Pa Daly (Kerry, Sinn Fein) | Oireachtas source

Níl fadhb leis an mBille ná leis na leasuithe seo. Tá fadhb leis an próiseas áfach agus leis an easpa dualgais dháiríre atá ann. Níl aon dualgas ar dhochtúirí a rá láithreach go bhfuil ceart ag an othar i leith athbhreithniú Pháirt 5 maidir leis an diagnóis. Ba chóir go mbeadh córas tríd an chlárlann ailse a thugann eolas do dhaoine go bhfuil an ceart acu ag an bpointe seo. Ní thugann sé cumhachtaí don Aire. Léiríonn sé conas an t-athbhreithniú a dhéanamh. Tá sé cosúil le self-regulation. Ní chuireann sé an sampla ailse san áireamh leis an t-othar a chur ar an eolas agus ná bac le conas nó cathain atá an othar ag fáil amach. Ba chóir go mbeadh dualgas dáiríre chun an disclosure sin a dhéanamh mar tá an ceart ag daoine a fháil amach. Is ceart agus is cóir é sin. Dá mbeadh an reachtaíocht seo ann in 2014, bheadh a fhios ag na hothair, na mná sin, an toradh a bhí acu.

We do not have any issue with what is in the Bill. We do not have any issue with the amendments either. Thanks be to God, there is information on other issues going through the system at present, for example through trolley count. I recently dealt with a case in Tralee involving a woman in her late 70s from the north of the county. Families are stressed because there is no isolation room in University Hospital Kerry. This woman was left on a trolley for days. We were able to do something about that because the information from trolley count was there.

We have an issue with the process and with the absence of any statutory duty of candour in the Bill. There is no obligation on a provider or clinician to inform a patient about the right to the Part 5 review. There should be a system through the cancer registry that notifies patients of their right. Ba chóir go mbeadh an ceart ag gach éinne gach eolas a bheith acu ar an gcóras sin. We do not have the discovery of a discordant, erroneous or otherwise inaccurate reading of the cancer screening sample as a notifiable incident. When the system was changed and the outsourcing happened it was Caoimhghín Ó Caoláin, almost alone, who pointed out that this would cause problems. He has not been given enough credit for his foresight on that occasion. If he had been listened to at the time, maybe many of the incidents would not have happened.

There should be a duty of candour and to make a disclosure. It is important to make this point again and again because the patient has the right to know. If this legislation about the anonymous programmatic audit was in place eight years ago, all those women would have been informed of the reading and would have been able to see it in their files. They would never have discovered it until they asked for a review. In the words of another, this legislation would have made sure that nobody would have found out what was going on with CervicalCheck, since people were not given the right to information unless they sought it.

Unfortunately, the Bill does not place an obligation on a clinician or service provider to inform a patient when the error or inaccuracy is discovered. No matter what type of information it is or how severe the misreading is, there is no obligation to tell anyone that something wrong was found. The Government is forgetting that patients are at the heart of this. We must protect the viability of the screening services. There will be about 250,000 screenings this year, which is welcome. We all want to see this grow but we must protect the rights of patients. We must have a national health service, like in England, which is free at the point of access. In the meantime, we must improve and expand medical card access to cover home care and palliative care.

When it comes to who is responsible for a person getting the truth, the burden should not be placed on the person who has cancer to ask. We must acknowledge the mistakes by clinicians and doctors in the past and not stand behind an approach which puts a responsibility on the patient to take the steps while placing no obligation, except after a request, on any clinician to make a proactive, open disclosure, whether about cancer screening or something else. One specialist who provides counselling said they see a State that pays lip service to acknowledge its mistake and that systematic failures are blocking and resistant to change, causing ongoing heartache.

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