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Doctors express serious concerns over open disclosure

Doctors expressed serious concerns about proposed legislation on open disclosure during the IMO AGM.

Dean of Professional Development and Practice of Surgical Affairs at the RCSI Prof Sean Tierney, who was speaking at an educational session on the subject ‘Patient Safety Bill and open disclosure’, said there was a danger that the Bill could lead to the “criminalising” of medical error.

In addition to threatening medical professionals, this would also pose a risk to patient safety, according to Prof Tierney.

He recommended that the Bill, which is still being drafted, incorporate the key changes proposed by the Forum of Irish Postgraduate Medical Training Bodies, such as the observation that the HSE open disclosure format is superior to the approach set out in the Bill.

Prof Tierney also said it was important that the responsibility for open disclosure was on the healthcare provider or organisation and not individual practitioners.

Speaking during a panel discussion following the presentation, Chief Clinical Officer with the HSE Dr Colm Henry said penalising individuals was not helpful.

It was Dr Henry’s understanding that the current draft of the legislation is focused on the healthcare provider and not the practitioner.

“After they finish the drafting it will go out to consultation, and certainly our position with the HSE is that anything that demonises individuals will work against, not just the ethos of open disclosure, but will work against patients in them getting access to the information they deserve,” Dr Henry said.

During the panel discussion, Prof Tierney also said the legislation was “very bureaucratic” in relation to the steps required for medical professionals following events where open disclosure is required, which follows the process outlined in the Civil Liabilities Act.

“Hopefully that can still be fixed. But if it doesn’t get fixed it will be very problematic.”

From the floor, Consultant Rheumatologist, Connolly Hospital, Dublin, Prof Trevor Duffy said the legislation is “cock-eyed”.

“Open disclosure is something we as a profession want to feel that we do naturally. We perhaps don’t always do it as well as we should. I think the principal reason we don’t do it is because of the highly litigious environment in Ireland. And the reason I say this legislation is cock-eyed is because it is legislation to protect us from a dysfunctional legal environment. And I think we should be tackling the legal environment first.”

Speaking earlier in the AGM during a debate on a motion regarding the issue, former IMO President and Dr Peadar Gilligan said he would rather see “supported and resourced open disclosure” rather than the “mandatory” model.

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