Seán Crowe (Dublin South West, Sinn Fein) | Oireachtas source

Most fair-minded people do not believe that doctors are infallible and they accept that mistakes are made. They are made every day, as we know, but doctors do not only make mistakes, and they make positive calls in regard to diagnosis in the majority of cases. What is galling for many people and what they do not accept is that the truth behind mistakes being made is denied to them. That is the nub of the issue for many of us in the Opposition.

The real fear I have about the legislation is that we are cementing a system that allows errors and inaccurate readings to be swept away and never disclosed to patients. It locks in a system that was already in place in 2014 when the CervicalCheck smears were missed. Under this Bill, as I read it, there will be no obligation on anyone to disclose that they ever made a mistake. Maybe I am wrong on that, but that is my reading of it. What are survivors saying about the Bill? They are not expressing confidence in it, that is for sure.

The question I am asking is whether we have learned anything. Patients could be left for years not knowing what is wrong with them or why they are feeling unwell. I can talk about my own situation. I knew at one stage that I was not well. I went into the medical system and I was told that clear was white, cancer was black and, in my situation, I was grey. For many years, that is what I was told by the system. I went for an MRI at one time and I was told not to worry and to come back in 12 months. I still knew there was something wrong and I knew my own body, so I went to try to get a second opinion. I went for another biopsy. When I was getting the second biopsy, which I did not particularly want as it was very uncomfortable, I was told that I would not get a second opinion. Lo and behold, after that biopsy it turned out I had cancer, and that is when my story began. Mistakes were made along the road but I do not think anyone ever came to me and said they made a mistake on that. Clearly, the MRI was read wrongly and if I had accepted that, I probably would not be here to speak tonight. Mistakes are made.

The waiting list crisis is such that if someone has a misread or erroneous scan, it will take months or even years to secure another one. I can give an example of someone I know who was in the hospital system. He had worked all his life. He had what they called a broken back and he was in extreme pain and on morphine-based medication which he tried to come off. He learned two years later that he was supposed to get pain injections and due to an oversight, he never got them. Again, mistakes are made.

Half of cancer treatment is learning to live with cancer, the effects on the body and how to fight the worst of its effects. The big journey for a lot of people is getting that news and how they respond. It cannot be said often enough that patients need absolute candour from the medical professionals who are in charge of their care. Real harm is done in the absence of candour. The question we are asking is why we are going down this path. The system does protect itself. It is hard to get one doctor or clinician to go against another, as we know. In many cases, people have to go to Britain or abroad to get one to give evidence against the other, and there is a cost involved in that.

We heard this week of the fear that some clinicians have about litigation and being sued, and we know how much the State Claims Agency pays out each year. The question is whether we are bound by that. Is that the reason we are not opting for absolute candour? As I said, the system protects itself. The system can afford the best of lawyers. There is no balance in regard to the people taking those cases because the power is on the side of the State. Is it the case that candour has been put on the back burner in regard to this legislation? If so, we are forgetting that patients’ needs must also come first. I do not understand how this Bill serves those needs. It may be better than nothing but there is a great deal that can be done to improve it. That is why we are all here tonight.

The House is split on this issue. I believe many on our side of the House and on the Minister’s side share these concerns. While we might say patients can always ask for a review, why is the burden placed on the cancer patient to ask the questions of their doctor or consultant? When many people hear they have cancer, they cannot think of anything else and their mind goes blank. When people are landed with a cancer diagnosis, who is going to be thinking about a Part 5 review or anonymous audits? Patients need to have full confidence in the medical system. They need to have faith in our doctors, nurses and consultants.

I do not believe the Bill gives anyone confidence. What has changed? That is the question hanging over us tonight. What have we learned? I am sure there are people at home watching these proceedings who are asking the same. It is a fair question.

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