STATEMENT OF LYNDY CANTILLON 1
RE: HIQA REPORT ON MIDLAND REGIONAL HOSPITAL PORTLAOISE
As someone who practices in the area of medical negligence, I welcome the publication today of the HIQA report into the Midland Regional Hospital Portlaoise. I am particularly pleased to note the style that it is written in. It does not pull its punches. I would agree with the recommendations that have been made. In particular, I welcome the recommendation that there be created an independent Patient Advocacy Service to ensure that patients’ experiences are recorded and investigated appropriately.
For far too long, medical errors in our Hospitals have been covered up. Risk Management Departments are facilitating these. This is providing short-term comfort to the Hospitals, but it is at the expense of the patient.
I would go further, and recommend that there should be introduced a statutory duty of candour. By this I mean that there would be an obligation upon Health Care Professionals (be they Nurses or Doctors), to inform, in a full and frank fashion, the patient of any adverse incident, and the full facts surrounding same. I believe that this duty should be backed up by criminal sanction. In other words, if there was an adverse outcome, that the Health Care Professional would be obligated to come clean and tell the patient what had happened, why it happened, and what were the consequences. If a Health Care Professional fails in their obligation, they should be subject to criminal sanction. I see no downside to this. This was recommended by the Francis Commission in the UK, following an investigation into a hospital misadventure in the UK, similar to what happened in Portlaoise.
It is a shame that it has come to this, where we have to legislate to require Health Professionals to tell the truth.
Minister Varadkar, when he was recently discussing the absence of candour that currently permeates the Doctor / Patient relationship, described such an approach as being akin to a hit and run. I agree. It is time to stop talking about it, and it is time for action. If individual patients and the community at large do not know (because they are not told) of adverse incidents, such events are likely to reoccur. This can be avoided by bringing in a statutory duty of candour, backed up by criminal sanction. The Medical Council currently provide for a duty of candour in their Guidelines. However, there are no statutory sanctions if there is a breach of obligations, and, of course, they do not apply to Hospitals, or Nurses, they apply merely to individual Doctors.
Mandatory reporting has been run on an experimental basis in Hospitals in other countries, such as in the University of Illinois Hospital, Chicago in the USA. There, if a Doctor fails to be candid with a patient, he is subject to fines of up to €100,000. Their experience resulted in a significant increase in the number of reportable incidents to their Risk Management Department. However, the number of claims fell. Patients who had adverse outcomes appreciated, and respected, the fact that they had been dealt with candidly. Of course the patients’ safety also improved, because, once problem areas were identified, they were dealt with. Our current strategy of ‘sweeping it all under the carpet’ has resulted in a rather big mountain developing under the carpet, over which we are all likely to trip, if we have to go to Hospital.
1 Lyndy Cantillon is a Solicitor in the Medical Negligence Department of Cantillons Solicitors, who specialises in medical negligence cases