Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

Two months have been lost on this and, hopefully, it was worth that delay. I want to welcome the fact that agreement was reached with the 221+ group last week around clarification on the notifications that would be provided to people to make them aware of the option of the Part 5 review. While that was provided for in the original legislation, it is good that there is additional clarity being brought to that about the points along the way when that information is to be provided to people who availed of the screening programmes. That is a good thing. On the process that is to be followed, it is good that there will be further consultation with the 221+ group and that there will be a review of the legislation in two years. All that is positive and I pay tribute to both the officials in the Department who have been helpful over recent months on all aspects of what is quite a complex Bill and the 221+ group, who has been active on this and who have engaged positively and constructively with the Department.

We just received the Minister's amendment this afternoon. I do not know why it was late as I understand that agreement had been reached a while ago on it but it is welcome nonetheless and I am happy to support it when it comes for decision. I will make some other points on this that arise from this group of amendments. I am seriously concerned that the recommendations made by Dr. Scally have not been taken on board fully. He did an excellent job over an extended period. His latest report that was published in October, and many from this House and others were at that briefing, identified a number of issues in particular. The key points he made at the press conference was to urge the need for a duty of candour on healthcare workers and organisations; the Bill is too narrow in the circumstances for mandatory open disclosure; it deals with the more serious end of errors that are made; and nearly all those circumstances in the Schedule relate to death so there is a whole range of other circumstances that could arise for which it is important that there be a duty of candour. In particular, given the issue before us of cancer screening, I am concerned that the points Dr. Scally made were not taken on board. Equally, he recognised that the Government amendments may deal with shortcomings in the Bill but he called for an amendment to establish a clinical complaints system. This would provide patients with answers to their concerns and remove most of the need for patients to take legal action. That is an important recommendation. It is true that, particularly in light of two high-profile cases in the news yesterday, there are significant lessons to be learned about the practice of the HSE and the State generally in not addressing serious errors that are made and putting families and individuals through the ringer over an extended period, leaving people who need financial support because of the need to provide services for a person with a disability as a result of negligence or errors and leaving a person for many years in some cases without that kind of financial support. There is the financial aspect of that and the further traumatisation and deprivation of people who have been affected by serious incidents where they have to do without services and supports that they need because of the long delay in addressing these cases. From the point of view of the individuals and families, there is the additional trauma, worry, concern and time taken up for the families. We saw an example of that yesterday. I am concerned that this issue has not been addressed in the context of this legislation. It is an associated issue to CervicalCheck but something has to be done about the kind of legal advice that is given to the Government to fight people all the way - we had a discussion about this last week, and it is continuing, around historical cases - when what people essentially want to know is why a serious incident happened, what is going to be done to prevent such incidents recurring and amends have to be made with financial compensation. That is one lesson out of this.

The other thing I wish to raise is the limited scope of the Bill. That is problematic. The Bill only specifies the mandatory requirements for open disclosure in the case of 13 categories. I tabled an amendment which was ruled out of order. I cannot understand why that is the case. Dr. Scally made it clear that the vast majority of the circumstances listed in the Schedule - 12 out of 13 - relate only to circumstances where a person dies. There is a range of other circumstances where there needs to be open disclosure. I cannot for the life of me understand why my amendments were ruled out of order. It should not have happened. What is the point of commissioning a person of the status of Dr. Scally, who is held in such regard by everybody, when some of his key recommendations are being ignored?

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