Being accountable could save us in long run

According to Tuesday’s Irish Examiner a simple admission of error may cut medical legal bills by €400m per annum.

That is an awful lot of money, but saving it when every penny counts, as it does in the Ireland of today, is very welcome.

It may only be 2% of the health budget, but it’s 2% that benefits nobody other than the recipients of the ridiculous legal fees that are the norm here.

This new ‘plan’ basically amounts to encouraging doctors to immediately admit to patients when they make mistakes. To date the policy has been one of denying that anything was done wrongly until the litigant can claim otherwise. Hence the enormous legal fees and often times agreements reached on the steps of the High Court. Supreme Court Judge William McKechnie said the current system can put hurdles in the way of patients finding out what exactly happened.

According to another report in the same edition of the Irish Examiner that is exactly what happened to the family of Brid Courtney when they sought to find out why their daughter had suffered serious complications, which resulted in brain damage, during her birth in 2003. The case that followed ended with the Courtney family being awarded €11m in what is one of the biggest medical negligence payments to be paid in Ireland. However the payment was made on a no-fault basis.

Despite the payout the Courtney family has yet to receive an apology, and explanation of what happened, and a guarantee that lessons were learned. It does seem ludicrous that this family was not advised of what happened. It would be easy to say that this is Ireland and we do not do honesty easily, and we do not do candour if at all possible. Yet that is what is being asked for in the future.

A professor from the University of Illinois has stated that a no-fault sharing of information in some hospitals in the US has resulted in a 40% to 50% reduction in claims and lawsuits, whilereporting of incidents by medics has gone from 2,000 to 9,000 cases per annum.

Why is this?

Unfortunately, our adversarial system ensures that we lawyer up at the first drop of a hat. Denial and obfuscation simply delay the inevitable while going legal simply exacerbates the problem and makes it more expensive to solve.

Unfortunately, a policy of refusing to answer a valid question, of denial and of obfuscation appear to be part and parcel of the ‘induction tool kit’ provided to politicians and public sector managers in Ireland. A few simple examples come to mind.

The trustees of the ESB Pension Fund write to the boss of the ESB in April about a pertinent matter relating to the pensions of ESB employees and the ESB boss does not answer them. In the last few days a judge has had to suggest to the ESB that it would be helpful to actually reply, as well as being more professional.

Dublin has serious water shortage problems. The problems are so serious that supplies have to be cut off at night for a time.

They are so serious that expertise has to be brought in from the UK to determine the problem and to see what can be done about it. However, communicating with its customers was at the bottom end of the scale of important things to do.

Dublin councillors have had to hit out at the officials for their lack of communication and some sort of ‘half- baked’ response has now been proffered.

Perhaps if we were more candid and more honest with one another we would be able to solve our problems that much faster. It might also mean that we would have more trust in our politicians and those who impact on us and how we live. It might also cost us a lot less money. If that same HSE 2% for legal fees is represented elsewhere there’s a lot of money to be saved.


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