Sunday 8 December 2019

PAC criticises failure to learn from clinical negligence cases amid 'eye-watering' estimated costs of €2.3bn

Committee chairman Seán Fleming TD. Photo: Collins
Committee chairman Seán Fleming TD. Photo: Collins
Cormac McQuinn

Cormac McQuinn

THE Dáil's spending watchdog has criticised a failure to learn from clinical negligence claims against the State amid "eye-watering" estimated liabilities of €2.3bn.

It comes as the Public Accounts Committee (PAC) published a report on its work from April to July this year which also includes separate findings in relation to the National Treasury Management Agency (NTMA) and the Gardaí.

PAC chairman Seán Fleming said the number and cost of claims against the State continues to escalate year-on-year, particularly those that arise from clinical negligence.

He said: "To date there is no evidence of a functioning systems-wide approach in the Health Service Executive (HSE) to incorporate learnings from associated incidents across the entire health sector."

The Fianna Fáil TD said the PAC report outlines how: "The failure to incorporate learnings is itself likely to contribute to the increase of such claims."

Social Democrats TD Catherine Murphy said the sums involved are "eye-watering", that the policy of open disclosure by health service staff is "essential if we're going to address that liability", and there needs to be a "cultural shift" in the approach to handling such claims.

The PAC recommends that the HSE, the State Claims Agency and Department of Health "puts in place a formal system to incorporate learnings from incidents of clinical negligence across the health sector in order to reduce the number of such incidents in the future."

In other findings the PAC said that the financial management of the HSE and oversight provided by the Department of Health is "unsatisfactory and does not demonstrate good governance or financial control."

The Cabinet was told last week that health service needs an extra €338m in funding this year.

The PAC report did acknowledge efforts to implement new controls to ensure the HSE remains within budget.

A HSE spokesperson said it will examine the PAC report and deal with questions from TDs when its officials appear before the committee next week.

They said: "It would be inappropriate to comment before then."

The requirement of the extra funding by the Gardaí every year between 2013 and 2017 “highlights ineffective management and control of the annual budget,” according to another conclusion in the report.

Separately, the report outlined how the Ireland Strategic Investment Fund lost €721,000 due to "unintended currency exposure as a result of human error."

The PAC recommended that the NTMA examines all operations on a regular basis to ensure such errors don't result in "a major financial loss to the Exchequer again".

Mr Fleming said the issue occurred when a transaction was recorded in euros instead of dollars.

He said the PAC has been told that there has been a review the system and that the mistake can't happen again.

Meanwhile, the report raises concern over the refusal by the Department of Finance to release details of payments to individual barristers providing services in relation to the Ireland Apple Escrow Fund.

The State has placed more than €14bn in escrow while legal challenges against the European Commission’s 2016 Apple tax ruling proceed.

The Department of Finance argued that it was not possible to release details relating to the individual barristers as it would be likely to breach General Data Protection Regulation (GDPR) and the Data Protection Act.

The PAC report recommends that mechanisms are put in place to ensure accountability and transparency for the spending of all public money is maintained, notwithstanding the requirements of GDPR.

Also on the Ireland Apple Escrow Fund the report says it is “concerning” by the end of 2018 it had declined in value by €16m to €14.2bn.

The PAC recommends that the investment strategy between Apple and the State is reviewed on a regular basis to ensure the long-term value of the fund is maintained.

Meanwhile, the report said it is “unacceptable” that 6,000 children had not been allocated a social worker by Tusla, the Child and Family Agency, even though the Department of Children surrendered €58.7m to the Exchequer in 2017.

The PAC recommends that the Department works with Tusla to ensure all children requiring a social worker are allocated one and gaps in the system are eliminated.

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