Maternity services: 80% increase in claims in four years

The quality and safety of Irish maternity services have been under unrelenting scrutiny over the past five years, a period that includes the tragic death of Savita Halappanavar and the report into needless and shocking baby deaths at Portlaoise hospital.

Obstetricians and midwives have had to contend, not just with the unremitting glare of publicity, but also with escalating claims made by affected patients. The burden of providing indemnity cover has fallen exclusively on the State after soaring indemnity costs – as high as €340,000 a year for obstetricians in private practice – contributed to the closure of the country’s last remaining private unit at Mount Carmel Hospital.

Processing claims

The

State Claims Agency

manages claims for the taxpayer, processing thousands of clinical negligence claims every year. But with the HSE, it is often blamed for delays in settling tragic and complex birth injury and other claims. Both bodies feel this criticism is unjust, but their viewpoint would not be shared by many families who wait years to settle cases on behalf of brain-damaged children.

Numerous reports in recent years have pointed to clinical failings that led to many of the unfortunate outcomes that occurred. Their recommendations are being implemented to improve services. A new national maternity strategy is due to be published shortly. It should provide a framework for future service delivery.

That still leaves the headache posed by increasing claims costs, which have soared 80 per cent in four years, according to the agency’s report. Unchecked, this trend threatens to swallow resources that are much needed elsewhere in the health service.

One of the consistent problems across the health service is the lack of data to show what is really happening. And even when data is available to inform policy, it often isn’t shared with the patients who are using the service.

The agency has attempted to rectify this lacuna in maternity and gynaecology with a report that quantifies the extent of the problem that exists with clinical incidents and claims. Unfortunately, the quality of the data it has been able to extract is often poor and comparisons are difficult.