Mr. Ernest Cantillon:

We seem to have started with the MPS successfully taking the eye off the ball in avoiding the elephant in the room, which is that it goes without saying that if there is no medical error there is no claim and there are no legal costs. We seem to have jumped to focus on the costs and not looked at how to reduce the error. We need to look at reducing the incidence of error; Senator Crown raised this issue last week. According to a report today, we are now 22nd in the European league of health care providers. All doctors will always say if resources are slashed, they will have problems. No one comes out and says if resources are slashed, someone will be injured as a consequence, but it is obvious this is happening. We need to focus on the primary problem, which is reducing the incidence of medical errors.

Senator Burke asked about non-legislative intervention and rightly highlighted problems regarding capping levels and trying to get them reduced, and the problem of doctors leaving. This is undoubtedly a problem. I am not so sure the legal profession is the cause of this problem. Perhaps we contribute to it, but I do not believe we do. He asked for non-legislative changes. Ms Moorehead made an obvious point that introducing rules of court which would make the system somewhat akin to the commercial court could assist in information being disclosed at an early point in time. The State Claims Agency or the MPS could be encouraged to have early settlements voluntarily. Deputy Regina Doherty asked what Ms Courtney might do from the date of birth to the time of settlement, given the costs which would be associated. The State Claims Agency and the MPS could be encouraged to make interim payments to people, without an admission of liability if needs be, to put some money in their pockets so they can provide the required therapy for the children.

Deputy Regina Doherty also asked about insurance premia and whether a claim against a doctor resulted in an increase in the premium. I do not believe it does. Many doctors complain about cross-subsidisation. All practitioners, for the plaintiff and the defendant, will have experience of the same names coming up with appalling regularity in certain areas. The rest of the doctors are carrying the can for this.

To answer Deputy Mitchell O'Connor, the position on the Statute of Limitations has been adequately explained by Ms Moorehead. With regard to the ten year position, the MPS advocated that once ten years had elapsed from an event irrespective of any mitigating circumstances, it should be out the door and one should not be able to claim, irrespective of its merits. Certainly from the Law Society's point of view and, as I understand, from Bar Council's point of view, they see the unfairness of this.

Deputy Catherine Byrne asked about Irish doctors not supporting cases. Unfortunately, this is the situation. From a plaintiff's point of view, by and large, one cannot get an Irish doctor, with a few honourable exceptions, to give evidence on behalf of the plaintiff. Unfortunately, this adds to the costs because the doctors who come from abroad are expensive.

Deputy McLellan rightly drew attention to the absence of legal aid. We do not have legal aid. This is slightly overstating it as there is theoretical legal aid, but there are no specialists and the numbers of cases brought by the legal aid board are minimal. I do not know whether any of them have come through.

A question was asked about delays, and certainly they add to the costs because every step taken must be paid for by somebody and a whole pile of unnecessary steps are taken because one is asked to prove what is ultimately admitted, which should have been admitted at an earlier stage and, if it had been, other costs would not have been incurred.

Deputy McLellan raised the question of defending the indefensible, which unfortunately is the experience. One should try to be balanced and ask what is the defence's explanation for this. It is hard to see what it is except, in fairness, that doctors may state they do not believe they did something wrong and want their professional reputations vindicated. These doctors should be told they are wrong, that their colleagues who are independent experts have said they are wrong, and that no one is prepared to waste taxpayers' money defending them.