Health managers and non-disclosure law
Sir, – The release of the final report on the current systems for the management of clinical negligence claims under Mr Justice Charles Meenan on December 16th was welcome.
In 2015 the then minister for health, on the advice of the chief medical officer, made the disastrous decision to remove the mandatory element from the open disclosure legislation. Thanks primarily to the tireless and brave efforts of Vicky Phelan and Dr Gabriel Scally, this terrible decision now looks likely to be reversed.
The recent report under Mr Justice Meenan now recommends that it be made a criminal offence not to disclose and to alter patient medical records which is a welcome and long overdue requirement. It does, however, raise questions as to why there is a need to criminalise the altering of patient medical records, and this is something health service management needs to address.
The recommendation that failure to make a disclosure should be considered to be either professional misconduct or poor professional performance, and should be the subject of an inquiry by the relevant professional body is also welcome. It does, however, risk creating a two-tier system for non-disclosure in our health service. Medical and nursing staff who are subject to regulatory body oversight ultimately are at risk of loss of licence for non-disclosure. Conversely HSE and Department of Health management are not currently subject to any regulatory body oversight and as such will face no personal sanction for non-disclosure.
In order to correct fully the failings of the disastrous 2015 open disclosure legislation, any legislation needs to provide parity of sanction for non-disclosure among medical and nursing staff with management. The most effective way to achieve this is the creation of a regulatory body overseeing the performance of the HSE and health management. All this will do is bring them into line with their colleagues on the front line. It’s hard to see how HSE and Department of Health management can credibly expect their frontline colleagues to be subject to independent oversight if they themselves are not willing to be subjected to a similar level of oversight.
I would urge the Ministers for Health and Justice to now move quickly to ensure full implementation of the recommendation of Mr Justice Meenan and this working group.
The Minister for Health now also needs to ensure frontline staff are not discriminated against and treated less favourably than management when failings occur in our health service by establishing a regulatory body to oversee HSE and Department of Health performance. – Yours, etc,