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Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: What would have been the nature of some of the larger settlements reached in cases which did not go before the courts by Mr. Breen's organisation? Will he provide a flavour of the two or three largest settlements that were agreed? I do not have a particular case in mind in this regard. The agencies before us are State agencies and if I were asked questions on clinical indemnity, the State...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: A court ruling?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: Would there have been many settlements amounting to over €1 million?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: Mr. Breen is aware of the type of information in respect of which I am seeking a breakdown.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: He can appreciate from where I am coming on this matter. I am not seeking to be totally prescriptive and Mr. Breen knows the information he can provide which will be of assistance to the committee. Perhaps he will also provide information on the payments made to the top five or ten barristers. I will leave it to him to decide what is a reasonable number in this regard.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: It is in respect of both matters we have been discussing. However, I accept that between 85% to 90% of the work involved relates to clinical negligence. I would be happy to receive the information in whatever way Mr. Breen sees fit to supply it. All I am trying to do is obtain a greater understanding of what is going on.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: Have they provided any good suggestions?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: When does Mr. Breen's office have sight of an original medical report file, as, for example, in the Gaffney case? When does his office have sight of the original medical report as written by the hospital staff? How long does it take for the file to come to his office?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: The most disturbing aspect is that according to the Comptroller and Auditor General, 40% of all the claims received had not already been notified to the agency as being adverse incidents. Mr. Breen referred to early disclosure but that is not working if, in 40% of the cases that land on his desk, his agency has no advance knowledge of them. Is that a correct presumption? We are miles away...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: During 2013 the State Claims Agency indicated that it had no standard management report of such consolidated data and the requested information would take a considerable amount of time to assemble. This is stated in paragraph 29.61 of the report of the Comptroller and Auditor General.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: Does the agency deal with hospitals directly rather than through the HSE?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: And private hospitals.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: I ask Mr. Breen to forward it to the committee and to give a breakdown of the cases that went to court or were settled.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: We will take whatever definition Mr. Breen wishes to give the committee. I will not specify the definition.

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: I ask Mr. Breen to separate the cases that do not go to court and to list the total awards in both categories, court and non-court, the average award, the legal costs for the cases that go to court. The committee does not yet have a picture of the difference between the average cost of a case that goes to court as against the average cost of a case that does not go to court and whether there...

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: What is the biggest case?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: Without going to court?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: Mr. Breen will not call that a court settlement in that case. Are any cases settled without the person going up the steps of the court?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: Mr. Breen refers to early negotiation and mediation yet everything seems to have to go to court for a day. We heard lovely flowery words earlier about mediation. How many are settled before going to court?

Public Accounts Committee: 2012 Annual Report of the Comptroller and Auditor General and Appropriation Accounts
Chapter 2 - Government Debt
Chapter 28 - Accounts of the National Treasury Management Agency
Chapter 29 - Clinical Indemnity Scheme
2012 Annual Report and Accounts - National Pensions Reserve Fund
(13 Feb 2014)

Seán Fleming: What about the cases that did not go to court? What were the two or three biggest cases in that category? I have no concept of it and I am still trying to get that simple answer. How many cases involve the State Claims Agency saying: "Hands up, we will not put you through the stress of having a senior counsel go to the High Court." How many such cases? I am trying to find out about all...

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