Dr. Colm Henry:

At the committee's hearing with the SCA weeks ago, we learned that the number of claims is steady but the amounts are going up. We heard that this is just one element of quality, whether it is of doctors or of services themselves. Some services, such as obstetrics, are more complex and more prone to claims than others. Approximately half of all claims pertain to catastrophic birth injuries, the consequences of which sometimes do not become apparent for many years. I assure the Deputy that there is a great deal of learning going on. The national women and infants health programme is examining the introduction of proxies for catastrophic birth injury. That would involve doing immediate incident reports in cases of neonatal cooling, which happens when there is hypoxia, and also in cases of perinatal events. It is absolutely the case that we want to learn. We do not want to wait for claims to come through four years down the line when cerebral palsy becomes evident. We want to learn from the at-risk cases as they happen. We want to apply that learning to all 19 maternity units in their safety statements and the measurements we provide to them through the Irish maternity indicator system, which is a quality report we give to all 19 units. It is absolutely the case that there is learning.