Debate contribution: Statutory Duty of Candour

Debate contribution by Miss Nuala McAllister on 11 November 2024.

MLA

Miss Nuala McAllister

Party at the time

Alliance Party

Date

11 November 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Statutory Duty of Candour

Assembly identifier

Official Report component 4667802

Read the official Assembly record

Text

I beg to move

I rise to propose our motion calling on the Health Minister to introduce a statutory organisational and individual duty of candour by the end of the mandate. Since the beginning of the hyponatraemia inquiry in 2004, following the deaths of five children in Northern Ireland, there have been consistent calls for a statutory duty of candour for healthcare workers to be enacted. Despite that, I stand here, 20 years later, with little progress to note from the Department of Health and a string of Health Ministers. Unfortunately, in those 20 years, we have also seen scandals that could and should have been prevented, such as the actions of Dr Michael Watt, the infected blood scandal, abuse in Muckamore Abbey Hospital, the urology and cervical smear reviews and the scandal at Dunmurry Manor, to name a few. I have engaged extensively with families of those who lost their lives and those whose lives were changed as a result of those scandals, and I have heard their pain first-hand. Some of those families are in the Public Gallery today, while others are watching online, and I pay tribute to each and every one of them. We should never underestimate the power of a person who has lost a loved one, who has watched a loved one suffer as a result of mistakes, deliberate or otherwise, or who has witnessed a cover-up instead of transparency to pursue justice, truth and accountability. Although a statutory duty of candour, applicable to both the organisation and the individuals in the organisation, with legal backing, would not have saved every life, it would, in all likelihood, have significantly decreased the time for which such actions were able to continue and the number of lives impacted on as a result. Since joining the Health Committee, I have taken every opportunity to speak up on behalf of families who have been impacted on by the abuse and neglect at Muckamore Abbey Hospital. Just last week, I met relatives of Muckamore residents who had experienced severe abuse during their time in the hospital, including the relatives of one young man who was in the hospital for 21 years. They made it clear to me that an individual statutory duty of candour, with legal backing, is essential in order to make sure that lessons are learned from the plethora of health scandals in Northern Ireland. Those are not my words but the words of Glynn Brown, whose son experienced horrendous abuse during his two years in Muckamore Abbey and who speaks on behalf of the majority of families involved in the scandal. My colleague Danny Donnelly and our wider Alliance Party reps have had ongoing engagement with relatives of deceased patients of Dr Michael Watt. Their fight for justice has been made all the more difficult as a result of delays with the deceased patients review process. I have given just a snapshot of the human impact that such scandals have had on families across Northern Ireland. The Alliance Party tabled the motion on their behalf, and I want them to know that, if there is anything that any of us can do for them, we will always be here to listen. I thank Sinn Féin for tabling the amendment, which calls for a:

"duty of candour to be ... co-produced in partnership with health and social care workers, alongside families".

That is an extremely important point. We welcome the amendment and will support it. From discussions with the sector, I am clear that it is in full agreement with the need for an organisational duty of candour with legislative backing. I will therefore focus instead on our call for an individual duty. An important discussion on the duty took place at the Northern Ireland Confederation for Health and Social Care (NICON) conference just a few weeks ago, at which an emphasis was placed on the need for any statutory framework to be introduced in tandem with support for cultural changes in an organisation. That is an important point to make. We are not arguing that the legislative approach proposed in the motion should happen alone. I acknowledge that, if the duty were to introduced in a vacuum, it would not be successful or effective. The duty must be implemented alongside efforts to implement an open and transparent environment in the health and social care sector. Staff must feel safe raising concerns at every level. I highlight the fact that the Belfast Trust has done some work on implementation by placing an emphasis on the psychological safety of staff. The trust aims to change behaviours from the macro level to the atomic level as a tangible example of supporting a cultural change, such as having weekly one-to-ones at which people can raise concerns, in order to ensure that it can meet the goal of being more open. Let us be honest, however: we cannot rely solely on the Department of Health to take the lead on changing the culture. How can we trust that a more open framework will be embedded when it has taken the Department so long to get to here in the first place? Two weeks ago, I learned at Committee that the Being Open framework should launch early next year. Is that acceptable? Is that the grand total of the efforts made since the launch of the hyponatraemia inquiry and the publication of its findings in 2018? I want to make it very clear to all healthcare workers that we appreciate and value their work. The overwhelming majority of healthcare workers carry out their work every day with the utmost integrity, and for that we are grateful. It is important to emphasise that we are not calling for mistakes to be criminalised. We have been told by the sector that the notion of criminalisation is a misunderstanding that was spread carelessly by the Department. To make a mistake is to be human. Doctors and healthcare staff are not immune to making mistakes. That is not the issue at hand. The issue that having a statutory duty of candour would address is where an effort is made to cover up mistakes when they are made. We recognise that the threshold must be high. Where there is an intentional cover-up, however, we recognise that there must be accountability. I have heard some argue that legislative backing for an individual duty is not required, as healthcare professionals can already be held accountable through the GMC. To that I say that they should speak to the parents of Claire Roberts. Alan and Jennifer have fought for almost 30 years for the truth about what happened to their daughter, Claire. We all recognise the smiling photo of Claire that we see in news articles to this day. When we talk about duty of candour and cover-ups, it is about ensuring that we get honesty. If we honestly believe that people can hold themselves to account and mark their own homework, we must speak not only to Alan and Jennifer but to every family member who has lost a loved one and still does not have the truth and accountability that they so deserve. The cervical smear review was launched by the Southern Trust in October last year, long after the scandals around hyponatraemia and the actions of Dr Michael Watt became clear and were headline news in Northern Ireland, yet cover-ups continue to occur. Clearly, something needs to change. The reports that have called for an individual duty to be implemented must not be in vain. I recognise that people have concerns about there being a fear factor as a result. To anyone who is worried, I say that we are not blind to the difficult decisions involved in practising medicine. We understand that risks sometimes have to be taken and that decisions may only become clear in hindsight, but truthfulness and honesty must be prevalent. Patient safety is paramount. I hope that we can get support on the matter. Most importantly, I hope that the Minister will commit today to introducing legislation and, perhaps, to exploring the Hillsborough law proposals as an opportunity to do legislative work here on organisational and individual duty of candour. We owe it to every person who was, and continues to be, unable to speak up for themselves. Before I finish, I pay tribute to the parents of Claire Roberts and the many victims of the plethora of scandals in Northern Ireland, some of whom are sitting in the Gallery today. We thank you for your ongoing campaign. We particularly thank Alan and Jennifer, who have fought for almost 30 years and who, as recently as last week, found themselves fighting these issues in court. It is for people like Alan and Jennifer that we need to ensure that the issue does not go unheard. We need to ensure that we instil a legislative basis upon which we can receive honesty and truth for any mistakes that have been made. I commend the motion to the House.

1,505 words. Text as published by the Northern Ireland Assembly.

Assessment

Not flagged

Jev’s structured answers

Assessed 21 October 2026 at 11:35 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

Disagree with this assessment?

Classifications can be challenged. A person reads every challenge, and any change is recorded publicly above with its reason.

Challenge this classification