Carol Nolan (Laois-Offaly, Independent) | Oireachtas source

Information supplied to me in response to a parliamentary question to the Minister for Health revealed that, since 2010, the total cost to the State of defending medical negligence litigation against the HSE and Department of Health, including court settlements, had exceeded €3 billion. In fact, there had been a 400% increase in costs from 2010 to 2023, rising from €74 million to just over €350 million. The Minister will agree that these are staggering costs and a clear indication that there is something profoundly broken when a health system for such a small a country can generate these kinds of costs and settlements.

These costs relate to claims against all HSE locations, namely, acute and community settings, section 38 service providers and the national services and disability sector locations. Behind them, however, are traumatised patients, devastated families left with life-long care needs, and doctors and medical professionals who have been broken by the adversarial and lengthy nature of the litigation process. We know that doctors are leaving our system because of this. As Professor Gabrielle Colleran, vice-president of the Irish Hospital Consultants Association, pointed out on RTÉ on Monday in response to my parliamentary question, Ireland and the United States were top of the table internationally in terms of medical negligence litigation. As Professor Colleran pointed out, some of the major reasons for this had to do with the ongoing failure to optimise care, treatment delays, unfilled medical posts and overcrowding in emergency departments, which generates its own kinds of adverse outcomes, including death.

In response to queries from a journalist, Mr. John Drennan, on this issue, the Private Hospitals Association of Ireland also expressed concerns about Ireland’s outlier status when it came to the cost of medical negligence. The PHA stated: "The human and financial cost of the current clinical negligence claims system reveals a system that is not fit for purpose and has not been fit for purpose for some time."

What are the possible solutions? According to Professor Colleran, the first thing we need to do is be ambitious about the introduction of pre-action protocols, which emphasise a less adversarial mediation process. As I understand it, when such pre-action protocols were introduced in Australia, the cost of claims fell by 50% and the average cost of litigation fell by 20%.

Given the costs involved and the high likelihood that we will face €500 million in costs in 2024, will the Minister commit to establishing a high-level HSE and Department of Health working group to examine options such as those put forward by Professor Colleran around pre-action protocols?

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