Other Questions. - No Fault Compensation Scheme.

Michael D. Higgins


22 Mr. M. Higgins asked the Minister for Health and Children if, in view of a number of recent serious cases, he will introduce a no fault compensation scheme where children are brain damaged during birth; and if he will make a statement on the matter. [14525/00]

I am concerned about a number of issues which arise from the increasing cost of settlements in cases where infants have suffered serious brain injury at or around the time of birth. In the first instance, I am concerned at the rate of increase in the quantum of damages awarded in cases where negligence is established or where settlements are made before cases go to court. I am also aware of cases where it has not been possible to establish that any negligence occurred but, nonetheless, parents are faced with the challenge of caring for severely injured babies. The needs of the children are similar in all these cases and it seems unfair that the provision of the fin ancial resources to care for them should be dependent on proving negligence on the part of a hospital or its medical and nursing staff. I am also aware of the fact that in these very lengthy and complex cases the legal costs associated with the claims sometimes exceed the damages awarded.

A further concern is that this small group of cases distort the overall cost of providing medical indemnity cover for doctors. Despite the fact that it can cost up to £70,000 a year to provide medical indemnity cover for one obstetrician, doctors in other specialities are paying higher subscriptions in order to keep the obstetric rate at its current level. This situation is hardly sustainable in the long term. I also have a concern that the high cost of obstetric medical negligence claims may make it unattractive to young doctors who may otherwise have been considering a career in that discipline.

For these and other reasons, my Department has been exploring the possibility of introducing a needs based or no fault compensation scheme for such cases. Similar schemes elsewhere have been examined and initial discussions have been held with interested parties here. However, the introduction of such a scheme raises a number of constitutional, legal and financial issues which need further study. The Government has asked that specific consideration be given to the implications of introducing such a scheme in Ireland.

The Minister's response is similar to previous responses from his predecessor. Surely he would accept it is time the Department issued an interim statement on progress on this issue? There is nothing new in his response. This matter is raised every time there is a high profile case, as recently occured involving a settlement of £2 million. Will the Minister consider issuing some kind of progress report other than the same reply which has been given before? Would he accept that if he does not appear to make some progress on this issue, young doctors will be turned off becoming involved in obstetrics?

I will undertake to come back to the Deputy regarding a progress report and I intend to give this issue personal priority. I am concerned about this issue on which I wish to see progress.

Has the Minister considered a no fault compensation scheme beyond the area of obstetrics which would apply generally to issues which currently give rise to medical negligence claims? Has he considered the benefits of such an approach? What comparative study has been undertaken concerning similar schemes in other countries? Has the Government asked the Law Reform Commission to consider this issue? Would he consider such an approach if no conclusion of any nature has been reached on any of this by the Department?

I have not examined the Deputy's suggestion of the wider application of a no fault scheme in terms of general medical indemnity. We are concentrating on obstetrics in terms of such a scheme, including cases of cerebral palsy and so on. If we can make progress on this issue in the first instance, then we could consider the other issues identified by the Deputy.

A memorandum was brought to Government on this issue last December and it has been the subject of discussions between the Attorney General's office, the Department of Finance and other agencies. A number of papers have been prepared and we have engaged in consultations with other interested parties to seek their views.

From some of the documentation he has been examining, will the Minister confirm there are significant difficulties in introducing a no fault compensation scheme for one specific area of medical negligence and not applying it to a broader range of areas?

I am not a legal expert.

I am talking in practical terms.

I have been advised that there are legal implications in any no fault scheme. However, the Deputy will probably know better than me that we can surmount these obstacles in law. Nothing is insurmountable. If we are of the view that this is a good idea then we should proceed with it.

This issue needs to be looked at from a broader perspective.