Patient Safety Bill 'quite narrow' in scope, Dr Gabriel Scally says

Vivienne Clarke

Dr Gabriel Scally has said the Patient Safety Bill is “really quite narrow” and there remained the need to provide patients with the right to make a complaint about their clinical treatment.

The legislation, which will establish mandatory open disclosure in the healthcare system, passed through the Dáil on Wednesday evening.

The Patient Safety Bill will now go to the Seanad and is then expected to be signed into law by President Michael D Higgins.

An amendment was brought forward by the Minister for Health Stephen Donnelly which will make it mandatory for patients to be informed of their right to patient-requested reviews following representations from the 221+ CervicalCheck support group.

Mr Donnelly said the Bill was brought forward as a result of Vicky Phelan and others who had taken a “brave and difficult stance”.

Dr Scally, who led the inquiry into the CervicalCheck scandal, said the Bill was a move forward in general, but it was a very complex piece of legislation and instances of open disclosure remained limited.

Dr Scally told RTÉ radio’s Today with Claire Byrne that while the Minister could add other instances where open disclosure should apply, at present it was when patients died.

“I think there is a need for real reform of the system. I think that's the point. One of my recommendations, a very clear recommendation, was that there should be a duty of candour on all health care professionals, and that is that a health care professional should tell the truth to patients, particularly when something goes wrong, they should tell the truth to patients. And that hasn't been implemented. And I really think it should be.

“The Government accepted that recommendation, but there's no sign of it coming forward yet. There is a real opportunity with this Patient Safety Bill to improve the whole system.”

Dr Scally added that in 2019 he warned that Ireland was the only country in Europe that has legislation that bans a person making a complaint about their clinical treatment. The legislation at present says a patient is not entitled to make a complaint about clinical care, a clinical judgment about doctors or nurses service treating, he explained.

“You can complain about the length of time you might have to wait and you can complain if your room is dirty or if something else goes wrong. But if it's about the clinical care, you're actually banned from making a complaint.

“That legal ban is carried through into the HSE complaints procedure. The wording is really quite brutal. It says a person is not entitled to make complaints.”

Legal cases

Dr Scally said he had repeatedly pointed out that when things go wrong patients want three things. They want to know the truth. If something goes wrong they want someone to say sorry and to know that it will not happen again.

Unfortunately the only route open to people was the legal route, this was a great concern to him. That route could take a lot of time, it was costly and could be traumatic, he said, as the families involved in CervicalCheck had discovered.

If people could be assured of an apology and an acknowledgement that a mistake was made then there would be fewer legal cases, said Dr Scally.

No fault compensation for when something really does go wrong, needed to be discussed, he urged. Many of the women involved in CervicalCheck had not wanted to get involved in the “gladiatorial” legal system because “they had no faith and no trust and they didn't have the personal resources, financial or emotional to deal with that.

“We need a more humane system. I've talked about the importance of grace and compassion, and that's what's missing."

Dr Scally said it was outrageous that in this day and age patients still did not have the right to complain about their clinical care, it was good that an amendment on transparency around cancer screening had been included in the Bill, but it was a small part of the overall health service.

“We need real movement across the health service to really change this. It's completely outmoded, antiquated and it's grossly unfair.”