Debate contribution: Chief Medical Officer

Debate contribution by Mr Mike Nesbitt on 7 October 2024.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

7 October 2024

Type

Debate contribution (made as a minister)

Business

Questions for Urgent Oral Answer

Heading

Chief Medical Officer

Assembly identifier

Official Report component 4579531

Read the official Assembly record

Text

With your indulgence, Madam Principal Deputy Speaker, before I move to address the substantive issue, I wish to take this opportunity to reiterate, on behalf of the entire health service, the previous apology to all those who have been so badly let down.

Whilst the independent neurology inquiry revealed some deeply unpleasant truths, following the neurology recall, it also played an incredibly important role in identifying and spearheading changes that have since been made to improve patient safety. I am aware that the High Court in Belfast recently awarded damages to a former patient who pursued a medical negligence claim against Dr Michael Watt and the Belfast Health and Social Care Trust. I hope that Members will appreciate that it is not appropriate for any Minister to comment on individual cases, but I assure the House that I am aware of the ruling and its conclusions. The ruling in this case will, of course, be carefully considered. On 9 June, 2022, the then Minister of Health confirmed the arrangements for neurology compensation by way of a written statement. Each neurology recall case will be considered on its own merit to ensure a just outcome for those affected and to ensure that claimants receive the compensation that they deserve. All claimants against the Belfast Trust are managed by the Business Services Organisation's directorate of legal services on behalf of the trust. Recognising the scale of the issue at hand, however, Members may also be aware that there is already a dedicated neurology recall legal team in place in the legal services directorate. It acts on behalf of the Belfast Trust, with the aim of progressing claims at pace. In addition, there is potential to instruct a joint expert to provide a joint medical report —

I so beg your pardon, Principal Deputy Speaker.

If I may have one.

I beg your pardon. That joint expert is available at no expense to eligible patients or families. It is a streamlining approach that is supported by a set of guiding principles to ensure that eligible cases are progressed as quickly as possible. Claims in respect of private patients are not within the remit of the Department or the Belfast Trust. Claims against independent providers will be managed by the providers' legal advisers. I and my Department wish to ensure a just outcome for all those affected and to ensure that claimants receive the compensation that they deserve.

The Chief Medical Officer, Professor Sir Michael McBride, does indeed retain my confidence. In all my dealings with him, not just as the Minister of Health but previously as an MLA and even before that as a contributor to a medical charity, I have found him to be nothing but professional, engaged, knowledgeable and dedicated. I would never answer in the negative a question about whether an individual retained my confidence unless I had an evidence base that guided me towards saying, "No, I do not have confidence in that individual". If the Member has an evidence base in respect of that individual that she wants to produce, I am more than willing to listen to it, but the question as posed has a definitive and definite answer.

The inquiry was a substantive piece of work: I commend it to you. I think that there were 214 oral evidence sessions. It received in excess of 147,000 pages of documentary evidence. That should be the evidence base for reflecting on any individuals. Out of that detailed inquiry, which found opportunities wasted or missed as far back as 2006 and 2007, there are certainly lessons to be learned. I have been examining introducing a duty of candour, and, as I have said to the House before, a balance has to be struck between creating such a chill factor by placing an individual duty on an individual so that people are not willing to come forward and creating circumstances that maximise their willingness to step forward, particularly where an error has been made or something has gone wrong. I am still looking at that, still consulting and still open as to a final decision.

I thank the Member for her question. I can tell her that the independent neurology inquiry report was published in 2022 and included 76 recommendations for the Department, healthcare organisations, the independent healthcare sector and the General Medical Council to improve and ensure patient safety and to reduce the risk of similar events occurring. Ensuring that those recommendations are taken forward, implemented and critically delivered is a priority for the Department. A programme board chaired by the permanent secretary was established to oversee the implementation of the report's recommendations. The Department published an overarching implementation plan on 27 July 2023. The plan outlines the specific actions required against each recommendation and was published on 7 March this year. The work has been supported by two key independent groups: an assurance subgroup, the purpose of which is to provide the structure and process for an independent assessment and recommendations to the programme board in respect of actions required for each recommendation and to determine whether each recommendation has been fully implemented, and an independent neurology liaison group, the purpose of which is to align with the work of the assurance subgroup to further enhance feedback and recommendations from service users, carers and families on the assurance process and implementation programme. I hope that that gives the Member some assurance that a lot of work has been going on to make sure that this never happens again.

I thank the Member for his question and will simply say to him that, if he reflects on the answer that I just gave Mrs Dodds, he will see that a lot of work is going on to ensure that the recommendations are implemented. I give him a personal assurance that that will happen at pace.

