Maternity cases make up over half medical negligence payouts

Avoidable injury to infants in childbirth an ‘egregious insult’, senior doctor says

Dr Peter McKenna said preventable brain damage in normally formed infants is the “single biggest risk” in the health service. Photograph: Dara Mac Dónaill

Dr Peter McKenna said preventable brain damage in normally formed infants is the “single biggest risk” in the health service. Photograph: Dara Mac Dónaill

 

Negligence cases relating to maternity care make up more than half of the payouts made by the State, despite maternity services making up only 3 per cent of the Health Service Executive budget.

Payouts for maternity negligence have also increased by about 80 per cent according to the most recent figures available.

The figures were detailed on Friday at a conference on patient safety organised by the State Claims Agency (SCA).

Clinical director of the HSE’s national women and infant health programme, Dr Peter McKenna, said preventable brain damage in normally formed infants is the “single biggest risk” in the health service.

He said such injuries are “the most egregious insult the heath service can cause to a service user”.

He said if his service was given the equivalent of 5 per cent of the value of these payouts in funding, it could reduce the number of such cases by half. “That’s a money-back guarantee. Trust me, I’m a doctor,” he joked.

In 2014, the State paid out €58 million in compensation for medical negligence in maternity cases. This made up 54 per cent of the total medical negligence payouts by the State that year, Dr McKenna said.

“This is massive for a part of the health service that accounts for 3 per cent of total expenditure,” he said, pointing out that just €500 million of the HSE’s €15 billion budget goes on maternity services.

Average payouts

Between 2010 and 2014 the average medical negligence payout increased by 44 per cent but in maternity cases it increased by 80 per cent.

“In the past, six, seven, eight million might have been a big settlement. Now the figure is running at €15 million,” Dr McKenna told the conference.

This trend is not unique to Ireland. In the UK the NHS paid out roughly £2 billion in 2017 for maternity cases, up from £360 million in 2004. “The number of cases hasn’t changed but the payout amount has,” he said.

“I don’t think that one cent of what the parents get will compensate them for having a child that does not live up to their expectations,” Dr McKenna said. “If you think I am complaining about the size of the payouts, I’m not.”

He said there is an onus on the health service to investigate as early as possible how these injuries are caused during childbirth.

In money terms, medical negligence cases continue to make up the majority of claims against the State, SCA director Ciarán Breen told the conference.

The conference also heard from Simon Mills, formerly a doctor and now a barrister specialising in medical law, who questioned whether proposals to criminalise doctors who fail to follow open disclosure rules is a good idea.

The Patient Safety Bill 2018 will make it a criminal offence, punishable by up to six months in prison, for medical practitioners to fail to disclose certain information to patients.

Doctors, nurses and pharmacists are already required to abide by open disclosure rule by their respective professional bodies. “These regulators have the most astonishing powers including to end a practitioner’s career,” Mr Mills said.

The area of open disclosure is in flux following the CervicalCheck scandal, he said, and separate legislation contained in the Civil Liability Act designed to encourage voluntary open disclosure has not even been enacted yet.