Medical negligence claims are an emotional, legal, and financial minefield—not just for the injured parties but for practitioners, healthcare systems, and the Government. For families affected by catastrophic injuries, the adversarial litigation process is exhausting, often compounding trauma. Meanwhile, healthcare professionals experience stress, lower morale, and defensive practices due to litigation fears.
Despite recommendations from multiple reports (including the 2020 Meenan Report), the reforms within Ireland’s medical negligence framework remain stalled. The interdepartmental working group’s 2023 report echoes earlier findings, calling once again for pre-action protocols, enhanced case management, a dedicated High Court list, and periodic payment orders (PPOs).
Each one of these reforms could ease the burden on claimants while promoting collaboration and reducing costs. Below, we explore the challenges in Ireland’s medical negligence litigation system and why implementing these reforms is critical for injured individuals and their families.
The Challenges of the Current System
Healthcare practitioners and injured claimants alike find themselves trapped in an adversarial legal system that often exacerbates emotional, financial, and procedural challenges.
1. An Overwhelming Process for Claimants
For families affected by catastrophic injuries or adverse medical outcomes, the legal process presents immense hurdles. Many see litigation as their last option to seek clarity, apologise for their poor care outcomes, prevent further harm to others, or secure financial compensation. Yet the process is frequently described as retraumatising, slow, and combative.
2. Rising Costs and Delays
The costs of medical negligence litigation in Ireland have skyrocketed, particularly due to catastrophic claims involving perinatal brain injury and cerebral palsy. These high-value cases, representing only 2% of new claims, account for over half of the litigation costs. Between 2018 and 2022, settlements for catastrophic claims escalated significantly.
Yet, the system delays extend far beyond catastrophic claims. Although fewer clinical claims have been filed recently, the number of active unresolved claims continues to grow, adding further delay and stress to the process.
3. Practitioner Strain
Medical negligence claims take an emotional toll on healthcare practitioners, reducing self-esteem and affecting family lives. To avoid litigation, many employ defensive practices, which do little to improve system-wide care processes. Furthermore, practitioners feel constrained by media scrutiny and worry they cannot adequately respond to accusations.
It’s clear this current litigation environment serves neither injured patients nor medical professionals. However, the recommended reforms offer hope for a balanced and collaborative framework.
Prioritising Reform for Early Resolution
The interdepartmental working group has reaffirmed longstanding recommendations to modernise the medical negligence litigation system. Here’s why reforms—such as pre-action protocols, enhanced case management, PPOs, and more—are essential.
1. Pre-Action Protocols (PAPs)
Envisioned since 2015 as part of a fairer system of medical negligence claims, PAPs facilitate early engagement and resolution of disputes. Clear benefits include:
- Early Disclosure of patient records that allow both parties to fully evaluate claims before litigation begins.
- Encouraging Settlement discussions or alternative dispute resolution that avoids unnecessary court proceedings altogether.
- Clarifying Key Disagreements to streamline the litigation process in cases requiring trial.
- Providing Apologies to offer emotional closure and acknowledgment for claimants.
While initially included as part of the Government’s Justice Plan 2023, PAPs have seen repeated delays. It’s imperative that this mechanism becomes a core part of Ireland’s approach to managing claims.
2. Enhanced Case Management
Enhanced case management could transform how Ireland’s High Court handles medical negligence claims. Benefits include:
- Early Identification of Key Issues, accelerating settlement or resolution.
- Mandatory Mediation to reduce adversarial barriers, aiming for early agreements with less emotional strain.
- Streamlined Timelines for urgent cases or those with catastrophic consequences.
- Preemptive Witness Agreements, which spare claimants from delivering oral evidence unnecessarily.
Focused case management would pave the way for faster, more efficient resolutions, cutting through the delays present in today’s process.
3. Dedicated High Court List
A High Court list specifically for medical negligence claims can offer claimants more consistent handling of cases, especially those involving specialised legal or medical insights. Although Ireland lacks staffing resources to establish a dedicated court, a specialised list would ensure medical negligence cases are addressed quickly and fairly. Judges with expertise in this domain could tackle complex cases more effectively.
4. Mediation as a Key Step
Mediated resolutions already play an important role in settling medical negligence cases, with 34% of clinical compensation claims resolved this way in 2022. This trend underscores how mediation not only cuts costs but provides an empathetic platform for claimants to resolve issues without prolonged legal battles.
Proposed reforms could require mediation as an integral stage of every medical negligence claim, further enhancing resolution rates while minimising courtroom visits.
5. Periodic Payment Orders (PPOs)
PPOs offer injured claimants and their families an ongoing stream of inflation-adjusted payments for life. This vital reform would eliminate the financially unsatisfactory cycle of lump sums alongside repeated litigation.
However, PPOs require reinstatement after a High Court ruling deemed the current indexation system inadequate. Amending the Civil Liability (Amendment) Act 2017 would ensure healthcare costs are annually adjusted based on realistic expense measures, finally unlocking a sustainable compensation model.
The Human Cost—a Reminder for Reform
Behind these much-needed reforms lie human stories of adversity. For injured patients and grieving families seeking justice, improving medical negligence litigation isn’t abstract policy—it’s their path to apology, accountability, and resolution.
Similarly, streamlining litigation frameworks spares medical practitioners unnecessary distress. When claims necessitate genuine accountability, reforms encourage transparent practices. When none wrongdoing occurred, practitioners should be spared the emotional toll of protracted disputes.
Seeking Legal Guidance in Times of Need
For those affected by medical negligence in Ireland, navigating the current legal framework can feel overwhelming. With 55 years of experience, HOMS Assist is here to provide expert, compassionate legal advice. Whether your claim involves catastrophic injury, surgical errors, or misdiagnosis, our solicitors understand the medical intricacies and seek justice and accountability for every client.
If you or a loved one has been impacted by medical negligence, contact HOMS Assist for guidance and representation tailored to your needs. Our goal? To empower patients and their families while advocating for fair and lasting remedies to Ireland’s medical system.
Reach out today to have your voice heard and take the first step toward the justice you deserve.
