Michael Harty (Clare, Independent) | Oireachtas source

I am sharing time with Deputy Danny Healy-Rae.

Open disclosure, duty of candour or apology laws all mean the same thing. They are about the patient and trust. That is the fundamental issue that underpins these laws. They are not about the institutions, the doctors or the process. They are fundamentally about open disclosure to the patient if an adverse event has occurred. That is the critical element. The process should never trump the patient. The hospital or institution should never trump the patient.

The definition of open disclosure covers the transparent sharing of information of an adverse event with a patient. It is not rocket science. It is simple. Safeguards are built into the legislation to ensure that it operates without liability. The medical professional does not admit that he or she was at fault but admits that something has gone wrong. That issue is fundamental to what we are speaking about tonight.

Patients have a right to know. As the Minister said, rightly, voluntary does not mean optional. That is crucial. The Joint Committee on Health looked at open disclosure in two sittings in the context of the Civil Liability (Amendment) Bill. The committee came up with the recommendation that it should be voluntary. There were good reasons for that but of course, voluntary does not mean optional. The purpose of open disclosure is to foster a culture of openness. It is ethical and that is underpinned by the requirements of the Medical Council in its 2016 guidelines. It is absolutely a requirement to be ethical and open with patients. It improves patient safety and that is also an important issue. If there is an error, we need to review it, look back and see how that error can be prevented in future. It is also a learning opportunity for health professionals. Trust and openness are critical to what we are speaking about tonight. In fact, rather than increasing litigation, I believe open disclosure reduces litigation. Being open with patients is important because often all they want to know is that something went wrong.

While many of them are not seeking retribution, they need to know that something went wrong. Open disclosure in the case of CervicalCheck should have started when there was a look-back at the previous smear. Patients should have been informed that they had cancer, their previous smear would be subject to a look-back and they would be informed of its result. That was the fundamental issue in this case.

It is now proposed to introduce mandatory open disclosure. This may well be the approach we must take because voluntary open disclosure will not impose a requirement on health care institutions or the medical and nursing professions to admit something went wrong. As such, open disclosure must be mandatory. In the case of CervicalCheck, the process trumped the patient, which is wrong.

This controversy has again brought into sharp focus the recommendations in the Sláintecare report. The Taoiseach spoke this morning of reinstituting the board of the Health Service Executive. He also spoke of accountability, governance and answerability, all of which are embedded in the Sláintecare report. One year after it was delivered, the Minister has not yet responded to the Sláintecare report. None of the issues to which I alluded requires money. Only a change in legislation is required to underpin open disclosure, accountability and governance, from which everything else flows. The Minister must take the Sláintecare report seriously and respond to it positively as soon as possible.

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