Seán Kyne (Fine Gael) | Oireachtas source

I welcome the Minister and acknowledge his interest and dedication in engaging with the concerns the Opposition has raised during the course of debates on this legislation. It is always a testimony to a good Minister that he or she is willing to accept that things can be improved and to engage with issues that are raised in the Houses of the Oireachtas.I also acknowledge Vicky Phelan and all the campaigners who have advocated for and on behalf of the Bill and those in the Oireachtas, including Deputy Kelly and others across the political spectrum, who supported and pushed for this important legislation.

It goes without saying open disclosure in all aspects of medical care is important. Open disclosure is also important to all aspects of other types of engagement with the State. I acknowledge the amendments the Minister has tabled to enhance the Bill. The expansion of HIQA powers to cover private hospitals is welcome. I have no reason to believe that private hospitals are other than of the highest standard but where issues arise, it is important HIQA can and does have the powers to investigate. Mandatory disclosure of patient-requested reviews is also very important, as is the patient's right to a full look-back at a review before and after screening. These are all very important parts of the Bill.

There are obligations on the health practitioner, when he or she has formed the opinion that a notifiable incident has occurred, to inform the health service provider of it and, under section 7, which, as the Minister said, is an important section, establish the obligation of mandatory open disclosure. "Notifiable incident" relates to those issues listed under Schedule 1, in addition to the regulations that will be made under section 8. As others said, Schedule 1 relates to obligations where a fatality has, unfortunately, occurred across a wide range of areas. Some 12 notifiable incidents are listed under that Schedule, ranging from surgery "performed on the wrong patient ... [or] ... on the wrong site ... [or performed on a patient] ... resulting in an unintended and unanticipated death which did not arise from, or was a consequence of, an illness, or an underlying condition ... Unintended retention of a foreign object in a patient after surgery resulting in an unanticipated death ... Any unintended and unanticipated death occurring in an otherwise healthy patient undergoing elective surgery in any place or premises in which a health services provider provides a health service" and a series of other provisions. These are all comprehensive in respect of patients who have passed away. Section 8 concerns what the Minister may prescribe as a notifiable incident and includes:

an incident which has occurred in the course of the provision of a health service; ... an incident which, having regard to developments in clinical practice, healthcare and patient safety, may occur; ... an incident which, having regard to such developments internationally, has occurred or may occur. Regulations under this section shall only be made where the Minister is satisfied that ... the incident was or would be an unanticipated and unintended outcome of the health service provided.

All these are important in ensuring full confidence in the provision of healthcare and, where some patients may be incapacitated, that their next of kin or those responsible for them have the same rights to full disclosure. That is also highly important.

I acknowledge the work that has gone into the Bill. The Minister's openness to engagement with campaigning groups and individuals, their families, and people who have suffered and been bereaved in the past regarding issues of healthcare, and reacting to those requests, is testament to a Minister who is engaging and listening on a particular issue. I thank him for that.