Consultation response on Duty of Candour & Being Open to Department of Health Northern Ireland

Download the full consultation response >

Summary of our response

MPS fully supports a culture of openness in the healthcare sector and we advise members that they should apologise when something goes wrong. However, we have long standing concerns that codifying this ethical principle into legislation, such as a statutory Duty of Candour being proposed by the Department of Health, fail to provide the impetus necessary for behavioural change. We believe that the statutory Duty of Candour is unlikely to be effective in ensuring a genuinely open conversation with patients when things go wrong and can lead to unintended consequences.

MPS consistently raised concerns throughout the evolution of the statutory duty of candour in England and Wales, and Scotland. Similarly, we have concerns with the proposals of the Northern Ireland Department of Health.

A statutory duty could prove counterproductive to the development of an open learning culture in healthcare. For any statutory duty to be effective, a system will be required to monitor compliance and apply sanctions. Any such system will inevitably distract from the original objective of ensuring openness with patients and learning from mistakes. This is why cultural change rather than legislation is the appropriate way of creating safe, responsive, patient centred care and high-quality communication between professionals and patients. The legislation could instead result in a ‘tick-box’ reporting culture. 

While MPS does not support the introduction of a statutory Duty of Candour; if the Department is minded and wishes to proceed, we believe that the Duty should be limited to healthcare organisations and not be imposed upon individuals. We believe the statutory individual Duty of Candour is unhelpful and impractical given how healthcare is currently delivered; involving multidisciplinary teams across the healthcare organisation; and our modern understanding of medical error which takes into account the system in which practitioners operate. When something goes wrong in healthcare, the patient and/or the relatives want to not only seek information about what has occurred but also why and steps taken to mitigate this from happening again. It is the organization and not the individual practitioner which is best placed to address the range of factors leading to the adverse outcome, and to reflect on any changes introduced across the organization to stop this from happening again.

About MPS

MPS is the world’s leading protection organisation for doctors, dentists and healthcare professionals with almost 300,000 members around the world.

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

MPS is not an insurance company. We are a mutual non-for-profit organisation and the benefits of membership of MPS are discretionary as set out in the Memorandum of Articles of Association.

Contact

Should you require further information about any aspects of our response to this consultation, please do not hesitate to contact us.

Patricia Canedo
Policy and Public Affairs Manager
[email protected]