Cost of maternity-related claims spikes by 80pc in less than four years - State Claims Agency (SCA)
THE cost of maternity related claims has spiked by 80pc in less than four years and represents more than half of all clinical care related claims settled last year according to the State Claims Agency (SCA).
In 2010, the total expenditure on maternity related claims was €32m, but this rose to €58m last year.
Claims relating to cerebral palsy - which accounts for 82pc of all clinical claims in maternity services - also increased by 77pc from €27 million to €47 million between 2010 and 2014.
However, the SCA said that this increase is primarily due to victims receiving lump sum payments instead of certain previous Periodic Payment Orders (PPOs) and to the cumulative effect of the greater use of PPOs over time.
In October 2010, a High Court Working Group on Medical Negligence and Periodic Payments recommended that legislation should be enacted to allow the courts to make PPOs.
However, the law - which will see victims receiving structured settlements over time rather than by means of a lump sum - has still not been enacted, leading to a surge in the cost of maternity related claims.
The Government says it will bring in new periodic payment laws before the end of the year.
And SCA Director Ciarán Breen said there is "no doubt" that the cost of annual maternity related claims would fall if periodic payments were placed on a statutory footing.
Addressing the issue of delay, Mr Breen said that some lawyers were reluctant to go down the mediation route and said that agency is met with unreasonable demands on the quantum (compensation) side.
Mr Breen said that the real issue for a claims perspective in maternity care is the "very emotive" and complex cerebral palsy cases that require to be ruled by the courts as they are infant cases even where liability issues have already been addressed.
Mr Breen renewed calls for pre-action protocols for court proceedings to be introduced to address the frustrations including delays that families experience with the courts system here.
Mr Breen said that such protocols, which have been introduced in the UK, would regulate the conduct of lawyers for both sides and narrow the issues prior to court proceedings and reduce complex cerebral palsy cases to less than 18 months rather than up to four years as in Ireland.
Mr Breen said it was "timely" to review the prospects of a no fault system for clinical care claims that could, in time, replace the adversarial court system here based on the law of torts.
This morning the SCA published a new report analysing clinical incidents and claims in maternity and gynaecology services.
In all, the total expenditure on clinical care related claims increased by 43pc from €74m in 2010 to €106m last year, with maternity services accounting for 54pc of the overall expenditure in clinical care.
The five year review found that national incident rates in Irish maternity services are not dissimilar to international figures where comparisons are available.
The review recorded an increase in post partum haemorrhage which occurred in up to 1.5pc of all vaginal births.
The SCA settles around 500 clinical cases a year, with some 97pc resolved without a court hearing.
Speaking at the launch, Mr Breen said the SCA is "acutely conscious" that behind the statistics contained in this report are tragic events that have resulted in suffering and acute trauma for expectant mothers, their babies and their families.
"However, this report is valuable because it analyses crucial information on adverse event reporting in maternity and gynaecology services," said Mr Breen.
"This information assists in the identification of adverse trends and areas for improvement in the maternity and gynaecology services.
Last year 75 out of a total of 9,787 clinical incidents were rated as extreme in severity when reported to the national incident management system (NIMS).
However the SCA said that this number of "true" extreme incidents was fewer after detailed, manual clinical analysis.
Dr Dubhfeasa Slattery, head of clinical risk at the SCA, said the difficult journeys of mothers, babies, families and women with gynaecology symptoms in Ireland was central to the writing of the report and said that good quality data is critical.
"The SCA is dedicated to working with maternity and gynaecology services nationally to improve patient safety and experience through encouraging more uniformity in incident reporting," said Dr Dubhfeasa.