Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

I move:

“That Dáil Eireann:recognises that:

— the CervicalCheck scandal and the reports into the deaths of babies in Portiuncula and Portlaoise hospitals have undermined confidence in the healthcare service, caused hardship and injury to families and potentially impacted on the treatment of seriously ill women;

— the Health Service Executive (HSE), every healthcare organisation in the State, or services purchased by the State or delivered on behalf of the State by the private sector, and everyone working for them, must be honest, open and truthful in all their dealings with patients and the public, and organisational and personal interests must never be allowed to outweigh the duty to be honest, open and truthful;

— there is a need for justice and support for the women affected and for the families of those women who have tragically died;

— there is a need to rebuild confidence and trust between patients and the healthcare service;

— central to rebuilding trust is full disclosure of all relevant information to patients and accountability within the health service;

— to date, the Government has failed to introduce mandatory open disclosure;

— the introduction of mandatory open disclosure is a necessary and immediate step in rebuilding confidence in the healthcare service; and

— mandatory open disclosure should not only be confined to doctors, nurses, and healthcare professionals at all levels, but it should apply across the whole health service from the ward to the top of the HSE and the Department of Health, and include all grades and categories of workers; and

calls on the Government to:

— legislate for mandatory open disclosure of all information where an error occurred that has affected the patient’s care and to do so before the next Dáil summer recess;

— place a statutory duty on all officials in the Department of Health and HSE to provide full information to a healthcare regulator, statutory agency and Minister in cases of systemic failures in healthcare;

— ensure there is also a statutory duty imposed on all officials in the Department of Health and HSE, including the Minister for Health and the Director General of the HSE, to be truthful in any information given to the Health Information and Quality Authority (HIQA) and/or any relevant statutory agency, either personally or on behalf of their organisation; and

— ensure that it be made a criminal offence for any health service worker of any grade, group or category, official within the Department of Health, or official within the HSE, including the Minister for Health and the Director General of the HSE, to:

— knowingly obstruct another in the performance of these statutory duties;

— withhold information about a patient’s medical diagnosis or misdiagnosis;

— provide information to a patient or nearest relative intending to mislead them about such an incident; or

— dishonestly make an untruthful statement to HIQA and/or any relevant statutory agency knowing or believing that they are likely to rely on the statement in the performance of their duties.”

Recent weeks have been difficult for the State, the health service and those working in the health service who do their best, work hard, turn up and do a good job, but all of those difficulties pale into insignificance in comparison with the trauma endured by the victims of the CervicalCheck scandal. In addition to that, there was the recent report into the deaths of babies at Portiuncula and Portlaoise hospitals and the battle by their families to get some information on and accountability for the deaths of their loved ones.

The issues and problems surrounding these cases have served to undermine confidence in our health service. The public knows the Trojan work that is done by staff. From porters to care assistants, GPs, practice nurses, hospital doctors, paediatric nurses, radiographers and so on, the hard work that people do is known despite the bad press that our health service often gets. People know that these staff are hard working, honest and often doing their best in a system that is overmanaged and not accountable enough. Unfortunately, in a small number of cases, a failure to be honest and accountable has cast a dark shadow across the whole of our health service. This is not fair to victims of serious adverse medical incidents who are not told about mistakes or to the majority of the service's staff.

To be clear, this motion and any legislation that comes from it are not an effort to punish healthcare and medical professionals. Rather, the motion is meant to help them and patients. It is an attempt to begin the process of cultural change that is so necessary in our health service.

Seeing as how we are discussing honesty, let us be honest: the experiment with voluntary open disclosure has not exactly been a success. Given the advice on open disclosure that was given to the Taoiseach while he was the Minister for Health, we must be honest and say that it has not worked.

I cannot emphasise enough how mandatory disclosure is a benefit to medical professionals and patients. The global evidence tells the story for itself. The motion calls for the rebuilding of confidence and trust between patients and the healthcare service. Central to that are full disclosure of all relevant information to patients and accountability within the health service.

We all agree that medical professionals should have a legal duty to be open and honest when things go wrong. Many of them agree. However, the duty to disclose should not stop at healthcare professionals. With the CervicalCheck scandal in mind, the failure to disclose goes all the way to the top of the corporate body that is the HSE. That is why our motion calls for the mandatory open disclosure of patient safety incidents if they are known within the HSE or the Department of Health, as was the case with the CervicalCheck scandal.

Recent scandals have given the impression that there is endless protection for those at the top while no such protection exists for those on the front line. The actions or omissions of those at a high level in the HSE or the Department can affect far more patients than the actions or omissions of those on the front line. If we have open disclosure for those on the ward and in the surgery, surely there also needs to be accountability and disclosure among individual executives, hospital CEOs, and members of the HSE and the Department of Health. Organisational and personal interests must never be allowed to outweigh the duty to be honest and open. More importantly, they must never interfere with the right of a patient to get information about his or her own situation.

Transparency is much needed to ensure that all of the information about a patient is made known to him or her. It must be mandatory to ensure that any patient harmed by the provision of a healthcare service is informed of the fact and appropriate remedies offered regardless of whether a complaint has been made or a question asked about them.

This motion is an opportunity to do what the victims of the most recent scandal want us to do, namely, to learn from what has happened and to take steps to ensure that it will never happen again.

See this speech in context