House we have the capacity to share the wisdom of all in an effort to provide a better outcome for our citizens. I hope that this will be respected on another day.

It is vitally important that the appropriate mechanism is put in place to give security to those who work on behalf of the citizens and allow them to do their job without fearing the threat of negligence or of a risk that might evolve later. We need to change the method of communication between patient and doctor, something on which I am not qualified to speak except as a rare patient. The patient's belief that the doctor is infallible and there is no risk creates a barrier. The patient sees a visit to the doctor as a mechanical situation like bringing one's car to the garage where a part is taken out and a new one slotted in and everything is solved.

With advances in medical science the expectation of the medical practitioner becomes greater. We must accept that there are limitations to medical practice and that there is a risk inherent in almost all visits to hospitals or when one undergoes an operation or any other clinical procedure. That needs to be communicated and the patient needs to be more cognisant of it. We must recognise, as a consultant once said to me, that medicine is more an art than a science, and that we cannot always expect a 100% successful outcome. There is work to be done from the layman's perspective which hopefully would help to bring about a culture of more openness and transparency. Clinical professionals have not been good at that.

Several celebrated cases from my constituency have been discussed in this House particularly two cases of misdiagnosis in Ennis General Hospital, of young Edel Kelly and Ann Moriarty. I do not mention them to cause any distress to the families concerned but to highlight the point that there should have been more openness and transparency and communication with the patient rather than a desire by some of the professionals at all levels to conceal, perhaps because of the potential for medical negligence claims, fear that not having done what they should have done would result in a negative peer review, or not wanting to admit blame. One doctor pursued a woman who was at an advanced stage of her illness to plant in her mind and the minds of her family the belief that everything that could have been done was done. That kind of culture has to change because we must all accept that mistakes can be made and ensure that when they happen they are dealt with and addressed in a professional and upfront way.

The Health Information Quality Authority, HIQA, has a role in developing standards. The greatest work remains to change a culture of secrecy based on the notion that the professionals are in some way infallible which they cannot be and perhaps never wanted to be. We need to move that thinking along. If this Bill and the final legislation achieve anything to change the communication strategy and to develop a culture of openness and transparency and the acceptance of reality it will have gone a long way to resolving the issue from the points of view of the patient and his or her family.

I look forward to the passage of this Bill in some shape or form.

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