Philip Fagan, a senior clinical claims manager at the States Claims Agency which handles these cases told the gathering of doctors that he expects the long-awaited pre-action protocols to be put in place in 2026.
These protocols are key to making the whole area of medical negligence claims more “humane”, said former master of the National Maternity Hospital in Holles St, Dr Rhona Mahony.
Dr Mahony and Mr Fagan were one of the speakers at the annual meeting of the Irish Hospital Consultants Association (IHCA) today in Kilkenny at a presentation on medical negligence claims which has led to a surge in payouts running into billions in the last decade.
A pre-action protocol would see the claimant sending a a letter of claim outlining the allegations and the harm suffered.
Mr Fagan said it is “intended to remove the adversarial approach to exchanging information”.
It would “encourage the claimant and respondent to narrow the issues in the dispute at the outset and bring time and cost savings and no trial by ambush.”
The conference also heard that periodic payments, which are paid out by courts over several years instead of in a lump sum, will return in weeks after being suspended in recent years. They take account of a person left with a disability due to negligence having additional needs over the years.
The parties are expected to engage in talks which would whittle down the issues and potentially look at alternative dispute resolution methods like mediation, to try and resolve the case.
Dr Mahony who was part of a Government appointed expert group – the Interdepartmental Working Group on the Rising Cost of Health-Related Claims – which produced a report on how the better manage medical negligence claims said that pre-action protocols are the “biggie.”
She said that clinical catastrophic injury claims account for around 57pc of the cost of payouts.
Medical negligence cases can leave patients and doctors “pitted against each other,” she added.
Pre-action protocols would see all sides “getting around the table early on,” she told the gathering.
“Patients will find out what happened.It is more humane and will reduce costs.”
The current system is not serving patients or doctors, she added
Mr Fagan said the State Claims Agency receives around 650 new cases a year and around 75pc are the majority are settled.
He also called for a less adversarial system and said “reform is necessary” and the current system is unsustainable.
Referring to the human factors which lead to claims he said doctors make mistakes and may be under pressure or tired.
“People have good and bad days”, he added. And there can be a problem of pre-conceptions where people “see only what they expect to see”.
Opening the conference the President of the IHCA Consultants Dr Gabrielle Colleran said consultants agree it is essential to maximise the delivery of high-quality care for every euro invested by the taxpayer.
She was speaking after strong criticism of consultants earlier this year by Health Minister Jennifer Carroll MacNeill who said not enough senior doctors were on site in hospitals at weekends. The minister is not attending the conference.
Dr Colleran said: “Whilst it is great to see the €27.4 billion allocated to health in the 2026 budget the reality is that increased funding in recent years has not translated into meaningful patient impact across the board.
“Some in senior positions have given a reductive analysis that this is down to consultants. Consultant delivered patient care is, at its core, a team effort.
“It needs to be provided within the framework of a well-resourced system — one that offers the necessary infrastructure, modern IT systems, accessible outpatient clinics, nursing staff, and multidisciplinary teams.
“Expecting consultants to deliver care without ensuring ongoing access to essential infrastructure and team-based supports is not only unrealistic and unsustainable — it is fundamentally unjust, it reflects work as imagined not work as done.
“Even if every consultant vacancy — and there are far too many — were filled overnight, the persistent deficits in healthcare infrastructure and resourcing would still remain.
“Addressing these systemic issues is key if we are to provide the standard of care and patient experience that patients rightly deserve from their health service and in order to get real value for money from increased investment.”
She said that productivity is far from a “dirty word”. Consultants can always be relied upon to drive productivity.
“Consultants consistently have the lowest level of sick leave across all staff grades in the HSE, and this speaks volumes about our commitment to patient care.
“It is important that the right productivity metrics are used, and that they capture the ‘value’ for patients and their humanity as well as the volume of care provided in our acute hospitals. The Association is ready to have that discussion and to engage on meaningful solutions,” she added.