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 financial 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 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 distorts 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, it is a fact that doctors in other specialties 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.
