Initiatives to tackle high cost of health-related claims should be welcomed

Recently, hospital consultants from across the country attended workshops as part of a drive to establish a panel of expert witnesses from the Irish medical community.

The workshops, which were organised by the IHCA and the Expert Witness Site (EWS), took place across two days at King’s Inns, Dublin, last month.

The EWS is an Irish organisation founded by barristers who source expert witnesses for legal teams involved in clinical negligence cases.

The IHCA partnered with the EWS to offer these classes with a key aim in mind: To reduce the Irish legal system’s reliance on overseas testimony.

The workshops are part of the IHCA’s broader push for reforms to curb the escalating cost of medical negligence cases to the State. The Association also wants to ease the financial and emotional strain on patients and families navigating the claims process.

The workshops are part of the IHCA’s broader push for reforms to curb the escalating cost of medical negligence cases to the State

Key reforms sought include the introduction of pre-action protocols involving earlier disclosure of patient records, mediation and opportunities for settlement; the resumption of phased or periodic payments that spread the cost of claims over a lifetime; and a review of the real rate of return (the percentage applied by the courts to adjust the compensation awarded).

Announcing the workshops, the IHCA reiterated its call for the Government to fully implement the recommendations of the Department of Health’s 2024 report on the rising cost of health-related claims. The group that produced the report, which was chaired by Consultant Obstetrician and Specialist in Foetal and Maternal Medicine Prof Rhona Mahony, recommended all of the above reforms.

Led by senior barristers, the workshops aimed to give consultants a clear picture of what expert-witness work involves. The sessions focused on updating attendees on relevant case law, outlining the duties set out in court rules, and highlighting the common pitfalls that can catch out expert witnesses at home and abroad.

Commenting on the need for reform, IHCA President Prof Gabrielle Colleran said the current protracted claims processes are simply unfit for purpose.

Prof Colleran said they are resulting in not only increased legal costs that are among the highest in the world, but also “significant human costs” resulting from the litigation process.

“As an Association, we believe there is an urgency to address the spiralling cost of litigation that is draining both resources and morale from the health service,” she said.

Prof Colleran pointed out that despite a welcome reduction in the sum of medical negligence claims paid in 2024, the current estimated outstanding liability associated with the State Claims Agency claims portfolio is €5.35 billion. This could rise further if the status quo continues.

“Consultants want to see the reforms outlined in Prof Rhona Mahony’s report progressed without further delay, as not doing so will only increase the cost to the State and worsen the experience of the processes involved for patients.

“The parallel human cost of litigation is significant and these reforms are required to improve the patient’s journey through the medical negligence process and ensure no further harm is done by its adversarial nature.”

Prof Colleran said that the project with the EWS will develop a panel of expert witnesses from the Association’s membership to ensure that the highest standards of independence and excellence in expert evidence are upheld. In helping to reduce the current system’s reliance on overseas testimony, the Association hopes it will also lead to lower costs, while enhancing credibility in the courts.

Another recommendation in the 2024 report on the cost of health claims is the development of a new model of care for neonatology. This is due to be completed next year.

A story in the last edition of the Medical Independent provided an update on the development of the model, which will form the foundation upon which all condition-specific pathways, including those for children with hypoxic-ischaemic encephalopathy, can be delivered effectively.

While these initiatives are only in their early stages, they represent important steps toward creating a system that works more efficiently for patients, consultants, and the wider health service.