Mr. Simon Kayll:

A number of points have been raised. The policy of MPS is absolutely not to deny and defend. We believe a speedy resolution of claims is in the best interest of the patient, the doctor and our financial fund and we are keen to settle claims as quickly as possible. In our submission, we gave an example of a case where we admitted liability within six weeks of notification. However, because of the legal system, the plaintiff's solicitors, did not engage in an early settlement and the case ran on and on. We believe there is an element within the system that does not allow easy and quick resolution.

A number of committee members alluded to the point made by Professor Duffy that litigation is not the best way to go. However, in Ireland, there is a lack of a process of complaint to which patients could take their lesser concerns and complaints rather than pursue a legal complaint. We fully support honesty and open disclosure. We have supported the duty of candour in the United Kingdom and have worked with the HSE and the State Claims Agency here on a communication model we call "Assist". We have worked extensively on this communication model, which supports open and honest disclosure. On the dental side, we have worked with the Irish Dental Association to introduce a dental complaints resolution scheme. Again, we are trying to encourage, within the community in which we work, ways of resolving concerns of patients with their clinicians that do not necessarily result in litigation. I have no experience of fraudulent claims. It takes a lot to bring a fraudulent claim for medical negligence and our experience is pretty much nil in that respect.

A question was asked regarding which countries we might look to as examples. It is very difficult to do this because of the nature of health care and because the split between primary and secondary care and between private and state medicine change all over the world. However, pre-action protocols seem to have made a significant difference, as does judge-led case management, in the United Kingdom since they were introduced. Hence the reason we are building on that experience and making that recommendation here in Ireland.

I am not sure I have answered all of the questions.