Catherine Byrne (Dublin South Central, Fine Gael) | Oireachtas source

I will respond to the debate on behalf of the Minister, Deputy Harris. I echo the Minister, Deputy Harris’s gratitude to Vicky Phelan for speaking out. It cannot have been easy for her or her family to have chosen to take on this task. She has done a great service to the women of Ireland and to the people. The Minister, Deputy Harris, is intent on ensuring her actions will ultimately lead to improvements for all.

As the Minister, Deputy Harris outlined earlier, these matters have raised key issues of trust between patients and clinicians. The Minister is committed to taking any steps available to him that will assist in restoring that trust. I know the officials of the Department of Health share that conviction. In recent years, the Department has brought its commitment to a number of very serious patient safety matters in Portlaoise, Portiuncula and elsewhere in our health service. I emphasise it has been recognised for a number of years that there is a need to improve the safety of our health service. This field of patient safety is a relatively new one to healthcare as a whole. However, in Ireland there have been significant steps taken. A strategy developed a number of years ago to deliver improvements is now being delivered. I note, for example, the creation of the national patient safety office in the Department of Health, which was established in 2016, following the approval by Cabinet of a memo on patient safety in November 2015. The office is charged with delivering a programme of policy and legislative changes to improve the ability of the health service to anticipate, identify, respond to and manage patient safety issues.

Some of the progress which has been made to date includes the general scheme of the patient safety (licensing) Bill which was approved by Government in December 2017 and referred to the Oireachtas. The Bill will ensure the need for all hospitals to have strong clinical governance and patient safety operating frameworks in place in order to be granted and maintain a licence to provide health services. Other progress includes overseeing the commencement of the publication of monthly patient safety statements by all maternity hospitals and maternity units in the State, and hospital patient safety activity reports by public acute hospitals; an annual national healthcare quality reporting system which presents data across a number of quality and safety domains, the fourth report of which will be released in the coming months; progression of the development of a new national patient safety complaints advocacy service, which is expected to commence later this year; quality assurance by the national clinical effectiveness committee of 16 clinical guidelines and one audit, including those on sepsis management and early warning systems for both adults and children; in collaboration with the Department of Agriculture, Food and the Marine, the development of Ireland’s national action plan on antimicrobial resistance 2017 to 2020 which was approved by Government in July 2017; and the establishment in 2017 of the annual national patient experience survey that is administered by HIQA on behalf of the Department of Health, the HSE and HIQA. The second iteration of the survey is under way. Progress also includes the establishment of a patient safety surveillance system, which has also commenced. It will involve interrogation of health data and information from multiple datasets through a health analytic function, in order to produce national patient safety profiles. This will then provide indications of where both challenges and good practice are emerging within the health system in order to direct and inform healthcare quality improvement.

The office is also progressing the new patient safety Bill, which, as noted earlier, will provide for mandatory external notification of serious patient safety incidents to the appropriate regulatory body such as HIQA or the Mental Health Commission. The Minister for Health will designate those incidents which would be included in this measure. It will also provide for mandatory open disclosure of these serious incidents to the patients affected by them; ministerial guidelines for clinical audit; and the extension of the Health Information and Quality Authority’s remit to private hospitals.

In addition, as the House is aware, on Friday last the Government agreed a comprehensive package of health and social care measures to support the 209 women and their families who have been diagnosed with cervical cancer and whose audit result differed from their original smear test. The Government is absolutely committed to ensuring these women and their families receive all of the supports they require. I will not go through the supports because the Minister has already addressed them in his opening statement.

As the House is aware, regulations arising from the Civil Liability (Amendment) Act 2017 will be brought forward shortly. While this will provide the necessary legal protections for health service staff engaging in open disclosure, I emphasise the expectation of all of us that, regardless of whether open disclosure is described as voluntary or mandatory patients should and need to be told about all aspects of their care, including where an error has occurred or harm has been caused. This is entirely in line with the HSE’s national policy on open disclosure and the requirements of Medical Council for doctors. As acknowledged earlier, there is a need now to bring forward legislation to provide for mandatory open disclosure. These provisions will be incorporated into the forthcoming patient safety Bill, which will also provide for mandatory reporting of serious patient safety incidents. The Government has agreed to progress this as a matter of priority. Health services can be made much safer but it is inevitable that things will sometimes go wrong. There have been tremendous advances in health services but we are not always sufficiently clear that a degree of inexactitude and risk continues to be a feature of many areas. Nonetheless, the important action when things go wrong is to be honest and open with patients, to ensure patient and their families are looked after and to examine what improvements need to be implemented. This is the standard which as a health service we must live up to.

As others have stated, I cannot find words that are adequate to address the heartbreak, torment and torture that families are going through. As a woman I am horrified that any person would conceal such crucial information about my health or any other woman's health that would lead to women being exposed to a death sentence. As everyone in the House and around the country in families, homes and communities, all I want is the truth. Under Dr. Gabriel Scally, who will lead the scoping inquiry, the truth will emerge. On behalf of the Minister, I thank everyone who has contributed to the debate this evening. The Government will not oppose the motion.

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