Marc MacSharry (Sligo-Leitrim, Fianna Fail) | Oireachtas source

As we have learned, the HSE's 300-page guidance document on the open disclosure policy is honoured more in the breach than in the observance. It is clear that open disclosure is a selective policy that is applied when it suits and abandoned when it does not suit. I want to say a couple of things. The five principles of care of the Royal College of Obstetricians and Gynaecologists were the subject of a question in an exam taken by UCC medical students recently. The first of the five principles, to which we all aspire, is that "women should be at the centre of their own care". I suggest the way we operate in this country is that women should be at the centre of their own care as long as it does not pose any threat to the establishment or to the system. We have seen from the HSE and from the management of this issue that as a collective, these organisations, which have some very fine individuals working in them, serve the system rather than the people or the patient. We have heard about and seen the documentation that has been referred to by many Deputies, including Deputy Donnelly. One of the most shocking things we have learned about is the existence of pro forma letters. Other Deputies may have mentioned them before I came to the Chamber. These letters were drafted in the same way that one drafts a word document with little boxes to suggest that this or that might be spelled differently. A box in the section of the letters dealing with open disclosure stated that this should be deleted if the person in question was deceased. That is a damning indictment of the situation.

I have to say that in recent days, the Minister for Health and the Taoiseach have been excellent commentators on events as they have been happening. However, I have seen no leadership and I still see no leadership. Where is the open disclosure? I acknowledge that we got some documents today. It has been suggested that there are 40 million documents. It seems to me from looking at the documents that have been provided that they have been very selectively chosen. There are some things in them. I think there are many more documents we have not yet seen. The Minister has said he knew nothing about this situation, just as the Taoiseach has said he knew nothing about it when he was Minister for Health. I am sad to say I simply do not believe them. It is simply not credible. I understand there are weekly or monthly management meetings between the assistant secretaries for acute hospitals, the Secretary General and the Minister. The Taoiseach would have attended these meetings when he was Minister for Health. Are there minutes for those meetings? If so, why were they not included in the information that was released to us today? They should have been included.

I would like to ask a question about the staff of the Department at assistant secretary or Secretary General level, and down the chain of command as defined under section 5 of the health Act 2013. Does that legislation endow plenipotentiary status on the staff in question to act in the names of the Minister and the Taoiseach without running it by the Minister first? The Minister might not have had the memo in his hand, but I find it incredible that he was not advised of what was in it and what was going on. While I cannot prove it yet, I have no doubt that the health committee and the Committee of Public Accounts will find out that this is the case. I ask the Minister to be much more forthcoming with the facts and not to drip-feed them. I am hugely sceptical regarding the reason for the selective leak from the Cabinet of Dr. Scally's comment that the committees are disruptive to his work. I am equally sceptical regarding the Taoiseach's remark last week that the Committee of Public Accounts is not a place for this. Where would we be without the Committee of Public Accounts? I will conclude on that point as I do not want to take any more of my colleagues' time.

See this speech in context