Plan to cut legal costs in medical negligence claims

RADICAL PROPOSALS to cut payouts to lawyers involved in long-running medical negligence cases have been made by Minister for …

RADICAL PROPOSALS to cut payouts to lawyers involved in long-running medical negligence cases have been made by Minister for Enterprise and Jobs Richard Bruton.

The plan would see the assessment of damages in such cases given to a State body rather than being fought through the courts. By dealing with claims in a non-adversarial manner without the use of lawyers, it is hoped to save the Exchequer up to €50 million over three years and resolve cases more quickly.

The proposal to create a medical injuries assessment board is modelled on the Personal Injuries Assessment Board, which was set up in 2004 to handle many other types of injury claims. It is credited with reducing these costs from 46 per cent of the value of awards to just 8 per cent.

Fine Gael is committed to reducing the number of State agencies to save on exchequer funding, but any new quango could be modelled along the lines of the self-financing personal injuries board.

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Under the plan, the handling of medical negligence claims could be assigned to a new agency, or to the personal injuries board.

The legal profession is likely to view with dismay any attempt to take medical negligence work away from the profession. The State Claims Agency, which handles most injury claims against the State, is also understood to be concerned at the proposal.

However, the proposal may be favourably received by Ireland’s international creditors; since the signing of the EU-IMF memorandum of understanding late last year, the Government has been under pressure to tackle “sheltered sectors” such as the legal and medical professions.

The plan might also assuage the concerns of Labour backbenchers, some of whom have attacked Mr Bruton in recent weeks for seeking to cut wages for low-paid workers in regulated areas rather than going after the “sheltered sectors”.

The Minister’s officials circulated a memorandum outlining the proposal to other Government departments, including health, education and finance, last month and asked for responses by yesterday.

Before the election, Fine Gael’s fiscal plan claimed a €55 million reduction in State payments for profession services could be achieved by extending the personal injuries board model to other areas such as medical negligence and Garda compensation “where high legal costs still dominate”.

The party also promised to introduce a no-fault compensation scheme for children who suffer catastrophic birth injuries. Neither proposal featured in the programme for government.

More than 4,000 claims have been lodged against the State, and more than 90 per cent of these by value relate to clinical issues. Most of this €700 million liability relates to obstetric claims, due to the high costs associated with cerebral palsy and other serious birth-related claims.

Opponents of the proposal say it will not work because medical negligence claims differ from other claims, for example those resulting from car crashes or accidents at work, in their complexity and reliance on the evidence of expert witnesses.

It is also claimed that the creation of an injuries board for medical negligence cases would create another layer of bureaucracy.

More than 80,000 medical incidents are reported each year, but only about 500 result in claims. The State has indemnified staff in all public hospitals, and in some private obstetric hospitals, against clinical negligence claims.

A High Court working group is currently looking at the handling of medical negligence claims in the courts. The group, which has issued a first report last year and is expected to report again shortly, favours a move away from the payment of single lump sums to people who have suffered catastrophic injuries in favour of periodic payments over the whole of their life.

The group is also expected to back a new approach that would allow parties to admit liability at an earlier stage, rather than when the case is in court. This could serve to reduce the costs involved.

Paul Cullen

Paul Cullen

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