HSE head asks why State contests negligence cases

Tony O’Brien says challenges delay compensation and State loses virtually all of them

Tony O’Brien, director general of the HSEhas criticised the adversarial framework used to resolve litigation surrounding birth injuries and provide compensation for victims and their families. Photograph: Dara Mac Dónaill / The Irish TimesPhotograph: Dara Mac Donaill / The Irish Times
Tony O’Brien, director general of the HSEhas criticised the adversarial framework used to resolve litigation surrounding birth injuries and provide compensation for victims and their families. Photograph: Dara Mac Dónaill / The Irish TimesPhotograph: Dara Mac Donaill / The Irish Times

The head of the Health Service Executive has questioned why the State contests long-running medical negligence cases that delay compensation for families when it loses virtually all of them.

HSE director general Tony O'Brien criticised the adversarial framework used to resolve litigation surrounding birth injuries and provide compensation for victims and their families.

He said he understood why people had to fight tooth and nail for compensation, often for up to a decade, and pointed out this affected the general population’s perception of the issue.

He told the Oireachtas health committee he supported a move to a different system for cerebral palsy and other cases [such as the creation of a compensation fund].

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“These cases go on for up to 10 years and the State loses 99 per cent of them, so why all that trauma for people to get what they need.”

Mr O’Brien criticised what he termed an “unrealistic” view about risk and safety in healthcare.

Providing healthcare was an inherently risky business and it was appropriate to have accountability where this was required.

However, increasingly, there were “show trials” around performance issues that were dangerous for those working in the service.

Health professionals under inquiry were not facing criminal offences, yet they faced cameras at the entrance to the hearing while very little attention was paid to the eventual result of the process.

Mr O’Brien said Ireland as a State since its foundation hadn’t developed a settled notion of what it wanted from the health service.

Referring to a weekend newspaper interview, he said his comments were intended to encourage a “grown-up” debate about the healthcare system.

Unfortunately, because of the headline, his words were used in “a knockabout way” that didn’t contribute to a national consensus.

Mr O’Brien said trolley numbers were down on 3.5 per cent on last year on a 30-day moving average basis based on the count by the Irish Nurses and Midwives Organisation.

Numbers were down 8 per cent based on the HSE’s own count.

He said the health service continued to remain vigilant about the challenges that always present at this time of the year.

Lessons had been learned from last year, especially about providing services in the first two weeks of the New Year.

New measures had been implemented to help the throughput of patients, including the assignment of new tasks to nurses, 8am to 8pm opening for many radiology departments and the opening of up to 440 additional beds.

Responding to Mr O’Brien’s comments in a statement the State Claims agency on Thursday night said 97 per cent of cases handled by the agency are resolved without a contested court action.

In cases where the agency fully contests liability, the courts find in its favour in 75 per cent of cases.

Paul Cullen

Paul Cullen

Paul Cullen is a former heath editor of The Irish Times.