Sir, –Your editorial "The failings in our medical negligence regime persist" (September 17th) casts light on a serious problem. Studies have shown that what patients who bring medical negligence claims want most of all is to be given an explanation and, where appropriate, an apology for what occurred. It is the desire to get to the truth that is the real driving force behind patients suing, not the compensation. Behind every court award and newspaper headline is a personal human tragedy. Why are mistakes not admitted until the 11th hour, if at all?
We need to take a long, hard look at risk management in medicine. At present it clearly amounts to no more than lip-service. The purpose of risk management is to provide the organisation with a memory. It is only by remembering its mistakes that the organisation is ever likely to learn from them and to improve.
A proper system of risk management would ensure that when a mistake is made it is not swept under the carpet but is out in the open. It is recorded and remembered and as a result is less likely to be repeated.
A “duty of candour” sounds like a good idea but trying to graft a duty of candour on top of our present medical culture is like building on sand. Without proper risk management there is simply no foundation. How can we have a duty of candour if we can’t even acknowledge when the same mistakes are being made over and over again?
Substantial effort will be needed to bring about change – perhaps the duty of candour should be made a statutory duty, with consequences for those in breach of it. Without taking such a measure, unfortunately, it is difficult to see how a common culture of being open and honest with patients when things go wrong will spread. – Yours, etc,
DOIREANN
O’MAHONY, BL
Dublin 7.