Duty of Candour in Healthcare: What It Could Mean

According to Infostart, Health Minister Zsolt Hegedűs has announced the introduction of a duty of candour in Hungarian healthcare. Modelled on the British approach, it would require an institution not to remain silent after an unexpected complication or failure in care, but to explain the situation clearly to the patient, investigate what happened and apologise.

The announcement may signal an important shift in patient rights, but a distinction must still be made between a political announcement and a detailed, applicable rule in force. Until the precise terms of the Hungarian legislation are known, it cannot be established with certainty when, in which circumstances and through what procedure patients will be able to invoke the new obligation.

What does the duty of candour mean?

In the British system, candour does not simply mean that a doctor answers a patient’s questions. According to UK government guidance, the institutional duty includes openness, notifying and supporting the patient or their representative, apologising and providing written follow-up in relation to specified patient safety incidents.

This matters because an adverse outcome alone does not prove that someone made a mistake. The purpose of candour is not to establish liability automatically, but to ensure that the patient is not left without an explanation and that the institution investigates what happened in a structured manner.

What could patients expect after an unexpected incident?

According to Infostart’s report, the proposed Hungarian obligation would include fully informing the patient and their family, reporting unexpected complications internally and to the authorities, and an institutional apology. These measures do not yet replace detailed Hungarian rules, but they outline the main direction of the new approach.

In practice, meaningful information should explain what happened, what known consequences the incident may have, what further care may be needed and how the institution will investigate the case. Patients should also clearly understand from whom and in what form they can obtain further information.

Clarity is at least as important as the amount of information provided. An explanation expressed solely in technical terms may not help patients understand what happened to them, so they should have an opportunity to ask questions and clarify uncertain details.

Not every complication amounts to medical negligence

Medical procedures may carry known risks, and an adverse outcome can occur even when appropriate care has been provided. A complication, a patient safety incident and professional negligence must therefore be distinguished from one another; they are not assessed in the same way under law or medical practice.

Candour may be particularly important when the cause of what happened has not yet been established. In such cases, the institution can communicate the facts already known, set out the next steps in the investigation and later explain its findings. Openness does not justify presenting an assumption as certain before an investigation has concluded.

Why is an apology important?

In human terms, an apology acknowledges that the patient has experienced harm, fear or uncertainty. According to the British professional approach and a research review examining the subject, an apology is not necessarily the same as an admission of civil liability.

However, it does not automatically follow that an apology will have the same precise legal effect in Hungary. This may be determined by the Hungarian legislation, institutional procedures and, where necessary, the application of the law. Patients should therefore not infer from an apologetic statement alone that the institution has formally admitted or ruled out liability.

Two types of obligation should be distinguished

In the British model, an institution’s legal duty is distinct from the professional and ethical duty of healthcare workers. The former governs how a provider must act in relation to a specified safety incident; the latter requires doctors and other professionals to be open and honest when something goes wrong.

This distinction may also be crucial to implementation in Hungary. It matters whether responsibility for providing information lies with the treating doctor, the department, hospital management or several parties jointly, and whether the patient receives official information verbally, in writing or both.

Hungarian media reports primarily present the plan as an institutional reform. Detailed regulation will need to clarify how the professional responsibilities of individual healthcare workers relate to it.

Protecting staff who speak up may also form part of the change

According to reports by Telex and HVG, the minister described the concealment of errors and harmful management practices as patient safety risks, and also emphasised the protection of staff who speak up. This has significance beyond individual patient complaints: an institution can learn from errors only if employees are able to report unsafe processes without fear.

According to Medical Online, the approach may be intended to ensure that identifying problems serves not merely to impose sanctions, but to improve the safety of the system. For this to work in practice, however, clear reporting channels, transparent investigations and genuine safeguards against retaliation are needed.

What should patients consider if a problem arises after care?

Until the detailed new rules are known, patients should focus primarily on establishing precisely what happened. It may be useful to record when the care was provided, the substance of the explanation received and the next steps, as well as to retain any documents supplied.

During a discussion with the treating doctor or the institution, it may be helpful to seek answers to the following questions:

• What happened during the provision of care, and which facts have already been established?
• Is this a known complication or a patient safety incident requiring investigation?
• What health consequences and further care can be expected?
• Has an institutional investigation begun, and how will its findings be communicated?
• Who can be contacted if the information is unclear or incomplete?

These are general points for consideration and do not constitute personalised medical or legal advice. A healthcare professional can provide assistance for health concerns, while an appropriate legal expert or patient rights representative can offer guidance tailored to an individual legal dispute.

The detailed rules will determine how strong the new patient right is

The announcement alone does not answer which incidents will trigger the obligation, what deadlines will apply, who must inform the patient or what the consequences of a failure to comply will be. Nor has it yet been decided precisely which documents patients may receive or how they will be able to access the findings of an investigation.

The change could represent genuine progress if candour becomes a verifiable institutional procedure rather than an occasional gesture. For patients, the most important outcome would be that, after an unexpected incident, they would not have to piece together what happened themselves, but would receive information proactively, clearly and in documented form.

Until the final Hungarian rules are published, cautious wording is therefore warranted: a new direction has been announced, but the precise content and enforceability of the new rights will be determined by the legislation once promulgated.