Candour. For the children.

Candour: open, honest, frank, the quality of being honest and telling the truth, especially about a difficult or embarrassing subject. All in all, a good thing.

Openness and honesty are some of the Nolan principles of public life, the ethical standards those working in the public sector are expected to adhere to. Openness and honesty are key values for health and social care in NI. Everyone agrees. No big deal. What are you on about, Speccy?

Imagine this. The worst thing. Your sick child is at the the regional children’s hospital. They may have been sent there from somewhere else, because that’s where the experts are. Something happens and your child dies. Imagine the horror, the grief, the loss.

What if information about your child’s treatment was deliberately withheld from you? What if there was a cover up? What, even, if you discovered that your child’s death was avoidable?

Imagine that your child’s death was avoidable and that the behaviour of individuals contributed to their death. What if the arrangements to ensure quality and the culture of the organisation contributed to the death?

Imagine that very experience happening to other families.

The loved ones of Adam Strain (4), Raychel Ferguson (9), Claire Roberts (9), Conor Mitchell (15), and Lucy Crawford (17 months) don’t have to imagine. Those children died. Their deaths were avoidable. Some of the people involved in their care lied. Rather than tell the families the truth, people acted to protect reputations and avoid blame.

Adam, Raychel, Claire and Conor. Lucy’s family chose not to release a picture.

People who choose to work in health and social care generally do so because they want to help, support and care for others. They don’t set out to be the bad guys, but shit happens. The organisation wins.

Clearly, it’s not just me saying this. Mr Justice O’Hara spent 14 years investigating what happened to the children. It took so long because the health organisations involved were reluctant to release any information. 14 years.

The O’Hara report is a gripping read. Gobsmacking. What happened was truly awful. O’Hara didn’t just tell the tale, he provided 96 recommendations to ensure it couldn’t happen again.

Key recommendations are for a legal Duty of Candour, for both organisations and individuals. O’Hara’s experience taught him that professional ethical guidelines/ standards aren’t always enough to protect patients. That’s why he recommended that it should be a criminal offence to breach that duty.

“All that is required is that people be told honestly what has happened, and a legally enforceable duty of candour for individuals will not threaten those whose conduct is appropriate.”

The Department of Health have been leading preparatory work on the proposed Duty of Candour. Now they want to know what you think. Do let them know.

Do you want medical professionals & organisations to be able to continue to withhold or destroy information, mislead, or lie when something goes wrong. Or do you simply want to know the truth of the thing?

Rites of passage

You know the sort of thing- a child takes a step, gets a sticker, stands on a stage, passes a driving test, gets dressed up for a formal occasion, joins in a riot. All while you stand proudly by, beaming at their progress, revelling in their joy. Great stuff all together.

Go back a bit. Look at the video I took from Twitter. I’ve not been able to get it out of my head. I’m old enough to remember the marching band coming down along Main Street for Billy, the tales of people being waved off to war, but I’d never imagined that sort of celebration for a riot in Belfast.

There are many reasons for the current tensions in NI. Poor leadership and governance, criminality, chronic deprivation, inter generational trauma, the need for a night out. There are genuine concerns about the impact of Brexit. Children are being encouraged to ‘earn their stripes’ by those involved in organised criminality, drug dealing and paramilitarism.

More of this sort of thing

Unionist politicians have stirred trouble, met with loyalist paramilitaries, raised the temperature. Now they’re tut tutting and staying at home, well away from the affected areas. That distance highlights one of the problems, lack of representation. Other issues continue to be educational & health inequalities. There’s been no ‘peace dividend’ for many in NI since the Agreement of 1998.

As I was writing this, news broke of the death of the Queen’s husband, Prince Philip. Oh, we wondered, surely those protesting their loyalty to the Crown would stop? Most did. Not all, of course. Some had been looking forward to some Friday night action, so went ahead. I don’t know how that affects their loyalty ranking.

It appears that paramilitary gangs will receive public funding to ‘transition’ to community groups. I thought we did that already.

Simply throwing money at such groups doesn’t work. Sustained investment in education, youth work, family support is required. Create opportunities, allow communities to move away from the control of drug gangs. Give it time and support. Believe that it’s work worth doing. Believe the people are worth doing it for.

Believe in people.