Mr. Ciar?n Breen:

I thank the Chairman and members. I will concentrate on one or two things that arise from the opening statement.

I will address a couple of things that are really by way of tort reforms, which are set out in the opening statement. One is to do with the periodic payment orders and what has been happening on that. As members know, the statutory scheme ultimately failed in a particular court hearing where the index was deemed not to be appropriate. Only six such statutory periodic payment orders were made. That has been in suspension since then and we have been unable to use those.

I will draw attention to the pre-action protocol. As the Chairman possibly knows, I have said on many occasions in this venue in the past that if there was one thing that would improve the management of clinical negligence litigation, not just for us but the families of persons involved in clinical negligence events, a pre-action protocol would be a considerable game changer in easing the more adversarial elements of such litigation.

On the figures referenced by the Comptroller and Auditor General, I will point out some idiosyncratic points in the overall figures. We have 11,204 active claims as of the end of 2022. There are 7,329 claims on the general indemnity scheme and 3,875 claims on the clinical indemnity scheme. The combined outstanding liability in respect of those is €4.95 billion. This is broken down as follows: €3.85 billion against the clinical indemnity scheme and €1.1 billion against the general indemnity scheme. Some of the more idiosyncratic points here relate to maternity services. There are 914 active claims, which is 24% of the portfolio, accounting for 63% of the outstanding liability of €2.4 billion. On what we paid last year, 54%, or €200 million, related to paid maternity claims. Catastrophic injuries represent a particular challenge for the scheme. We have 365 active catastrophic injury claims, which is approximately 9% of the active claims portfolio but accounts for €2.8 billion or 73% of the outstanding liability.

I will mention mass actions because these are a particular volatile category. We have 1,795 mass action claims.

Of those, 535 relate to the clinical indemnity scheme and 1,260 to the general indemnity scheme. The total estimated cost of those is €550 million.

In anticipation of a question from members or the Chair as to how we fare with a comparator, I thought it would be useful to make contextual reference to the NHS Resolution in the UK, which is the equivalent of the State Claims Agency. Maternity-related claims represent 70% of the UK’s body’s overall £128 billion, while 60% of the annual cost of £13.3 billion relates to maternity care. Comparison of our outstanding liability with theirs shows a favourable position for us, even taking into account the population difference and so on.