I thank the leader of the Opposition for his question. On the last point, yes, I am always willing to meet people who feel that they have been badly treated by the health service. In this case, that is beyond any doubt: they have been extremely badly treated. I can only assure the Member that it is a matter that I take extremely seriously. When the Department started to offer briefings to MLAs, although it was not my particular area, I got engaged and attended the meetings with the then permanent secretary and the Chief Medical Officer. It just should not happen that something such as this is allowed to occur. We put so much emphasis on safe practices that it should not happen, so, when it does happen, it is not only shocking but a scandal. I am determined that we will follow this through. We will not deliver everything for all the families involved, because many of the families simply want their loved ones back, and we cannot, of course, do that.

Again, I say to the Member that you can take actions in introducing some sort of duty of candour, and I know that some people would like a duty of candour that reflects not just a corporate responsibility but an individual responsibility and maybe an individual responsibility that has the facility to lead to legal action against somebody who is not being open, honest, transparent and candid. The question is this: does that help, or does that hinder the process? I still have an open mind on that. I hear evidence from some who think that it is a good thing, and I hear evidence from some who think that it would be a retrograde step and would not work in the interests of patients and of openness, transparency and candour. Therefore, I have to continue to ponder that and reflect on it, and, finally, I will come to the Committee and maybe come to the House with my recommendation.

I thank the Member. He has definitive and well-expressed views on the issue. However, one of the questions that I have to ask myself is this: would it be right to bring in the sort of legislation that the Member obviously prefers and favours simply for people working in Health and Social Care? Should it not be brought in for the entire public sector? I accept that some people may be frustrated that I am taking too long, in their opinion, to come to a conclusion. However, the Member need only look at the number of debates on health in the Chamber to be aware that there are a huge number of issues that people want prioritised. They cannot all be done at one time, not with the staffing, resource and budget that is available to the Department of Health.

I thank the Member. I absolutely apologise, through him, to anybody who feels that they have not been well served by what has happened since the revelations about Dr Watt. At the moment, my mind is with phase 3 of the dead patients review, and the Member will, I am sure, be aware that a third phase is beginning. That will see a number of families, 18 in total, having expressed an interest in having a review of what happened to their loved one. There will be a period between now and the end of the year when other families can come forward and ask for the same thing from the Regulation and Quality Improvement Authority (RQIA). The reason it is not being opened to everybody is that I do not think that it is right to force a family that does not want to be involved in a review process to do so.

That is based, primarily, on the family reviews that took place during phases one and two. I want to be person-orientated and family-orientated in this process. I am very open to hearing any valid criticism or recommendations on how we might do this better.

I assure the Member that I am genuine when I say that I am here to deliver better outcomes. That is not just a catchy phrase that I hope people will remember me by; it actually sets me up to be judged. Hopefully, I will be in post until May 2027, and, at the end of that time, I expect that people will reflect and make a decision on whether I, in any way, delivered better outcomes. Is it possible in the time remaining, with the budgets, resources and staffing levels, to fix everything and deliver better outcomes? That is a valid question. It is something that I will try to do. You have, in a way, defined the nature and the scale of the problem and the challenge, but I will try to rise to it. That is all that I can say to the Member. I cannot give a guarantee.

I regret that the Member feels that way. As she obviously puts so little faith in the answer, I will not rehearse it. I simply ask her to reflect on the fact that health professionals are vocational people. They do not just do it for the money or because it is a job; they do it because they really want to. Yes, we get examples like Dr Watt that disrupt public confidence in the way that health and social care is delivered, but, ultimately, it is down to people to decide whether what I have said gives them any confidence. You may have had a bad experience of a Dr Watt, or perhaps you simply read about an incident and it has impacted on you or even traumatised you. It is very difficult for a politician to stand in a Chamber like this and restore public confidence if people are not willing to give it a try and accept that others are working genuinely and professionally to improve services.

I thank the Member for his question. I am not quite sure what he has in mind. I have confidence in the individuals who are conducting this particular bit of business, but if the Member would like to speak to me offline about how he thinks it could be done better in a way that does not disrupt the workings of what is going on but adds to public confidence, I am willing to meet him.

I thank the Member for his question and his comment. Yes. As a generalisation, we have overcomplicated the delivery of healthcare, and, in this case, we certainly have not made available a smooth and easy process. The work streams, the associated reviews and the investigations have been long and very difficult processes, especially for the former patients of Dr Watt and their families. I can say that I am committed — I will repeat that: I am committed — to restoring public confidence, but making it as quick and easy and also as fair and accurate as possible is always the challenge. Again, if, as I believe, there are frustrations amongst families, I can only apologise for that and commit to trying to continuously improve the service that we offer.

2,175 words. Text as published by the Northern Ireland Assembly.

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Assessed 21 October 2026 at 11:22 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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