Healthcare is not, and never will be an exact science. Unwanted adverse outcomes cannot be eliminated, but can be reduced. Most adverse outcomes are not the result of errors by doctors and nurses; rather they are recognised side-effects of investigations or treatment. However figures provided to this newspaper indicating the Health Service Executive has spent about €367 million in compensation payments for more than 2,000 cases over the past decade are an indication of the scale of the problem.
Specifically some €67 million was paid out in compensation for medical malpractice during birth procedures over the past five years. There was a particular spike in birth-specific payouts in 2013, when compensation rose to almost €25 million.
Obstetrics is a high-risk speciality with the health of both mother and baby at stake. Oxygen deprivation for a baby can be catastrophic, resulting in cerebral palsy, intellectual disability and even death. A child from Cork was last year awarded €13.5 million – the largest personal injury settlement in the history of the State – as a result of brain damage caused at birth.
And the alleged poor management of oxygen deprivation during the births of seven babies at Ballinasloe's Portiuncula hospital is the subject of an ongoing examination* by the Oireachtas Joint Committee on Health.
Higher compensation amounts are reflected in an exponential increase in clinical indemnity costs. Obstetricians are effectively uninsurable and would be unable to practise without the cover provided to those in public practice by the State Claims Agency.
There is real concern that some surgical specialities will disappear from private hospitals as clinical indemnity rates continue to climb. A compensation culture and inefficient legal processes have been blamed by doctors organisations.
But an adversarial system described by one father as adopting a “poker approach” to compensating his son with cerebral palsy is absolutely unacceptable. For patients who are clearly harmed by medical negligence a humane and cost-effective redress system must be found.
*This article was amended on March 31st, 2015