Open disclosure legislation
A prolonged exchange follows on whether open disclosure is voluntary or mandatory, and whether the Government has done enough. The Taoiseach outlines the legislation already passed, says the Civil Liability Act and current guidelines support open disclosure, and argues the aim is to change culture in the health service rather than simply pass a law.
-----am head of the Government which brought in legislation providing for open disclosure. Any number of Ministers for Health or Justice and Equality could have done those things in the past. We are the ones who did it - the Civil Liability (Amendment) Act, the Legal Services Regulation Act-------
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That is voluntary, not mandatory.
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The Government also abolished the board of the HSE.
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The legislation does not provide for mandatory open disclosure.
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------the Mediation Act and the establishment of the patient safety office. I went through the issue of open disclosure yesterday and am happy to do so again and explain it in detail. Open disclosure and duty of candour already form part of the guidelines of the Medical Council for ethical practice by doctors.
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Those are guidelines, not legislation.
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The guidelines are not optional and doctors can be struck off for not following them. Open disclosure has been policy for all HSE staff since 2013 and staff can be disciplined for not following open disclosure. The decision we made - it is in the programme for Government in black and white - is to proceed with voluntary open disclosure for all errors and mandatory open disclosure for those most serious errors, what are called serious reportable errors. That is also explained. The Civil Liability (Amendment) Act supports voluntary open disclosure and puts it on a statutory footing. We enacted that in this Dáil in the past couple of months. I, as Taoiseach, led the Government that did that. People have been talking about that for ten or 20 years but this Government got it done.
Comment on this
The Act will be commenced by June and is designed to create a culture of truth in which doctors, nurses, midwives, scientists and others feel they can make an apology without it being seen as an admission of guilt and admit a mistake without it being used against them. We need to create a culture of truth in the health service where people operate in that space. The next step is to legislate for mandatory open disclosure of serious reportable incidents. We indicated we would do that at the time. But it is a mistake if people believe it is as simple as passing a law.
