Officer for Ireland message - June 2021

Dr Ray Nethercott sets out some key observations on the Northern Ireland policy landscape; the recently published NI Executive Child poverty Strategy report and; the next steps the College are taking to respond to the ongoing Department of Health's consultation, Duty of Candour and Being Open.
Dr Ray Nethercott
Dr Ray Nethercott

Changes in the Northern Ireland Executive

We find ourselves in interesting times yet again; the announcement of a further leadership nomination process within the DUP and new ministerial portfolio holders, including Education, the lead Department for the 10 Year Children and Young People's Strategy, is symbolic of the changeable political framework we are well used to in NI.

We watch in hope that that our political institutions are embedded enough and our political representatives steadfast in their commitment to public service to weather these changes.

Child poverty and health inequalities

As members will know, poverty and health inequality are issues of great concern to the College, and we make recommendations through State of Child Health and other outputs aimed at ameliorating the insidious impact of poverty.

It is no surprise that the recently published 2020/21 report on the NI Executive Child Poverty Strategy makes grim reading with 20% of the most deprived Wards or SOAs showing poorer outcomes across health indicators including dental caries, obesity and self-harm diagnoses.  Increases in both relative and absolute poverty have been observed. The College will continue to engage with the Department of Communities on health inequality.

A consultation on duty of candour

As members are aware, the Department of Health consultation on Duty of Candour and Being Open is now open. Our position, which will be re-clarified at College Executive, is that we are completely for a Duty of Candour, but without criminal sanctions. We are in the process of re-gathering evidence to consolidate our belief that attaching criminal sanction for individuals undermines the intention of having an open culture.

Looking forward to a better, more open system where mistakes, when made, are surfaced quickly, and such events comprehensively explored in full transparency: that is something that we all wish to see occur. To ensure this happens with all due haste will require much more trust, frankness and maturity, not simply within the health system itself, but with across our whole society.

Investing in the system and its people to engender a blame free culture with the appropriate knowledge systems and supports for service providers and service users is not going to be easy, but it’s completely necessary.
We are highlighting that this is not simply a NI issue to be dealt with in isolation; there have been public inquiries in other UK jurisdictions that have called for this or equivalent processes that have been not been adopted. We envisage a potential plethora of unintended consequences as a result of placing this unnecessary criminal offence on the statute books, from retention and recruitment to defensive practice. Moreover, the nuance of working with children and families places upon paediatricians an additional burden in this context that we must consider and balance.

The College will be surveying members for their views to support the response to this consultation from 28 June. We'll email members in Northern Ireland who are opted in to receive survey communications - you can log in to your online account and check your contact preferences. We hope you will consider sharing your thoughts with us.

Best wishes,

Dr Ray Nethercott, Officer for Ireland

This message is part of the RCPCH Ireland eBulletin for June 2021, which was emailed to all RCPCH members in Northern Ireland and Republic of Ireland opted in to receive College updates / professional updates. You can update your contact preferences at any time - log in to your RCPCH online account, go to My account | Your contact preferences, then make sure you've ticked College updates / professional updates.