A group of 14 leading organisations representing patients, doctors and dentists as well as legal firms in Ireland, has united to urge the new Government to reduce the human and financial costs associated with clinical negligence claims, by taking the final steps needed to implement pre-action protocols.

The letter addressed to Minister for Health, Jennifer Carroll MacNeill and Minister for Justice, Jim O’Callaghan, was coordinated by the Medical Protection Society and signed by Patients for Patient Safety Ireland, Irish Patients Association, Patient Empowerment, Irish College of General Practitioners, Royal College of Surgeons in Ireland, College of Anaesthesiologists of Ireland, Irish College of Ophthalmologists, Association of Anaesthetists, Irish Dental Association, Irish Dental Hygienists Association, Hayes Solicitors LLP, Carson McDowell  and Matheson LLP.

It said the protracted claims system ‘adds insult to injury’ for patients whilst also impacting negatively on healthcare professionals’ mental wellbeing.

The slow process is also leading to high legal costs. Medical Protection Society data shows that a claim in Ireland takes just over four years (1462 days) on average to resolve, which is 56% longer than in Hong Kong (940 days), the UK (939 days) and Singapore (938 days). The average legal cost for a claim in Ireland - €34,646 - is 191% more expensive than in the UK, 26% more expensive than in Singapore and 56% more expensive than in Malaysia.

The letter said pre-action protocols - a set of guidelines, laid out through legislation, which explain the conduct and steps a court expects parties to take before claims proceedings can commence - would go some way towards fixing a system that does not currently benefit anyone involved, and called on the Government to take the final steps needed to implement them, relieving needless suffering for all concerned.

 “When something goes wrong, it is a difficult decision to seek legal redress. As well as the personal and financial risk, patients face a protracted claims system which is overburdened, deeply traumatic and adds insult to injury. Our legal system should seek to mitigate further harm to patients and families.

“For the healthcare professionals involved, the claims process is described as having a profound emotional and psychological impact resulting in anxiety, depression and for some, the consideration of ending their clinical career or even suicidal thoughts.

“A protracted process without clear, standardised routes for early information sharing also leads to increased legal costs. This can impact all parties, as well as having an onward impact on the amount of public finances otherwise better invested in the provision of high-quality healthcare.

“The delivery of pre-action protocols is long overdue and has been a commitment of successive Ministers for both Justice and Health departments. The provisions already exist in section 219 of the Legal Services (Regulation) Act 2015.

“As organisations working with health and dental professionals, patients, lawyers and researchers, we would welcome your focus on this crucial tort reform and to take the final steps needed to ensure it is implemented without delay.

“Their implementation would go some way towards fixing a system that does not currently benefit anyone involved.

“The ambition of our combined request of you, in your ministerial roles, is to use the gift of your positions to relieve needless suffering for all concerned.”

END

For further information or a copy of the letter contact: [email protected]

Notes:

• The 2025 Draft Programme for Government committed to implementing the findings of the Interdepartmental Working Group on the Rising Cost of Health -Related Claims report : gov - Interdepartmental Working Group on the Rising Cost of Health-Related Claims Report (www.gov.ie)
• The MPS report: The human and financial cost of clinical negligence claims: The “case for pre-action protocols: www.medicalprotection.org/ireland/about/policy-and-public-affairs/tort-reform
• Pre-action protocols are a set of guidelines, laid out through legislation, which explain the conduct and steps a court expects parties to take before claims can commence. This encourages claims to be settled outside of litigation and reduces the time the process takes.
• Other support for pre-action protocols in Ireland: The Review Group chaired by Peter Kelly, recommended that the Minister for Justice give early attention to the introduction of the regulations prescribing the pre-action protocols in clinical negligence cases. The Government accepted in full the recommendations from Peter Kelly.  Pre-action protocols had also been recommended earlier in 2012, by the Working Group on Medical Negligence and Periodic Payments, established in 2010 and chaired by Ms Justice Mary Irvine, former President of the High Court. In 2020, the Expert Group report to review the law of torts and the current systems for the management of clinical negligence claims, chaired by Mr Justice Charles Meenan, also called for pre-action protocols to be implemented. The 2022 and 2023 Justice Plans set out commitment to introducing pre-action protocol regulations through implementation of Part 15 of the Legal Services Regulation Act: gov.ie - Justice Plan 2023 (www.gov.ie)
• The Medical Protection survey exploring the impact of clinical negligence claims on doctors in Ireland, had responses from 200 doctors who have experienced a claim. Key results:

- 91% of doctors were worried about their mental wellbeing during the claim

- 70% were worried about the impact of the claim on loved ones

- 88% were worried about the length of time the process was taking

- 44% said that their experience of a claim has resulted in them reconsidering their future as a doctor

- 96% would support the earlier resolution of claims by having legislation for pre-action protocols

- 96% would support the introduction of a case management system in the High Court whereby parties are obligated to adhere to a reasonable timescale.

About MPS

The Medical Protection Society Limited (“MPS”) is the world’s leading protection organisation for doctors, dentists and healthcare professionals. We protect and support the professional interests of more than 300,000 members around the world. Membership provides access to expert advice and support and can also provide, depending on the type of membership required, the right to request indemnity for any complaints or claims arising from professional practice.

Our in-house experts assist with the wide range of legal and ethical problems that arise from professional practice. This can include clinical negligence claims, complaints, medical and dental council inquiries, legal and ethical dilemmas, disciplinary procedures, inquests and fatal accident inquiries.

Our philosophy is to support safe practice in medicine and dentistry by helping to avert problems in the first place. We do this by promoting risk management through our workshops, E-learning, clinical risk assessments, publications, conferences, lectures and presentations.

MPS is not an insurance company. All the benefits of membership of MPS are discretionary as set out in the Memorandum and Articles of Association.