State indemnity for personal injury and third party property damage is set out in the National Treasury Management Agency (Amendment) Act, 2000 where the management of personal injury and third party property damage claims against certain State authorities, and underlying risks, was delegated to the National Treasury Management Agency (NTMA). When performing these functions, the NTMA is known as the State Claims Agency (SCA). The principal objectives of the State Claims Agency are:
To ensure that the State's liabilities in relation to personal injury claims, and the expenses of the SCA in relation to their management, are contained at the lowest achievable level;
To implement its employer liability, public liability and clinical risk work programmes, including the minimisation of litigation risk factors in State authorities and healthcare enterprises, and the implementation and audit of risk management systems.
Where State indemnity applies the State does not purchase insurance for personal injury (employer's and public liability) and third party property damage and as such will not have to bear associated premium costs. Indemnity works on a pay as you go basis so that all costs associated with personal injury and third party property damage claims are paid directly by the State through a reimbursement system operated by the SCA. Analysis has demonstrated that the States cost of dealing with claims directly is significantly lower than the premium cost of insuring the risk. This has yielded significant annual savings as the State no longer has to pay insurance premiums for delegated classes of claims.
In order to maximise the savings the State must manage the claims made against it at the best possible cost. In conjunction with the State the SCA has a strong track record in reducing the cost of managing claims under its remit. For example during 2011 the SCA achieved significant savings on claims and related legal costs associated with the management of the Clinical Indemnity Scheme (CIS). An independent actuarial assessment projected that €106 million would be required to satisfy CIS claims and related costs in 2011. The outturn for the year was €81 million, representing a saving of €25 million.
To date the SCA has managed over 10,000 personal injury (including clinical negligence claims) and third party property damage claims. The SCA manages a claim from the point of claims notification through to final resolution. Claims are investigated in a thorough and timely fashion in order to facilitate early decision-making in relation to liability and strategy. The SCA uses panels of service providers, such as solicitors, medical consultants and engineers to provide expert advice on the State's behalf. Each claim is allocated a notional estimated liability and this is updated as new medical and other expert information becomes available. The SCA then decides, in relation to each claim, whether it should be contested in the courts or whether settlement negotiations should begin and then manages the claim through to final resolution.
The SCA hosts a national electronic reporting system which facilitates the identification of clusters of adverse incidents and allows for root cause analysis of claims. The lessons learned from this analysis support the improvement of employee, public and patient safety and contribute to the reduction of incidents and claims in delegated State Authorities. When serious adverse events or trends are identified by the SCA, it responds by undertaking detailed analysis, providing advice and making recommendations. The SCA responds by undertaking detailed analysis and/or reviews/audits and providing advice and making recommendations. Annually, the SCA plans and implements employers liability, public liability (including clinical risk) and third party property damage risk management work programmes in conjunction with State Authorities under its remit, based on claims and incident data trend analysis, legal requirements and precedents and recent developments in litigation risk management, nationally or internationally.
Significant projects implemented in 2010 and 2011 included:
Rollout of the new safety management system to all Irish Prison Service locations and certification of two locations to the international specification OHSAS 18001 — the first prison locations in Europe to receive this award;
Training in general health and safety and field risk assessments to almost 400 staff in the Department of Agriculture, Fisheries and the Marine;
Issuance of the ‘Guidelines on Managing Safety and Health in Post-Primary School's — a joint project undertaken with the Department of Education and Skills, the Health and Safety Authority and the School Development Planning Initiative. This was supported by subsequent educational seminars;
A self-assessment on-line survey of over 700 State buildings, including over 400 Garda Síochána locations, focussing on fire safety management. All participating authorities and locations were presented with a report of the findings and recommendations.
Systems Analysis Training — courses delivered to Hospital consultants and multidisciplinary HSE clinical staff;
Presentations provided to numerous forums ranging from medical emergency services, graduate medical programmes in various universities, clinical nurse management staff, mental health services, paediatric units, etc;
Bi-annual obstetric forum meetings, hosted by the Agency, of all maternity and maternity units in the State.
State Authorities who have actively engaged in these initiatives have shown significant reduction in numbers and costs of incidents and claims. In addition to this, over 2,500 ad-hoc requests for advice and consultancy services are received annually. This includes insurance advice on contracts, licenses, schemes and tenders in circumstances where State indemnity applies or on insurances required where it does not apply. This ensures that the State's liabilities are minimised in the most cost-effective manner.