Last week I spoke in this House about Jessica Sheedy, who died in University Hospital Limerick, UHL, and the case of Dr. Lal, who admitted to 13 counts of misconduct. That has been dealt with on its own. I see the Minister for justice is here as well. I also need his help on this. Today I want to talk to the Taoiseach and the Minister about the hospital management, who used non-disclosure agreements, NDAs, to silence people and to avoid accountability. I am aware of people in UHL who came forward with concerns well prior to Jessica Sheedy's operation. Those people were victimised, their careers would not excel and they might have to look for references. They were used to sign non-disclosure agreements. This is wrong.

Under the Maternity Protection, Employment Equality and Preservation of Certain Records Act 2024, NDAs are void when victimisation occurs, including harassment, sexual harassment or discrimination in relation to employment. Are those people who came forward in whatever hospital around this country protected under the 2024 Act where patients and the public were put at risk and NDAs were used to withhold information from inquiries and investigations? Why were the public and patients put at risk under people who were not competent to do their job? I have full respect for people in all parts of the medical profession who are competent at doing their job. Sometimes a mistake happens, but you learn from the mistake; you do not cover it up. Eight years it took to get the information out, for somebody to admit guilt - eight years. How many more non-disclosure agreements have been signed to prevent the course of justice? That is what I want to know. Will these people be fully protected under this Act if they come forward now? I do not want to hear, like others say, "You are 100% protected". We have heard that before where whistleblowers were involved. This time I need to know from the Government and I need an official response.

I thank the Deputy for raising the issue. Without question, there should be no cover-up in respect of any medical misadventure, any error or any wrongdoing. Hospitals and the medical community should own up immediately. That is good practice. It is unacceptable that for decades many families have had to go long periods endeavouring to find out the full truth in respect of what happened to their loved ones.

The Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023, landmark patient safety legislation, was commenced in September 2024. It provides a legislative framework for a number of important patient safety issues, including the mandatory open disclosure of a list of specified serious patient safety incidents that must be disclosed to the patient and to their family. It was passed by both Houses and signed by the President in May 2023. It is to ensure that families and patients have access to comprehensive and timely information.

It is achieved by an open disclosure mechanism in the Act. It contributes to embedding a culture whereby clinicians in the health service as a whole engage openly, transparently and compassionately with patients and their families. The requirements apply to all healthcare bodies, including the HSE, all section 38 and section 39 organisations, private hospitals and private health and social care providers, such as GPs, dentists and pharmacists. The Act contains a provision by which the Minister can add to this list via regulation. Patients and their families must have access, as I have said, to comprehensive and timely information, including an apology where appropriate.

We have seen good examples recently from the chief executive officer, Bernard Gloster, who in a number of cases has changed the culture, it would appear to me, come forward, identified clear faults, and apologised himself publicly on behalf of the HSE in respect of significant wrongdoing and errors that have been made. The HSE has updated its national open disclosure policy. The Department and the HSE, in consultation with stakeholders, are currently finalising a revised HSE incident management framework that sets out how serious incidents are reviewed and learned from.

I am told that the Act was commenced, other than section 68. I do not have the specifics around that section with me, but that is what I have been told and the information I have here. The implementation of the Clarke report into the tragic death of Aoife Johnston at University Hospital Limerick also brought forward a number of significant improvements, supporting the implementation of key initiatives, such as the framework for safe nurse staffing and skill mix, the emergency medicine early warning system, updated sepsis guidelines and a new national quality improvement framework for emergency department triage and local escalation plans.

I thank the Taoiseach. He can come back in. I call Deputy O’Donoghue.

Disciplinary action was also initiated in respect of that.

Management actions caused serious bodily harm and, in some cases, caused death. If there has been eight years of withholding information here, how many other cases like this have there been? The Taoiseach mentioned Aoife Johnston, God rest her soul. We have Jessica Sheedy as well. Management withheld information, had non-disclosure agreements signed and spent eight years with one case alone. That is obstructing the course of justice. This is my problem. They obstructed the course of justice. People and patients were put in harm’s way, and some people died.

If this was outside the remit of the health service, the Minister, Deputy Jim O’Callaghan, would have me up the steps and have me in prison now for obstruction of justice and serious bodily harm. You would be put in prison if you had done this. We have management that are still in place in this hospital-----

I thank the Deputy. I call the Taoiseach.

-----who have covered up information that could have helped the learning in the hospital and saved lives, rather than covering it up. That is what I need to try to make sure of.

Historically, it is fair to say the cultural norm in medicine was not to disclose openly. Over time, that has changed, to be honest to all involved, but we still have a distance to go. We learn through error and medicine is not failure-proof, although the more you create a systemic approach to medicine, the less error you have. The cult of the miracle worker or of the brilliant person was always a challenge and a cultural challenge within health. It is a system-wide approach that reduces adverse incidents, bad practice and poor practice. We must have a systemic approach and the culture has to be all about that. In most of the training colleges now, it is all about that, with multidisciplinary teams working together and every person on that team being an important cog in the wheel to make sure the surgery or treatment of a condition goes properly. Open disclosure is the key to that. Non-disclosure agreements have no part in that.