Mick Wallace (Wexford, Independent) | Oireachtas source

As Deputy Daly said, our aim here is to place an obligation on health care providers to be open with patients in the aftermath of a serious incident resulting in the patient suffering serious harm. Our preference would have been to place an obligation on health care providers to always be open about any incident, no matter how minor, but in our amendments we have now restricted this to more serious incidents. This is because, as Deputy Daly noted, requiring open disclosure of every small incident or near miss could - though not necessarily - make things a bit difficult for health professionals. It remains open to providers to be open about near misses and minor incidents of course, but we are also trying to accommodate the qualms of the Department and the HSE over the strong need to make disclosure of more serious incidents obligatory.

We have been told in previous discussions over mandatory versus voluntary approaches that the latter would make open disclosure more likely.

12 o’clock

This is a tortured piece of reasoning for which there is no evidence. The Committee on Health's report on open disclosure cites one piece of so-called research on voluntary systems being more effective. In fact, this so-called research is a one page editorial in the British Medical Journalin 2000, 17 years ago, by a specialist in medication error from the US. It relates to the area of medication error reporting and is focused on anonymous reporting of errors and, by extension, adverse incidents. This is what the national incident management system, NIMS, is for. It is nothing to do with open disclosure. This is not a research article. It is an opinion piece based on a very small number - four - outdated references, one of which relates to aviation errors. None relates to disclosures of errors to patients.

The UK has a statutory duty of candour, as do Alberta, Quebec, Manitoba and Saskatchewan in Canada. Quebec introduced its legislation on foot of scandals similar to those in hospitals here. Litigation rates have remained exactly the same since, yet there seems to be considerable fear here that what we propose will lead to greater litigation. That is not borne out by the evidence elsewhere. Seven states in the USA have mandatory duties of candour, as does New Zealand.

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