Admission of error may cut medical legal bill by €400m

Government plans set to be announced next week could save the State €400m a year in legal cases against the HSE.

The groundbreaking move was revealed at a medical negligence conference yesterday, and said encouraging doctors to immediately admit to patients when they make mistakes would drastically reduce litigation claims.

Under the plan, which will be detailed by junior health minister Alex White next Tuesday, medics will be asked to sign up to a “candour” policy where they provide full details to patients when adverse incidents occur.

The scheme will be piloted at a number of hospitals — including Beaumont, Cork University Hospital, Kerry General in Tralee, Tallaght, Our Lady of Lourdes in Drogheda, Cavan/Monaghan, the Mater, and James Connolly Memorial Hospital in Blanchardstown — over the coming months.

Studies from countries including the US, Canada, and Australia, where the approach has replaced rigid legal defences in some hospital groups, suggest it drastically cuts the number of medical negligence lawsuits, which can cost the taxpayer millions in compensation claims.

This is because patients’ first priorities are to know what went wrong and that lessons have been learned, rather than costly legal cases.

Ann Duffy, State Claims Ag-ency official, said the policy change would need a number of years to bed into the system, meaning savings should be seen in the medium-term.

However, economist Moore McDowell told the patients’ rights conference if the policy is introduced here, it could cut “€250m to €400m” a year from legal fees and compensation claims taken by injured patients against the HSE.

“That’s only 2% of the health budget,” he said. “But 2% of €14bn is the kind of money you might notice if it fell out of your pocket. Or if you are a finance minister looking for it.”

The plan already the backing of Supreme Court judge Mr Justice William McKechnie SC, who said the current system can put hurdles in the way of patients attempting to find out what happened.

Tim McDonald, chief safety and risk officer for health affairs at the University of Illinois in Chicago, told the conference the no-fault sharing of information in some hospitals has led to “a 40% to 50% reduction in claims and lawsuits while reporting of incidents [by medics] has gone from 2,000 to 9,000 per annum”.

While accepting the policy “may seem counter-intuitive from a bottom-line perspective, given that it notifies patients early on about medical mistakes”, it is better for patients as they do not have to fight authorities to find out what went wrong, and is good for the medical system as it allows for greater transparency.

Noting how the latter point is vital for lessons to be learned quickly, Prof McDonald said the number of patients who die through some form of medical negligence in the US every day is the “equivalent of a packed 747” plane — and that hiding mistakes will cut more lives short.

The State has paid out over €400m in medical negligence compensation claims since the recession began. However, this figure does not include legal fees or court appearance expenditure.

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