Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

The Deputy makes some very valid points. There has been too much political point scoring on this issue and a degree of political opportunism. If we genuinely want to put women and patients in general first, we should look for solutions and ask what we can actually do to improve the situation that has gone on for decades. A suite of measures is required. I argue that we are making good progress in implementing it. The Government of Fine Gael, the Independent Alliance and Independents has brought about significant legal reforms in the past two years. For example, we have the Mediation Act 2017 and have seen cases in recent weeks that were settled by mediation to the satisfaction of both sides. We have brought forward the legislation on periodic payment orders to move away from massive settlements of €10 million or €13 million in order that a person's needs can be assessed along the way and that he or she can be given additional compensation if he or she requires it. We also have the Legal Services Regulation Act 2015 which provides in law for pre-action protocols. I am aware that it has not yet been commenced, but we have the legislation which we will commence as soon as possible.

We have the Civil Liability (Amendment) Act 2017 which provides for voluntary open disclosure. That legislation is very important. I know that some people have dismissed it, but it is important because it removes the excuses. It tries to create a culture of truth rather than one of secrecy in which doctors, nurses, midwives and managers will not be afraid that an apology will be used against them in a court and that admitting to a mistake could be used against them as an admission of liability. That is why we brought forward and passed the Civil Liability (Amendment) Act 2017. That is why it will be commenced by June, once we have the guidelines in place. In addition, the Patient Safety Office has been established within the Department of Health. It is a very important measure.

The Deputy is correct - there are two major outstanding issues in the programme for Government which is a five-year programme and we are only entering year three. There are two outstanding issues in the programme for Government that need to be dealt with, the first of which is mandatory reporting of serious reportable incidents. We will do this. The heads of the patient safety Bill have been through the Cabinet and we will get it done in the next couple of months.

I have also initiated the establishment of a working group to look at alternative means of settling medical negligence cases, including a no fault system. Such a system operates in New Zealand and some other countries. There are pluses and minuses and it must be borne in mind that some people do want to ascribe fault and find out who was to blame. Where there is a no fault system in place, it can work quite well and should be considered as an option. We shall establish the working group, as committed to in the programme for Government, under an independent chairperson, which will involve my Department, the Office of the Attorney General, the Department of Justice and Equality, the Department of Health and the Department of Public Expenditure and Reform.

See this speech in context