The HSE is facing a claims crisis with the number of High Court cases against the health services almost doubling in five years to reach record levels.
Close to 1,000 new claims against the HSE, its hospitals, and other services were lodged with the High Court last year — almost twice as many as in 2010.
The cost of mistakes made within healthcare settings is already huge. The State Claims Agency (SCA) has reported it had more than 3,000 claims on hand at the end of 2013, arising from medical errors alone and was expecting payouts to run to €1bn.
That does not include the 936 claims lodged with the High Court last year, the 218 lodged in the first four months of this year, or the new claims being added every day.
The true number of claims is also likely to be higher as proceedings issued in the lower courts are not included, and the estimated costs also exclude claims arising from accidents and other incidents, such as injuries to staff, contractual disputes, and contested family and child protection cases.
Issues with maternity services have come under renewed scrutiny following the publication of the Hiqa report into failings that led to the deaths of newborn babies in Portlaoise Hospital. This also follows recent high-profile High Court settlements for children who suffered catastrophic injuries during birth.
However, while delays and obstructions in dealing with errors were highlighted in those cases, the High Court lists show a far wider — and growing — problem for the HSE in how it has handled grievances.
That is despite ‘open disclosure’ initiatives launched by the HSE and the SCA in 2013 aimed at defusing complaints by patients and encouraging the settlement of issues without involving the courts.
Health chiefs have been told to get to grips with the spiralling problem. Health Minister Leo Varadkar has expressed frustration with the ‘wall of silence’ approach whereby patients who have had a negative experience or outcome have to resort to the law to get answers as to what went wrong because management will not engage with them.
He says medical practitioners and managers need to learn to say sorry, to reassure patients that their grievance is being investigated and to make the findings known as soon as they are established.
Mr Varadkar told the Irish Examiner: “As a medical student, the concept of open disclosure was drummed into us but it seems that it hasn’t yet been fully embraced in all cases.
“When something goes wrong, it’s OK to say that you’re sorry about what happened. It does not mean you’re accepting liability.
“There is a never a good reason to conceal the truth from a patient or their family once the facts are known. Aside from making sense from a human point of view, it’s the right thing to do financially.
“Evidence shows that patients and families who are harmed are less likely to sue, and much more willing to accept a fair offer of compensation if they have been treated with compassion, courtesy and honestly.”
The Department of Health said legislation was being drawn up to underpin the policy of open disclosure and to enable health employees provide information to patients and their families without prejudicing any future legal proceedings.
The HSE, meanwhile, says it is continuing to implement the open disclosure policy adopted in 2013. “The focus for 2015 is on the roll out of a national open disclosure ‘train the trainer’ programme.
“All hospital groups and community healthcare organisations have been requested to nominate staff as open disclosure leads and as open disclosure trainers,” it said.
It added that an independent evaluation of open disclosure pilot programmes undertaken in Cork University Hospital and the Mater Hospital in Dublin would be available shortly.
However, with High Court claims routinely taking several years to process and no slowdown in new claims evident, no reduction in payouts is anticipated in the short term.
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