What does a legal ‘Duty of Candour’ mean?

A legal duty of candour means that when a ‘patient safety incident’ happens, that results in injury or death of a patient; healthcare professionals are legally bound to tell the truth to the patient and their family.

Why Call it Robbie’s Law?

It was Robbie’s case that highlighted the absence of the duty of candour in healthcare. This happened when the case reached the European Court of Human Rights.

“Before Powell v Boladz, there was no binding decision of the courts as to the existence of such a duty. As the law stands now, doctors have no duty to give parents of a child who died as a result of their negligence a truthful account of the circumstances of the death, nor even to refrain from deliberately falsifying records.”  ECHR, 2000.

The Powell family lost all of their estimated £300,000 compensation, challenging this perverse law. This is a campaign not only for Robbie, but for the protection of anybody getting medical treatment in the UK. This means that if things go wrong, and a loved one is injured or dies, families can know the truth about what happened.

Currently, healthcare staff have a ‘professional duty‘ to tell the truth to next of kin. Isn’t this enough?

This doesn’t go far enough actually.  This is because professional or ethical duty isn’t the same as a legal duty. It’s merely a guide and is not written in stone.  So that’s why regulators have difficulty enforcing this ‘professional duty’, with inconsistent and unsatisfactory results. A formal law that enshrines a legal duty of candour, will protect patients and their families.

But the NHS has a policy of ‘being open’ and the NHS Constitution. Isn’t this enough?

The NHS Constitution makes a valuable statement about honesty and best practices in healthcare. Unfortunately, there’s no way of enforcing this without a legal duty of candour.  Also, this constitution applies only to the NHS and not to private healthcare providers.

Creating Robbie’s Law isn’t going to change the culture of a healthcare organisation…

Cultural change is often gradual and stubbornly reluctant. When things like this are said: ”GPs could now put a gloss on the cause of death without fear of litigation” (GP Magazine, 1997) – it’s a warning sign that the law needs to change.

Laws send out a message about what’s acceptable and not acceptable. Think of drink driving laws, seatbelts and smoking bans in pubs.  When these laws came in, people initially were suspicious of their efficacy. However, the culture naturally adapted along with it, and these laws have undoubtedly improved people’s health and well-being.  The introduction of Robbie’s Law is the same.  This law along with training and coaching, will usher in a much more open, honest and accountable healthcare system.

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  1. […] But maybe there is more hope with the new ‘duty of candour’ which will place a contractual obligation on all NHS bodies, including private providers to the NHS, to tell patients if their safety has been compromised? The duty is designed to encourage a more open culture, but it won’t create a fully open culture. The duty has been watered down from the original Lib Dem manifesto promise to put a legal duty in place. The need for a full legal duty is put forward on the Robbie’s Law campaign site. […]