The Northern Ireland health department is consulting on proposals to ensure healthcare organisations and individuals working for them have a legal duty to be honest when things go wrong.
A legal duty of candour was one of the key recommendations of the report of the IHRD (Public Inquiry into Hyponatraemia Related Deaths). The inquiry, which found that the deaths of four children in hospital were avoidable, makes a number of recommendations aimed at improving care and safety and how health services handle mistakes.
Specifically on candour, the report recommends that a statutory duty of candour should be implemented at an organisational and individual level, and that there should be criminal sanctions attached to both to ensure openness and honesty.
Threat of prosecution
The health department’s consultation puts forward several options, including a statutory duty of candour with criminal sanctions for breaches, and one without.
If the criminal sanctions for individuals were removed from the duty, it would mean that any breach of the duty would be referred to employers or professional regulators who would take action as appropriate.
The other option would be a duty of candour without criminal sanctions attached, but separate criminal offences for withholding information, destroying information, or providing false or misleading information.
Tom Black, chair of the BMA in Northern Ireland, welcomed the consultation, but warned against criminalising individual doctors as the focus needs to be on creating the conditions for openness and transparency in the whole system.
‘The BMA supports the introduction of the organisational duty of candour with criminal sanctions similar to developments in the rest of the UK. We also welcome the individual duty of candour, but we are opposed to attaching criminal sanctions to this duty for individual doctors,’ he said.
‘We are in the process of developing a plan of action to engage with members on this work, including a survey of members and a series of FAQs to ensure members are aware of the very serious implications this would have on them as a doctor, and to make sure our members are able to engage with this issue effectively.
'We will be holding an interactive meeting on this to ensure that member voices and experiences are central to our submission and we also strongly encourage members to participate in department-led consultation events.’
The Department of Health consultation closes on 2 August 2021.