Four Courts ‘not the place’ to resolve negative patient outcomes

The Four Courts is not the place to resolve issues arising from negative outcomes for patients, a health conference has heard.

Aisling Gannon, a partner and healthcare litigation lawyer in Eversheds Sutherland, was speaking at the Future Health Summit at the Convention Centre Dublin on Monday on the issue of "pre-action protocols" and open disclosure to patients following incidents that had negative outcomes during their care.

Noting the recent CervicalCheck scandal, Ms Gannon said that “other than in the media”, there had been very positive and frank discussions around open disclosure, be it voluntary or mandatory.

There was a “very large and seismic problem” to deal with in the media, she said.

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Citing a note written by clinicians in connection with the CervicalCheck scandal and reported in the media in recent weesk, Ms Gannon said she could understand that note in the context in which it was needed to be heard and interpreted.

She said the reality was that all clinicians wanted to be honest and straightforward. She said they wanted to share information with their patients, but there was always a concern in their minds that they could do “more harm than good”.

There was already a large body of work done to assist clinicians to know what they could do and what they should do, added Ms Gannon.

She said no doctor should have to “reinvent the wheel” or be faced with having to decide for themselves how much they should tell, what should they tell, when should they tell it and who they should tell following a negative incident.

This work had already been done in hospitals in very clearly corralled settings.

“The Four Courts are places where black and white decisions are made,” she said. “There’s a winner and there’s a loser.”

No clinician had gone into healthcare on the basis that there would be winners and losers, she added. “You always do the best for your patients.”

The two-day event has 14 separate conferences, 100 speakers, an estimated 1,500 delegates and 80 exhibitors.

Monday's event also heard from Eilish Hardiman, the chief executive of the children's hospital group.

Ms Hardiman said there were now small numbers of children in total control of their chronic healthcare because they were using an app connected to the hospital’s IT system and the clinicians were working in a different way.

The best example of this was in haemophilia patients, who now had the tools at home to test their blood-clotting factor if they got a bump or a cut, and through which they could send the details to Crumlin Children’s Hospital.

Prof Garry Courtney, consultant physician at St Luke's Hospital, told the clinical leaders' session that in Ireland, we are "overspecialising" in the health service and needed to pull back a bit from this.

Waiting lists for elective surgeries are increasing because we could not manage patients at the “front door”, he said.

He also noted the demographic problem in the health service, saying that every year we are adding “the population of Kilkenny city” to our over-65s and that this group accounted for 50 per cent of spend on healthcare every year.

“We cannot afford the health service we are running right now. We are absolutely broke,” he said. “If we were a company, we would be insolvent.”

Prof Courtney said we were in a position where we had to make decisions about where we wanted healthcare to go.

The event continues on Tuesday and will include sessions on innovation in e-health, the use of wearable devices in healthcare, elderly care and primary and integrated care.