The Irish Times view on open disclosure: An important step

The Patient Safety Bill, approved by Government last week, is an important step in ensuring open disclosure becomes a central part of healthcare in the Republic. It provides for mandatory disclosure in respect of serious patient safety incidents. It facilitates a consistent approach to communicating with patients and their families when things go wrong in healthcare. The Patient Safety Bill restates the legal protections for healthcare professionals who engage in open disclosure.

The new legislation also closes a loophole that meant private hospitals were not under the regulatory remit of the Health Information and Quality Authority (Hiqa). This means patients in both the public and private health sectors will benefit equally from ongoing monitoring and standard-setting. Duty of candour has emerged as a key factor in recent health controversies. The proposed legislation goes further than a similar 2016 law covering England and Wales, which categorises patient harm as serious, moderate or mild. While open disclosure applies to all three categories, only those considered serious are subject to mandatory reporting.

The absence of specific reference to the obligations of health service managers under mandatory open disclosure should be addressed during the Committee stage of the Bill

British legislation is working well in practice. The Bill brought to Cabinet by Minister for Health Simon Harris, however, specifies exact clinical scenarios where a new law will apply. While understandable in the light of recent problems involving screening, maternity deaths and other specific cases that have emerged from the legal system, an overly prescriptive approach may not be the best way forward. There is a risk of promoting a narrow, checklist culture when a broader adoption of open disclosure across the health system is required.

The absence of specific reference to the obligations of health service managers under mandatory open disclosure should be addressed during the Committee stage of the Bill. Many failures that lead to serious patient harm can be traced to systems rather than individual professionals. For open disclosure to take root, it must be adopted by everyone involved in healthcare here.