Jeremy hunt agrees to “think again” about restriction of duty of candour

Published: 19 Nov 2013

The so called “Duty of Candour” – one of the flagship policies announced today by Jeremy Hunt in response to the Francis report on Mid Staffordshire –  is to be re-thought following pressure from AvMA.  AvMA and other patients’ groups were furious that the duty of candour – a legal duty on healthcare organisations to be open and honest with patients whom they have harmed – is to be restricted only to cases where death or severe permanent injury is known to have been caused under current plans. They pointed out that this would mean that the vast majority of incidents which cause significant harm would not be covered by this rule, meaning that organisations would be breaking no statutory rule in covering up such incidents.

The charity warned that this would have “disastrous” unintended consequences, effectively legitimising the cover up of most serious incidents and actually make things worse, not better. Following 11th hour discussions with AvMA yesterday , the Secretary of State has now promised to reconsider his policy on this.

Peter Walsh, chief executive of AvMA, said: “We are grateful to Mr Hunt for listening to our concerns and agreeing to reconsider this controversial policy, but frankly are dismayed that he needs any more time to think about it.”

“The case for a full Duty of Candour about any significant incident and applying to everyone in the organisation, from board to ward, is overpowering. It would be the biggest advance in patient safety and patients’ rights in a lifetime. The current proposals would be disastrous – in effect legitimising cover ups of the vast majority of incidents which cause serious harm to patients. As well as this being grossly unjust to the patients and families concerned, this means that the NHS would continue to fail to learn lessons. When I met him yesterday, Mr Hunt told me he was worried about the requiring informing patients about all significant harm incidents because it might snare up the NHS in bureaucracy. However NHS organisations already have an existing contractual duty to report any incident of significant harm and the vast majority are already doing this – we want that in law. We will do everything in our power to ensure Jeremy Hunt makes the right decision about this.”

Will Powell, father of Robbie Powell from South Wales whose case led to the campaign for Robbie’s Law after his avoidable death over 20 years ago said:

“If the current plans to restrict the duty of candour go ahead, it would be another very sad and tragic day for our NHS with regards to the continuing absence of openness and transparency . There is something drastically lacking with this proposed legislation as individual doctors responsible for causing damage to a patient do not have a personal legal Duty of Candour, in all circumstances, to tell the truth about adverse clinical incidents or even refrain from falsifying medical records to cover-up their mistakes. We will continue our campaign for Robbie’s Law in memory of our son and to ensure that other parents are not forced to suffer as we have, for more than 23 years, as a consequence of dishonesty.”

Frank and Janet Robinson from Leicestershire, parents of John Moore-Robinson, whose case made a huge impression on Robert Francis QC and probably convinced him of the need for a Duty of Candour, said:

“What a step backwards this would be. It makes no sense at all to even consider this option. This would also enable NHS staff  to withhold information as they did in our son’s case when things go wrong with no fear of being held to account.”

AvMA are also unhappy that some of Robert Francis’s other recommendations have not found favour, such as  regulation of healthcare assistants; national guidance on minimum staffing levels; and reform of the Healthwatch patients’ body.

Mr Walsh added:

“We have heard about a lot of positive steps that are being taken to improve safety today, and we are sure that these will lead to some improvement. However, overall it has been a missed opportunity to reflect the priorities of patients and to make the clearest possible statement that the culture will change and cover ups no longer be tolerated.”