Dr. Tony Holohan:

Yes. We are happy to come back and clarify that question.

The Deputy's question on costs and rising costs is a fair one. I point out in a general sense that the consideration of litigation is of importance and that we look at trends. There has been a significant trend, in particular in regard to birth injuries. The proportion of State Claims Agency claims relating to obstetric activities is very high and is increasing in this country.

The so-called patient safety surveillance was mentioned in passing in the opening statement. It arises from work we did in Portlaoise, where it became clear that in respect of that hospital there were different pieces of information in different parts of the overall health system. Some of the regulators, such as the Medical Council, HIQA, the HSE or the State Claims Agency had dealt or had engagement with issues there. Different agencies at a national level had small pieces of the jigsaw but nobody was putting the whole picture together. The claims experience of a service is one part of the picture. The Department is trying to build and strengthen that so-called patient safety surveillance system so that we have a profiling of all the pieces of the jigsaw at any one point in time in respect of every hospital. That is part of the function of the patient safety office. If an incident occurs in a certain setting, one is able to put that into a better context than might previously been the case because one now has a better understanding of the care and practice in that setting. Claims and understanding the claims experience is one of the aspects which feed into that system of patient surveillance.