Open disclosure is a stated policy of our health service. There is also a commitment to a duty of candour for health professionals and healthcare organisations. In his latest progress report on the CervicalCheck controversy, however, Dr Gabriel Scally notes that the current open disclosure policy, which he has described as deeply contradictory and unsatisfactory because it does not compel clinicians to disclose failings in the care of patients, has yet to be updated.
The HSE’s 2013 open disclosure policy states that “patients who experience harm as a result of their health care are communicated with in an open, honest, empathic and timely manner and that an apology which is sincere and meaningful is provided.”
However, it failed to prevent hundreds of women with cervical cancer not being told for years of an audit that showed they had received incorrect smear test results.
Meanwhile, the HSE has also refused to disclose the outcome of a process set up to determine whether any of its staff had a case to answer for a series of avoidable baby deaths at Portlaoise hospital.
The process, comprising an investigation by an external review group followed by a HSE disciplinary process, took more than three years to complete.
The Medical Council has already found one doctor, accused of wrongdoing at Portlaoise, guilty on two out of seven charges of professional misconduct. This contrasts with the refusal by the HSE to disclose the outcome of its investigation into the performance of managers in Portlaoise or give details of any disciplinary action taken.
Healthcare will always have adverse outcomes. But patients, healthcare professionals and managers must be left in no doubt that a commitment to candour and openness is at the top of everyone’s agenda when things go wrong.
The recent foot-dragging on disclosure and around legislation for a duty of candour is absolutely unacceptable.