Sir, – It is disappointing that Minister for Health Leo Varadkar no longer plans to legislate for a statutory duty of candour in the Health Information Bill ("Minister admits shelving plan to force doctors to disclose mistakes", January 23rd). However this does not address the underlying issue, which is that the HSE needs more than legislation to restore trust in our health system.
While one can mandate disclosure, legislation cannot deliver the attributes of high-quality and open communication, such as empathy, sincerity and honesty.
Many patients are motivated to take legal action because they are angry and their anger is often precipitated by no information, incomplete information or delayed information about what happened and why. Restoring trust requires building a culture whereby doctors are encouraged to understand and accept that errors can and do happen and are taught how to handle them without fear of being branded incompetent. Similarly, this culture should encompass healthcare organisations at a governance level to ensure there is the necessary support for doctors who follow their ethical responsibility and are open and honest with patients when there are unanticipated events.
There is understandable appeal of a legislated duty of candour; however, this will not achieve the objective of high-quality, open communication.
The risk with any legislation is creating a “tick-box” mentality that does not support the intensely sensitive, personalised and meaningful disclosures that should happen with patients and their families when something goes wrong. It is harder to change culture than change law. – Yours, etc,
Dr PETER LONERGAN,
Dublin 8.