Chris Andrews (Dublin Bay South, Sinn Fein) | Oireachtas source

I certainly believe the Minister is working exceptionally hard. Every Minister works hard but the Minister for Health goes above and beyond in his commitment. I support the Bill. There are good things in it and it is an important Bill. However, it will not build trust in the health system, where trust is in short supply. It will not build trust in the cancer screening process or the CervicalCheck system. It will not build trust in any of those. As has been said previously, we have no issues with what is in the Bill or the amendments but we have an issue with the process and the absence of a statutory duty of candour in the Bill. There has to be transparency. Patients have to be at the centre of this legislation, and the health system. Patients are vulnerable by their very nature and they need to be supported. Patient rights are a crucial human right. Patient rights are essential pillars in providing good healthcare and promoting good medical practices.

A core element of patient care is to allowing patients to make decisions about their own care. To do that, they need all the information, whether it is good or bad, and they should not have to request that. There needs to be more clarity around the process. Patients are vulnerable; they are not well. They may have little family support. In my experience, particularly recently, I have found that medical practitioners can be quite dismissive of patients, particularly older patients. I have a letter from a woman who wrote to me who is in her mid-80s. In the late 1970s she went for a tubal ligation in a Munster hospital; one would imagine that this would have been a pretty standard operation. A number of years later, she found out that menopause was hastened due to the operation. She found out when she got the menopause that she had a" full ovary removal" in her words. She is still traumatised by it. At the time, she got on with it. She had young children and was under a lot of pressure. Even now, when she reflects on her life, she is traumatised by it. The fact that this happened without her knowledge was devastating and had a huge negative impact on her life. She wants to know what happened; she is still not sure. She is looking for that information.

This is replicated throughout the health system, which is why confidence in it is low. This lady was let down by the health system. She should have been told automatically. She should not have possibly found out by mistake years later. It is unacceptable. The Bill is being fast-tracked. I accept there is a time and place to fast-track legislation but this is not one of those Bills. We need to ensure that patient safety and information are prioritised. This is an important Bill. It does not place an obligation on a provider or clinician to inform a patient of the right to a Part 5 review at the point of diagnosis. This can and needs to be done; it is essential. If we are going to rebuild confidence in the health system and the cervical cancer screening system, this information must be automatic and there must be a process by which people can get information. It does not matter how this or any woman discovers that there was a mistake or a procedure was carried out without their knowledge. Patients need to be told. It is completely unacceptable. In the words of a survivor, this legislation would have made sure that "nobody would have found out what was going on with CervicalCheck".

The bottom line is that this is not giving everyone the right to information, unless they seek it. It does not place an obligation on a clinician or a service provider to inform a patient when an error, mistake or inaccuracy is discovered. Whether that is minor, within the margin of error or a severely negligent misreading, there is no obligation on anybody to tell anyone that they found something wrong. This is self-regulation. It will not work in the health system, which has been proven in the past. Self-regulation generally does not work and it certainly does not work in the health system. The right to information needs to be introduced.

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