Ongoing disputes with the judiciary regarding how best to compensate plaintiffs is likely to “have unwelcome consequences”, according to the head of the State's Claims Agency.
Ciaran Breen, the director of the State Claims Agency, said it is strongly of the view that Periodic Payment Orders (PPOs) “represent the best system of compensating people who have suffered catastrophic injuries, because PPOs ensure that families will not have the worry that a lump-sum payment may run out during their loved ones’ lifetime”.
Addressing the agency’s annual conference on clinical risk and patient safety in Dublin, Mr Breen acknowledged that “others may not necessarily agree”.
His comments reference a judgement handed down by the High Court that the law surrounding PPOs is “a dead letter” unless periodic payments take into account the effects of wage inflation.
“At the very least, it suggests there is a risk that the High Court may not be disposed to approve PPOs in future,” he said.
Mr Breen said that clinical negligence cases “represent a very significant economic challenge for the State”. He said that thus far in 2019 €287.3 million has been spent by the Agency in settling such cases, and that actuarial advice had indicated that roughly €374 million, a record annual payout figure, would be the overall total paid out in 2020.
He argued that the present tort-based system by which clinical negligence cases are resolved is “not fit for purpose”.
The SCA, which is managed by the National Treasury Management Agency, had paid out €3.15 billion by the end of 2018, a 300% increase on the same figure as at end December 2012.
The overall number of live claims under management has increased significantly over the past six years, with 10,658 claims outstanding at the end of 2018, compared with just under 6,000 in 2012.
Mr Breen cited a figure, by way of example of the “size and complexity” of catastrophic injury cases, of €32.5 million being paid out in 2019 in order to resolve a single case.
Separately, the conference heard that workplace bullying of medical trainees in the Irish health service is four times more likely to occur than in its UK counterpart.
“We continue to work with training bodies, but more importantly we are looking for the employers to address this issue,” Bill Prasifka, chief executive of the Medical Council, said.
He said that his organisation had first begun to look at the issue of bullying five years ago and had hoped to improve the situation by “putting a spotlight on it”, but had rather seen the levels increase.
“The time is long overdue for us to see some improvement,” Mr Prasifka said.
The conference also saw a senior HSE executive quizzed as to the effect an ongoing hiring freeze at the health authority is having on quality and safety within the service.
“There is lots of recruitment going on in the HSE, but people are not being allowed to recruit for roles that they haven’t got the money to fund,” Ciaran Devane, chair of the HSE’s board, said, adding that “in the long run” the executive will have to “recruit in the community for roles that keep people out of hospital”.