Debate contribution: Statutory Duty of Candour

Debate contribution by Ms Liz Kimmins on 11 November 2024.

MLA

Ms Liz Kimmins

Party at the time

Sinn Féin

Date

11 November 2024

Type

Debate contribution

Business

Private Members' Business

Heading

Statutory Duty of Candour

Assembly identifier

Official Report component 4667818

Read the official Assembly record

Text

Go raibh míle maith agat, a Phríomh-LeasCheann Comhairle. I thank Alliance for tabling this very important motion. We have had numerous discussions on the issue in the short time that the Health Committee has been in place. Without speaking for others, I think that we are all very much on the same page on the issue. Even in the short time since February, when we first came together, we have heard, time and time again, about the very difficult reality than many patients and families face. We have listened to and met numerous families and people with lived experience of the harm that has come to them as a result of mistakes, cover-ups and other factors. We felt very strongly that now is the time for change. We cannot wait any longer. We cannot continue to see such inquiries and scandals coming to the fore. I, too, acknowledge all the families who have used their experience to ensure that those who come behind them do not go through the same traumatic and distressing experience that they went through. Without them, we probably would not be in this place today, although what we are discussing is a sad indictment of the system. Openness and transparency are fundamental to underpinning trust in our health and social care system. It is what all users of those services are entitled to expect. A culture of openness benefits patients and service users, but it also benefits those who work in Health and Social Care (HSC). A statutory duty of candour seeks not to punish workers for mistakes but to empower them with the knowledge that, if harm is caused, they can flag it to ensure that there is learning and to help improve the processes and systems that are in place. By initiating an openness framework, we can start to make the change from a blame culture to a culture of learning. The most important piece of work is the cultural shift that is required in the health and social care system. That shift needs to ensure that staff feel supported to assist in system learning and improving outcomes for patients.

As mentioned, we have experienced a number of scandals in the health and social care service in the past number of years that have left many patients, families and staff with a sense of distrust in the system and a feeling that many issues were missed that developed into major incidents for patient safety. As MLAs, a lot of us will have dealt with individual cases of families who have lost a loved one or faced life-altering conditions as a result of mistakes being made and have waited and continue to wait far too long for answers and for change to occur. We believe that it is important that we have both an organisational and an individual duty of candour to ensure that the highest levels of transparency can be relied on at every level of our health service. Families have a right to know the circumstances, if their loved ones experience harm. It is only right that they get that. Likewise, staff need to feel safe to be open and honest, as that protects them in the crucial work that they do and ensures that our healthcare is delivered to the highest possible standard. Sinn Féin commends the patients and families impacted by the hyponatraemia and other scandals in Health and Social Care for their perseverance and endurance in their search for truth and justice. The outcome of their efforts must be a health and social care system that is open and transparent and inspires trust and confidence in all those who deliver and use its services. We need to make the changes, otherwise more and more scandals will continue to blight our services and our society. We cannot allow that to be the case. It is important that the organisational statutory duty of candour requires each organisation to provide training, support and protection for staff to enable and empower them to fulfil their individual duty of candour, underpinning the open and honest culture for which we strive. An overwhelming majority of our dedicated Health and Social Care workers are committed to and strive to provide the best care for their patients. That is why the amendment seeks to ensure that there is genuine co-production and co-design that involves staff, patients and families who have experienced harm. It is crucial that those with lived experience of the serious adverse incident (SAI) process are involved in the development of legislation around duty of candour. Understandably, a number of representative bodies for professions in our health service have outlined their concerns and a lack of support for the proposals, particularly for those around individual duty of candour, citing that workforce pressures have not, to date, formed part of the discussions and that staff feel very much that they are the low-hanging fruit when harm is caused and blame ensues. That is crucial in any discussion of or decision to move to an individual duty of candour. That is why we seek to amend the motion to ensure that there is full co-design and co-production with staff as well as families. Staff must be part of any process to develop legislation, to ensure that they can outline their key concerns and are listened to. In a climate in which our health service is under extreme pressure, staff are burnt out and often work in unsafe conditions and mistakes and errors are at a higher risk of occurring it is vital that that is recognised and informs any proposals. Staff must not be the collateral damage for organisational failings or poor management and planning. That must be abundantly clear when it comes to duty of candour. As a whole Executive, we must collectively strive to reduce the significant pressures on our health service. Sinn Féin wants to ensure that patients, their families and all our staff have confidence and trust in our health service and that people feel safe to speak out when things are not done how they should be or when mistakes are made, so that steps can be taken to address that at the earliest stage. Any culture of cover-up must be eliminated. We need to put the best interests of patients at the forefront to ensure that no family has to wait years upon years for the truth when a loved one comes to harm. We have seen that time and again, through the hyponatraemia, neurology, urology and infected blood inquiries, to name just a few. The huge impact that that has on patients and their families must not be underestimated, and one thing has been consistently made clear: had facts been made available at the earliest possible stage, a lot of the pain and trauma could have been avoided. Families could get some level of closure and justice for their loved one, and the learning from those experiences could be used to reduce the risks of the same mistakes being made time and again. That is the motion's ultimate objective, and, essentially, the amendment would ensure that all stakeholders are an integral part of the process and that the principles of co-design and co-production are fully implemented throughout. There is no doubt that difficult conversations remain to be had, but we cannot stand still on this any longer. By working together, we can ensure that there are strong frameworks in place to protect all of our patients, uphold strong confidence and trust in our system and protect staff, going forward.

1,258 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