Dr. Cathal O'Keeffe:

We would engage with hospitals. The way we approach it is from the perspective of the claim. If we see a claim where we feel there has been a particularly significant issue or concern, we would raise this directly with the hospital. On the maternity side of things, it is probably also worth mentioning the work of the national neonatal encephalopathy action group, NNEAG, which we partner with the national women and infants health programme, NWIHP. This programme, the HSE and our organisation work in partnership on the NNEAG. This is specifically designed to try to address the causes of these claims occurring in the first place. There are several elements to this endeavour. One of them, arising out of the work of the NNEAG, was the setting up of a group called the obstetric event support team, OEST.

This means that all significant injuries, whether a significant birth injury or maternal injury, must be reported to the OEST that sits within the NWIHP. On that basis, the NWIHP engages directly with the hospital to ensure that a review is undertaken of such cases. It advises on the review and examines it again. This is the angle we look at this context from in terms of the incidents, the claims, as they are occurring. Separately, we also engage directly with hospitals concerning several metrics and not just their number or value of claims. These include their incident reporting levels and these sorts of things. A range of metrics feeds into our analysis. It is also important to say that we have this unique claims perspective, whereas if the safety of a hospital is being examined, that actually involves looking across a much broader range of measures which we do not have.