James Browne (Wexford, Fianna Fail) | Oireachtas source

I welcome the very important Patient Safety (Notifiable Patient Safety Incidents) Bill 2019 or, to put it in layperson's terms, the mandatory open disclosure Bill. It is long overdue but it is now very welcome. I am glad to see that patients will be entitled to get the full facts about their medical tests, conditions and medical information. They need to be able to trust that they will get that information.

The proposed legislation represents a cultural change for the hospital, medical and clinical sectors. It is also a legal change. There needs to be leadership within the HSE to drive this change. Other policies and laws which were changed in the past were not implemented in the manner they should have been.

As Deputy Donnelly stated, in 2016 the then Minister for Health, the Taoiseach, Deputy Varadkar, stated that he was opposed to mandatory reporting. In 2012, the national healthcare charter was published and contained open disclosure guidelines, but it was never properly or fully implemented.

The Bill aims to ensure that the health service learns from its mistakes and errors in order to prevent them from being repeated. It is also about the right of patients to know about their own bodies, medical conditions and bodily integrity. The World Health Organization has stated that one in ten hospital patients experiences harm, but at least 50% of these cases are preventable.

It is questionable whether we would be introducing mandatory open disclosure were it not for the CervicalCheck scandal. In May 2018, the emergence of a failure to disclose to affected women the results of a cervical screening audit led to widespread and very understandable anger. Women had been badly let down. In his report, Dr. Gabriel Scally made clear his view that the system for dealing with medical errors in Ireland was "not fit for purpose". Dr. Scally went on to say that patients in particular were left with no other option but to pursue legal action "to find out the truth of what went wrong". "Until that changes", he added, "we're not going anywhere". Litigation is the only option. As a barrister, I have represented a number of patients in medical negligence cases. I know what it is like, as a member of a small legal team, to go up against the might of the legal apparatus of the HSE. I have seen cases where people who had suffered serious medical negligence in heartbreaking and stressful circumstances were willing to settle their case early because they were simply unable to deal with the stress of a court case.

Yesterday, I said in a discussion on the perjury Bill that the vast majority of people in this country never go to court. The vast majority of those who do go to court find it extremely stressful and do not want to be there. To face the might of those legal teams is quite phenomenal.

Dr. Scally went on to say the current system is deeply flawed. The legal system takes an error and converts it into an injustice and then converts that into a financial sum. Even then, it is for the lucky few who are able to withstand the might of the HSE legal system and can afford their own lawyers or can get lawyers willing to take on the case on a no foal, no fee basis.

Dr. Scally also said the failure to inform patients about errors in their treatment in CervicalCheck were catastrophic and the catastrophe came about when rushed and botched attempts were made to disclose, as some of those disclosures were made in an appalling way.

Today is the UN's universal health coverage day and it calls for all citizens to be provided with affordable and quality healthcare. It is very apt that the Bill is being discussed today because it is about quality healthcare. We cannot have quality healthcare without patients being informed about the healthcare they are receiving.

I want to touch on a very particular aspect that is not specifically dealt with in the Bill, as far as I can see, but it is an important matter in terms of disclosure. We have a record in recent years of appointing unqualified non-specialist doctors to work as consultants who are not trained to take up these roles. They have not taken on leadership training and they are not on the Medical Council's specialist register but they are treating patients who are not aware that the people holding themselves out as consultants are not qualified. The vast majority of patients simply take a consultant at his or her word. When they hear someone is a consultant they believe that person has been through all of the necessary training. Many people would be very surprised, very hurt and very concerned if they realised the consultant treating them was not on the specialist register and had not completed specialist training. As a senior nurse said to me, one day a junior doctor needs a nurse to help him or her put a needle into an arm and the next day that doctor is leading an entire medical team in a hospital. This is simply not acceptable. This is a real patient safety issue. Where a non-specialist doctor is acting as a consultant is it not, prima facie, a safety issue? Under one interpretation of the Bill should those consultants who are not on the specialist register be compelled to inform the patient of this? In December 2017, the Minister said this probably should be the case and I would like to hear his views on it.

I welcome the Bill. It is overdue and I am glad to see it is now happening.

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