Irish Medical Organisation

IMO calls for immediate implementation of the JOHC report on medical negligence

Urgent attention must be given to address the currently inhumane process of medical negligence

Friday 19 June 2015 The Irish Medical Organisation (IMO) has called for urgent review of the medical negligence process in order to protect patients and raise standards. Progress must be made on the introduction of an Open Disclosure regime for medicine in Ireland which protects health professionals from the risk of admitting liability when apologising to patients. Professor Trevor Duffy said that such an Open Disclosure regime was badly needed and the current adversarial system of medicine was helping neither Doctors nor their patients.

The IMO also welcomed the Report from the Joint Oireachtas Committee on Health and Children on the Cost of Medical Indemnity Insurance.

The IMO said it welcomed in particular the call for: 

  • open disclosure,
  • greater use of alternative dispute resolution mechanisms and
  • Tort reform to include pre-action protocols and
  • periodic payment orders

The IMO said that medical negligence procedures should support patients and doctors and focus more on learning from adverse events rather than apportioning blame. Professor Duffy said much needed to be done to address the culture of adversarial litigation following an adverse event. He said; “the current system is failing patients and medical professionals alike. It forces patients to take an emotionally difficult adversarial approach when they have already suffered significant trauma. And medical professionals are forced into defensive postures which can be traumatic and where there is little acknowledgement of the reality of modern medicine.”
Professor Duffy warned that an unreformed adversarial system would force medical professionals to practice defensively and that would add costs and delays to the health system and the risk of over-treatment.

The IMO also said that alternative dispute resolution mechanisms and Tort reform would also go a long way to speeding up the process and reducing the cost of litigation. The IMO believes that further consideration should be given to a no-faults claims mechanism for certain procedures.

Under no faults claims systems it is no longer necessary to prove clinical negligence but patients do have to prove that the treatment or medical process caused them harm. There is generally some guidance on compensation payments and in some countries the system is limited to certain types of injury. Since introducing a no fault claims system in 2004, court proceedings for clinical negligence in France have been reduced to a third. In New Zealand the data from all claims is gathered and analysts attempt to identify systems failures and correct them.

Finally the IMO said that the single most effective measure the state can undertake is to ensure that our healthcare system is staffed and resourced to safe levels. Under-resourcing and under-staffing are regularly cited as contributing to major adverse events. OECD figures show that in 2012 Irish hospitals were operating at 92.6% patient occupancy rate, a figure well over the established safe occupancy threshold of 85%, and just above the identified 92.5% tipping point that has been shown to result in significantly higher patient mortality, due to rationing of resources and elevated stress levels. Similarly adequate financing should be provided to all initiatives that improve patient safety.

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