Sir, – Your editorial "Facing up to blame" (September 17th), on the subject of medical negligence, suggests that the State Claims Agency prevents hospitals and medical professionals from saying sorry or admitting fault. I wish to state categorically for the record that the State Claims Agency has not and does not advise the HSE and/or hospitals and medical professionals not to apologise or admit liability. It is a matter for them and they are entirely free to do so. It is always and without exception appropriate for an institution or individual medical practitioner to say sorry or express regret following an adverse clinical event.
In fact, the State Claims Agency, in conjunction with the HSE, has piloted a significant Open Disclosure project which has been rolled out to approximately 50 hospitals and nine community healthcare organisations countrywide.
It includes expressing regret for what has happened, keeping the patient informed, and providing feedback on investigations and the steps taken to prevent a recurrence of the adverse event.
The State Claims Agency becomes involved in these cases when legal proceedings are initiated, typically some years after the event that gives rise to the claim.
From that point onwards the State Claims Agency endeavours to ensure that the litigation is handled sensitively and as quickly as possible within the limitations of the tort system. Independent experts are engaged (by both sides) to explore the issues of liability, causation, condition, prognosis and the calculation of special damages.
This inevitably takes time and is frustrating for plaintiffs and their families but where the resulting experts’ evidence points to both a breach of duty and causation, the State Claims Agency moves to admit liability and settle the case as soon as possible.
The State Claims Agency recognises that the current system requires reform. That is why it has taken a number of important initiatives – such as pioneering the use of periodic payment orders to compensate catastrophically injured victims or offering to resolve cases via mediation – in an effort to shorten the time required to settle cases and make the process easier and less adversarial for the families involved. – Yours, etc,
CIARÁN BREEN,
Director,
State Claims Agency,
Treasury Building,
Grand Canal Street,
Dublin 2.