Colm Burke (Fine Gael) | Oireachtas source

I thank all the delegates for their very comprehensive presentations. I wish to start with Mr. Breen of the State Claims Agency. He might indicate to us the change in the level of litigation in the past three or four years, in particular the figures paid out in 2014, 2015 and 2016. What is his view in this regard for the next 12 months to two years? My understanding from listening to Deputy Kelleher this morning is that the figure has almost doubled in the past two to three years. Obviously, the system we have is not working. Therefore, it is important we take on board the open disclosure being talked about to see whether we can have a better system put in place.

The second issue I wish to raise concerns staffing levels in hospitals, especially where there is a whole changeover of medical staff. With nursing staff, there is a little more permanency, but many general doctors, in particular in the past few years, have been hired as locums and agency staff. I am concerned about the handover process within hospitals and whether we have a safe handover system. According to Mr. Breen's information, what is the evidence that this is causing some of the problems whereby, for example, an agency doctor is on one site today and a totally different site tomorrow and, therefore, the patients cannot get an explanation and the consultant is left trying to put the pieces together? From Mr. Breen's experience, has this been causing a problem?

Another issue is coming up which I have heard articulated by people who work in the hospital system. Given that so many staff have left the Irish medical scene and gone to England, Australia, Canada and the United States, we are not necessarily getting the best staff in many areas. The big challenge has been in maternity services. A report in 2003 indicated that by 2012 we should have 180 maternity consultants. Currently, I think we have about 130 whole-time equivalent consultants in maternity services. This is the field which sees the highest level of litigation. There does not appear to be an urgency on the part of the HSE and the Department to resolve this issue.

My final question is for Mr. McMahon. He talked about 21 years' experience. I know he is convinced this is the right way to go, but in that 21 years, has anything really changed or are we just getting more of the same?