Medical negligence payment reform to roll out ‘within weeks,’ conference hears

Professor Rhona Mahony also expressed support for the move, saying it allows for a real-time assessment of costs. Picture: Sam Boal/Rollingnews.ie

Patients pursuing medical negligence cases will see changes in how compensation is paid “within weeks” as a long-awaited reform takes effect, a consultants’ conference heard on Saturday.

Next year could also see the long-delayed introduction of better information sharing and mediation between legal teams for patients and hospitals, aimed at reducing the need for court proceedings.

State Claims Agency senior clinical claims manager Philip Fagan told the Irish Hospital Consultants Association (IHCA) about the upcoming reforms.

Payments awarded to patients will now be staggered over their lifetimes and adjusted based on individual needs. The Periodic Payment Order (PPO) system has been paused since 2019.

He said the change is “coming very quickly” and expects it to be implemented “within weeks.” While acknowledging it will be more expensive for the State, he said it is also more just.

Professor Rhona Mahony also expressed support for the move, saying it allows for a real-time assessment of costs.

She urged: “Periodic payment orders need to come back.”

However, she noted: “It is really difficult to access very good services, even if you give parents all the money in the world.” She described access as “a postcode lottery” and criticised the inconsistency.

An obstetrician at the National Maternity Hospital, Prof Mahony chaired a working group examining the spiralling costs of medical negligence claims.

At the end of last year, the State’s outstanding liability was estimated at €5.35bn, most of it arising from a small number of clinical claims.

She called for the urgent introduction of pre-action protocols, which involve mediation and the exchange of information between legal teams before cases go to court.

This approach has been successfully used in the UK to reduce both court cases and legal costs.

Mr Fagan said the measure is still being developed, but he expects it to be introduced next year.

“I think 2026 it will be introduced,” he said, adding that it is not much further down the road.

The legislation supporting the change has been in place since 2015, though Prof Mahony remarked that she has been told its implementation is “imminent” many times before.

IHCA president Professor Gabrielle Colleran said the association is focused on delivering solutions rather than simply highlighting problems in the health service.

However, she noted that while the health budget now stands at €27.4bn, this has not translated into better care for patients across the board.

Ms Colleran said: “Some in senior positions have given a reductive analysis that this is down to consultants.”

She added: “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."

Margaret Murphy, a patient advocate from Cork, described how she became involved in advocacy after the tragic death of her 21-year-old son.

She called for systemic change in healthcare to promote learning from medical errors.

Ms Murphy recounted how she attempted to contact one of the doctors involved in her son’s care to have an open discussion, saying: “I would like to give him a hug.”

Prof Mahony echoed her sentiment, acknowledging that such events cause trauma for everyone involved.

“When you have a dead baby, and you feel you are responsible for that, that is really difficult,” she said.