Debate contribution: Statutory Duty of Candour

Debate contribution by Mr Danny Donnelly on 11 November 2024.

MLA

Mr Danny Donnelly

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 4667925

Read the official Assembly record

Text

A statutory and legally enforceable duty of candour in our health and social care system is urgently needed on both an organisational and individual basis. Although there is no question that the vast majority of our health and social care staff are committed to the highest standards of care, it is impossible to pretend that mistakes will not be made, so we must ensure that appropriate safeguards are in place to ensure that they are not repeated and that we learn the lessons that are necessary to ensure that there is the utmost care for all our patients. It is very disappointing that limited progress has been made on introducing a statutory duty of candour and that successive Health Ministers have failed to introduce legislation on the issue. The case for reform is more relevant than ever, following a number of important inquiries, including the hyponatraemia-related deaths inquiry, the infected blood inquiry and, in England, the proposal for the Hillsborough law. There has been encouraging progress on the proposed Hillsborough law since the election of the new Labour Government, with the Prime Minister recently announcing that the Bill will be introduced in Parliament early next year. A report from the Joint Committee on Human Rights last year highlighted the importance of such a Bill to ensuring compliance with articles 2 and 3 of the European Convention on Human Rights. Legislation from this place would and should be compliant with those articles due to our membership of the ECHR and the legislative competence of this place under section 6 of the Northern Ireland Act 1998. The other inquiries mentioned reiterate the need for a statutory duty of candour. The hyponatraemia-related deaths inquiry, which began 20 years ago, recommended the introduction of a statutory duty of candour in situations in which it was suspected or believed:

"death or serious harm has been or may have been caused to a patient by an act or omission of the organisation or its staff".

The report stated that, in such circumstances, the patient or family:

"should be informed of the incident and given a full and honest explanation".

The recommendations were specifically for healthcare professionals, NHS healthcare organisations and private providers. The inquiry noted that, in 2015, the then Health Minister Jim Wells informed the Assembly that a statutory duty of candour should be introduced in Northern Ireland, and that that was a priority for him and the Department. However, as with so many other things that we discuss in the Chamber, such legislation has been delayed by years due to political instability and the prolonged absence of an Executive and Ministers. More recently, the infected blood inquiry also highlighted the need for an introduction of a statutory duty of candour. In May this year, the Health Committee heard from Nigel Hamilton from Haemophilia NI. Nigel spoke very powerfully during that Committee session about the need for a statutory duty of candour. I recommend that Members revisit his contributions. He, rightly, said that people need to have confidence in our public institutions, whether it is the Assembly or our medical institutions. He also said that openness is vital and that those in positions of leadership and responsibility need to listen, not just tell. Furthermore, he, rightly, stated that it is important that we have our own specific legislation on duty of candour in Northern Ireland, given our unique circumstances, and that, given the realities of devolution, we should not simply wait to see what Westminster chooses to do. We must ensure that that is a priority in the remaining two and a half years of the mandate. In 2021, the Department ran a 16-week consultation on draft policy proposals for a statutory duty of candour and a Being Open framework. There were varying levels of support for the proposals among the organisations that responded, and we have since met and corresponded with some of them. Some stated that they could not support the recommendations, pointing out that their members were already professionally regulated. The proposals are not about diluting the existing regulation of healthcare professionals; they are a means of complementing and expanding that regulation. It was also said that a duty of candour may affect the recruitment and retention of staff. Some people talk about a chill effect in the health service. I do not see how working with that duty would put anyone off, particularly if they are already professionally regulated. As someone who has worked in the health service, I know that it is important to emphasise that this is not about punishing people for mistakes. Mistakes can happen in any profession, but it is essential that we learn from such mistakes, and that we have a culture in our healthcare system that promotes the highest standards of care and openness, including the highlighting of mistakes and what must be learned from them. When things go wrong and someone suffers harm in the course of receiving healthcare, it is absolutely right that the patient or their loved ones get clarity on what happened from the people responsible for their care and that steps are taken to make sure that no one else suffers in that manner. A duty of candour is about reassuring the public that they will get answers and truth when things go wrong and rebuilding trust in the health service after the scathing conclusions of some inquiries. It should not be lost on any of us that the health service in Northern Ireland is under enormous pressure. Our waiting lists are scandalous: people wait for years for routine operations and, in many cases, are forced into paying for private healthcare. We, effectively, have a two-tier health system. Wards in our hospitals regularly have extra patients lying in corridors. Our A&E departments are overcrowded, and the whole system operates under prolonged periods of intense pressure. Sadly, those are precisely the circumstances in which things go wrong. Staff feel exhausted, and they are overworked and undervalued. In conjunction with the duty of candour, we need the Health Minister to introduce safe staffing legislation for Northern Ireland —

— to ensure that patients have the correct number of staff to deliver safe and effective care for them.

1,035 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