Regina Doherty (Meath East, Fine Gael) | Oireachtas source

Last Tuesday the Oireachtas Joint Committee on Health and Children heard the experiences of two families whose babies died in Midland Regional Hospital, Portlaoise. I believe we owe them a great debt. They described how they courageously fought against a system for many years which was supposed to support them and care about them and their experiences as well as learn by those experiences to ensure that no other family would go through what they went through. The recent HIQA report into the investigation of the quality, safety and procedures in Midland Regional Hospital demonstrates what happens when the health service fails patients. In this instance, not only are we seeing the evidence of a failure in terms of clinical services provided but also a deep failure in the lack of support and answers provided to patients, a lack of clear and consistent policies in respect of how patients can make a complaint and ensure that they will be heard, and that actions will arise from their complaints.

This morning an investigation by the Ombudsman, Peter Tyndall, found that people are afraid to complain about the care and treatment they receive in hospitals because they are concerned about the repercussions for themselves and their loved ones. The investigation also found that people do not complain because they do not believe it will make any difference. The Ombudsman's report, Learning to Get Better, was published today. He carried out the investigation because he was concerned that his office was not receiving the amount of complaints that the health care system should be generating. The recommendations he made this morning are similar to the recommendations made by HIQA some weeks ago arising from its investigation into Portlaoise.

I believe this moment holds the possibility of real change in our health service and with it the safety and quality that will restore the trust of the people. The recommendation by HIQA to establish an independent safety advocacy service is a starting point. This agency must above all be truly independent of the HSE and must have a direct reporting relationship to the Minister for Health. It is essential that this agency is set up in an honest, inclusive and transparent way to enable trust to be restored for patients and the public. Failure to do so will cause irreparable damage. Currently, Ireland has a fragmented poorly co-ordinated ad hocpublic health care advocacy service, one that often sees those advocating for change being funded by the HSE and, therefore, controlled by them. This practice cannot continue. Advocacy must be funded differently if we are to ensure that patients have an accessible and equitable advocacy service.

The people need the integrated agencies currently representing patients and the public to leverage a stronger organised voice and streamline their work with the Government's plans. We need an agency that will provide a unified voice for patients, carers, family members and the public and to engage in dialogue with our health services. We need an agency that provides a single easy-access point for public concerns and complaints about the public health service, one that will ensure transparency, restore public trust and educate our stakeholders to achieve safe, high-quality health care for everyone in Ireland.

Feedback is the best way to learn if we are doing things well. However, in Ireland we see feedback, specifically, complaints, as a negative for some reason. We do not see the value of learning from it or the value in learning from an adverse event because it can prevent another tragedy occurring. The last independent patient survey of experiences in the Irish health services highlighted that almost four in ten patients did not feel encouraged to voice their opinion about the services they received. Over six in ten were unaware of how to complain. Many who wanted to make a complaint failed to do so because the system is not set up in a way that makes it easy to provide feedback. The Ombudsman report from today bears that out.

Litigation is often the route forced on patients and family members. Often they simply want answers, assurances that it will not happen again, someone to take responsibility or, sometimes, simply for those responsible in the service to say sorry. Patients should not have to go to court or to the media to get these answers. There are other ways that we can promote trust, including by ensuring that patients have clearly-defined rights to services, the right to choose the hospital they attend, the right to seek a second opinion and the right to access their own records. We say that patients have these entitlements in Ireland but often the choice of hospital attended is decided by someone other than the patient. If a patient seeks a second opinion in this country she is often made to feel intimidated or viewed as an awkward patient. Despite evidence showing that working collaboratively with patients at the point of writing patient records has so many benefits, patients generally only have access to their records if they make a formal request. We have a habit of talking the talk in Ireland, but open disclosure is an example of where we do not walk the walk.

The many HIQA reports to date are a clear indication that the HSE is not functioning for the benefit of patients or the organisation's staff. It is time for the silos to come down, for egos to be left at home and to put the patients truly at the centre of care rather than simply pay them lip service. I believe it is the very least we owe the parents whose babies died on our watch and who explained their stories and experiences so eloquently last Tuesday.

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