Maire Devine (Sinn Fein) | Oireachtas source

I welcome the Minister to the House. It is an apt time to take this Bill. I am delighted to open the Second Stage debate. This Bill is about being transparent in healthcare, being protected by law and not being protected by the idea of doing something voluntarily, which is unenforceable. We know that to be the case now. More than that, this Bill is about delivering for the men, women, and children who have suffered as the result of medical mistakes which occurred completely unintentionally, but nevertheless happened and caused much harm and heartbreak.

We should keep those people in mind as we debate this Bill. We should think, especially, of those who died as a result of medical mistakes. I am sure we can all remember some of them. The recent reports into the baby deaths at the Midland Regional Hospital Portlaoise and Portiuncula Hospital are to the forefront of my mind this evening. The practice of keeping quiet when something goes wrong is often prevalent in our medical culture and only a statutory duty of candour will address this. That is why we are bringing forward this legislation. The decision by the Government last year, supported by a Fianna Fáil abstention, to make open disclosures voluntary was a grave mistake. They now know how much of a grave mistake that was.

Sinn Féin has always opposed making open disclosure a voluntary concept. Along with independent Members and others in the Lower House, we voted to make it mandatory on 8 November 2017 on Report Stage of the Civil Liability (Amendment) Bill 2017. We were defeated that day, but this Bill seeks to right that wrong. Most recently, the fallout from the CervicalCheck scandal has shown the limitations of a process of voluntary open disclosure. I welcome that the need for mandatory open disclosure with legislative underpinning is now accepted and the passing last month of a Sinn Féin Private Members’ motion in the Dáil calling for mandatory open disclosure. I hope this House will go one better and begin the legislative process to make this a reality.

For open disclosure to work, it must be mandatory and legally binding. As an example, when we passed the Children First Act 2015, we made it mandatory to report child neglect and abuse. That only came into being on 11 December 2017. We know that is what is needed. We know to protect our children but now we have to protect our health, and the health of all the people on this island, when mistakes are made. Mandatory disclosure is the only show in town. This Bill addresses the problems surrounding the current system and amends the Civil Liability (Amendment) Act 2017 to provide for a mandatory system of open disclosure in our health system. It provides for mandatory open disclosure of a patient safety incident, the introduction of a mandatory requirement that the patient be provided with any and all additional information which later becomes available and, for that purpose, to amend the Civil Liability (Amendment) Act 2017 and to provide for related matters.

Recent scandals have given the impression that there is endless protection for those at the top while no such protection exists for those at the coalface. The actions or omissions of those at a high level in the Health Service Executive, HSE, or the Department of Health can affect more patients than the actions or omissions of those on the front line. We have open disclosure for those on the ward and in the surgery. Surely, there also needs to be accountability and disclosure among individual executives, hospital CEOs, and members of the HSE and the Department of Health. It is a healthy proposition.

I reiterate what I say so often in this House and it comes from my experience. Public participation at all levels of healthcare is vital. If we have more public participation in the top tiers and at the top tables of the HSE, strategy and steering groups, accountability will follow. I ask the Minister to consider this seriously as we deal with the fallout from yet another scandal. The Government is resistant to this Bill. There is a suite of excuses for not supporting it. The Minister might attempt to argue that the current legislation does not allow for voluntary disclosure and that the best practice of mandatory disclosure is being followed, but we have evidence from recent scandals that this is far from the case.

The Minister may reference the recommendations regarding mandatory reporting arising from the Commission on Patient Safety and Quality Assurance or the Madden report. This is good policy, but it does not go far enough because when we talk to the HSE at the various Oireachtas committees, everything has changed. If the Government is wary of voluntary decisions around disclosure, and it is something it denies is happening, then there is no harm in strengthening the legislation to take away the risk. This is about the culture of the HSE and legislation such as this is the strongest way to change that and provide protection and honesty. The Minister may also reference the recent approval of legislative provisions to provide for mandatory open disclosure through the development of the general scheme of a patient safety Bill. That is with a view to having it brought to the Government for consideration in early July 2018. The Minister stated that it is hoped that it will be possible to commence drafting shortly thereafter.However, that is too late. It is early July now and we do not have any time to waste. The Minister cannot tell Vicky Phelan to wait and he cannot tell Emma Mhic Mhathúna to wait. They and many others have lost so much.

The Minister should allow this Bill to proceed to Committee Stage today in order that we can make the changes necessary as soon as possible. It is the right thing to do and I know the Minister knows that too. We cannot suffer in the meantime but many will suffer if the Minister and his Government do not take this opportunity now. I will quote from what the Minister said on this issue from the Dáil last month: “I want to be clear that the Government is committed to progressing, as a matter of urgency, legislation to provide for mandatory open disclosure for patients and mandatory reporting of serious incidents to the relevant regulator”. This has not happened but this Bill will make it happen. It will be a continuation of our journey to honesty and openness. I therefore look forward to this Bill proceeding to Committee Stage with support from all sides of the House.