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Headlines and deadlines

Claims environment continues deterioration

The deteriorating claims environment in Ireland was the subject of much discussion at an MPS reception in Dublin, held in February.

The event, held at the Royal College of Physicians of Ireland, had more than 70 figures from the healthcare and legal fields in attendance. It was hosted by new MPS Chief Executive Simon Kayll and focused on the medicolegal challenges facing Ireland now and in the future.

Dr Stephanie Bown, MPS Director of Policy and Communications, and Editor-in-chief of Casebook, said at the event: “These are turbulent times. In the past five years, we have seen medical claims costs increase by 26% per annum. And for dental claims, the numbers are escalating – last year there were three times as many claims as five years ago.

“We are pleased that the Legal Services Regulation Bill will give rise to greater transparency for legal costs. Legal fees are often disproportionate to what patients receive in compensation, which is wrong and plainly unfair.”

Meanwhile, the Health Service Executive (HSE) has revealed that it paid out over €81 million in 2011 for clinical negligence claims, compared to €49m in 2009.

Jerry Buttimer, Chairman of the Oireachtas Health Committee, said: “The figure of €81m is worrying. The figures are startling and they reveal an ongoing issue that needs to be addressed.”

Professional competence: procedures outlined

The Medical Council has published details of new procedures for assessing doctors’ performance when their professional competence is subject to investigation. The new procedures will involve on-site assessments of doctors’ performance for the first time.

Doctors selected for participation in the procedures will be assessed by an independent team of two medical doctors and one patient representative, who will conduct on-site assessments, observe interactions with patients and review performance in practice. The new rules are pursuant to the provisions of Section 11 and Part 11 of the Medical Practitioners Act 2007.

For an in-depth feature on these new procedures, read Dr Muiris Houston’s article in this edition of Casebook.

GP guidance on referrals

A national referral template has been launched by the ICGP and National GPIT Group. Two pages long and very easy to complete, software packages Health One, Socrates, Helix Practice Manager and Complete GP can now generate the national referral template with large parts of the form completed using information already stored with the electronic patient record.

For GPs not using certified GP software the referral template can be downloaded from The first page of the form seeks information regarding the specialty being referred to, the reason for referral and the GP’s impression of whether the referral is urgent or routine.

The patient’s demographic information and GP details make up the rest of page one. The second page contains a “Symptom” section where the GP indicates the history of the presenting complaint and interventions to date, as well as a section for examination findings. The rest of page two allows the GP software to list past medical history, medications and allergies, as well as relevant social and family history.

Time to scrub up

Doctors are the least likely hospital staff members to wash their hands, according to the latest Health Service Executive (HSE) report on hand hygiene compliance.

In an audit of hand hygiene in 42 acute hospitals carried out last October, doctors washed their hands on 68% of the opportunities open to them. Auxiliary staff, such as healthcare assistants and porters, washed their hands 79% of the time and nurses and midwives were compliant almost 84% of the time.

The survey showed hand hygiene compliance at seven hospitals had disimproved since the previous audit. The HSE said the report showed an overall compliance rate of 79.6%, above the 75% target for 2011. The target for this year is 85%. Assistant national director of health protection with the HSE Dr Kevin Kelleher said improving hand hygiene compliance was a priority.

Legislation Watch

Legal Services Regulation Bill
  • Status: The Bill is now in its second stage in the Dáil
  • Aim: The Bill makes provision for three key entities:
    • A new, independent, Legal Services Regulatory Authority with responsibility for oversight of both of the legal professions.
    • An Office of the Legal Costs Adjudicator to assume the role of the existing Office of the Taxing-Master, which will be conferred with enhanced transparency in its functions. The legal costs regime will be brought out into the open with better public awareness and entitlement to legal costs information.
    • An independent complaints structure to deal with complaints about professional misconduct – this will be supported by an independent Legal Practitioners Disciplinary Tribunal.

Mediation and Conciliation Bill

  • Status: The Bill provides for implementation of recommendations of the Law Reform Commission and is expected in 2012.
  • Aim: MPS is interested in the Mediation and Conciliation Bill as we strongly support measures that could resolve disputes more efficiently and reduce the cost of legal proceedings. Although we welcome plans to incorporate the use of mediation, our experience shows that some cases are better suited for mediation than others and careful consideration needs to be given to which cases should be the focus of any new dispute resolution system.
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