A health expert has said that the research on hyponatremia revealed "lies, deceit and concealment" in the health service.
Professor Gabriel Scally also said that the Department of Health could have saved the lives of some children whose deaths were investigated as part of the long-term investigation.
The final report of Judge O & # 39; Hara found the death of four Northern Ireland children: Adam Strain (4), Claire Roberts (9), Raychel Ferguson (9) and Lucy Crawford (17 months) could have been prevented and the doctors covered up flaws in the patient's care. The children died between 1995 and 2003.
He also highlighted the serious failures that the Health Department said was a source of "shame for all involved in medical care."
Speaking with BBC NI, Professor Scally, a former NHS senior physician who was a 14-year research adviser, said the department should have had the right systems.
He said: "This is a remarkable account of lies, deceit and concealment, of negligence and of secrecy and deliberate obstruction."
The doctor said that people "were not required to be held accountable" and that there was a relationship "toxic" among some health professionals in Northern Ireland.
"I've seen it before but only in individual institutions or between individual teams," he said.
"Here there seems to be a generalized pattern in almost the entire province."
Professor Scally added that the department could have saved lives if it had been acting correctly.
He said: "The Department of Health is not the health service, it's a state department, it's a department to serve people and serve people means to get the NHS to respond."
"That's what they should have been doing and I do not think they did. "
He also called for Northern Ireland's chief doctor, Dr. Michael McBride, to speak publicly about the matter and rebadure the public about how they are doing. making the improvements.
He added: "If it were me, I would say:" I'm sorry this has happened and I'm going to do my professional duty for the rest of my career to make sure this never happens again. "
] "The medical director, if he were involved, should talk about it and talk to the public and talk to families about what he learned from that, and to carry out the recommendations and carry out the change, he could be the best person because I knew it from within. " The Department of Health acknowledged the rulings highlighted by the report of Mr. Judge O & # 39; Hara.
Howe See, noted that Mr. Judge O & # 39; Hara agreed that the health service environment had been transformed since the period he reviewed.
The department said: "The detailed work continues in response to the 96 recommendations of the investigation and more details of this work will be made public in the near future.
" The latest update would have been made public now, but the Relevant staff has been very involved in the department's response to the memory of the Belfast Trust neurological patient. "