Dáil debates

Tuesday, 15 May 2018

Mandatory Open Disclosure: Motion

 

11:45 pm

Photo of Donnchadh Ó LaoghaireDonnchadh Ó Laoghaire (Cork South Central, Sinn Fein) | Oireachtas source

Thar ceann Shinn Féin, ba mhaith liom buíochas a ghabháil le gach Teachta a ghlac páirt sa díospóireacht seo, ina measc iad siúd a léirigh a gcuid tacaíochta don rún. Ba mhaith liom comhghairdeas a ghabháil leis an Teachta O'Reilly, a chum an rún.

The cases of Vicky Phelan, Emma Mhic Mhathúna, Irene Teap and others have seared the hearts of the nation over the past few weeks. The stories have played out in the media and we have all been touched by them. I concur with Deputy Ó Caoláin that the level of public anger and concern is extraordinary. It has left its mark on the nation. Anyone who heard Emma Mhic Mhathúna's interview on "Morning Ireland" last week will remember it as long as they live. When she said she worried about whether her son would remember her in years to come it stopped people in what they were doing. It was crushing and heartbreaking and there have been many moments like that in the course of this controversy.

On 26 April I took to my feet during Leaders' Questions, not knowing the true scale of what was being discussed that day. In the course of the debate I told the Tánaiste, Deputy Coveney, that it was my understanding that there is a contractual obligation to inform women within four weeks if a problem is identified with a smear test in the ordinary operation of the CervicalCheck programme. If a problem was found in a subsequent review, why did a similar contractual obligation not apply? I asked the Government this 18 days ago but it takes a Sinn Féin motion this evening to ensure that similar protections are in place.

Earlier, the Minister, Deputy Harris, referred to the Madden report, authored by Deirdre Madden in July 2008 and entitled the Report of the Commission on Patient Safety and Quality Assurance. The report contained a number of proposals with a mandatory system for reporting adverse events and open disclosure or a duty of candour were two elements of it which are relevant to this debate. The report highlighted that fear was a significant factor in cases of non-disclosure, whether it was fear of litigation or its repercussions. The reality is that we need to eradicate that fear and we must have a health system that holds patient safety and the right to information about one's treatment at its core, as its top priority.

This motion and any legislation flowing from it would not seek to punitively treat healthcare and medical professionals but would seek to help them, as well as patients. We firmly believe that mandatory disclosure could and would do that. It is vitally important that duty goes far beyond medical professionals. Indeed, it needs to go right to the top, to senior administrators and the corporate body of the HSE, the director general of the HSE, the Minister for Health and so on. It is some of those officials who have emerged with the greatest discredit in this sorry episode.

This issue was raised on a number of occasions and we moved the proposal for mandatory disclosure many years ago. Unfortunately, it was defeated by the Government and Fianna Fáil. I am glad they are supporting it this time and I hope it will be followed through on beyond this motion. The document that has come into the public domain in recent days has cast the HSE in a very poor light. It is a worrying catalogue of decisions to keep the women affected in the dark, so that they are the last ones to know, and fights over who should be responsible for telling them. Concern for the patient was not evident and not the top priority but was completely absent.

When I raised this on Leaders' Questions almost three weeks ago, I stated that the issue potentially related not only to information but also to the quality of testing. It was striking that Dr. David Gibbons, the head of quality assurance at the time resigned in protest at the decision to outsource the process to the US as decided by Mr. Tony O'Brien. I hope the Scally report will cast light on that but I retain significant concerns about the outsourcing and its implications.

There is no doubt but that the manner in which these cases have been handled has left a great deal to be desired. The State has a long and worrying history of dragging people, very often women, through the courts who are fighting for rights that should be self-evident. We need a re-evaluation of the way the State Claims Agency behaves and the way the State deals with mass harm generally. The attempt to force Vicky Phelan to sign a confidentiality agreement was a particular slight and without her bravery and determination we may never have learned of this. Her determinations, that some good would come of this, has been inspirational and I hope some good has come of this. It is a pity it has taken a scandal for attention to be brought back to this issue but let us work to right a wrong and make open disclosure a mandatory process.

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