Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

The answer to that lies with the State Claims Agency.

The management of these claims does not sit with the Department of Health but with the State Claims Agency. At a clinical and specialty level, a very high amount of the total is in obstetrics and the catastrophic birth injuries that are seen. As I said earlier, our approach to addressing this starts and ends with a patient safety view. The best way to bring the amounts of these awards down is to do exactly what the Cathaoirleach is saying: conduct a root cause analysis, identify where and why it is happening, and deal with that.

We all supported the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 when it went through. There are measures in that Act around things like mandatory open disclosure and transparency, which we know help. We know from the UK's National Health Service, for example, that when there is meaningful engagement with patients on things that have gone wrong they are less likely to sue. That is because for most people it is not about money but the fact that something potentially bad has happened to them and they must be engaged with.

The work Dr. Rhona Mahony is doing will be important. They are doing exactly what the Cathaoirleach is saying; they are looking at the root cause analysis and what is causing things like catastrophic birth injury. I mention Dr. Peter McKenna as well, who was the head of the national women and infants health programme. He is leading a piece of work whereby when there are patient safety incidents, they will go in, review and try to learn from them quickly. There is broad agreement on this and on what we wanted to do with the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023. The experience of too many patients has been that the State pulls the shutters down. From a patient perspective, the State has access to infinite resources and legal advice. It can be intimidating, stressful and difficult for patients. We want the courts to be a last resort and that is what the various pieces of work are looking to. They are following the approach the Cathaoirleach has laid out.