Current legislation recommends that a successful claim in a case for personal injury is settled with a lump-sum payment. However, a working group on medical negligence in Ireland has been established to examine the possible introduction of a periodic payment scheme (PPO) in the event of medical mistakes. PPO would mean that a successful claimant would be compensated for any injuries or illness they have sustained as the direct result of malpractice or negligence of healthcare professionals in capped payments over a period of time.
Professor Denis Cusack, a leading physician and barrister is concerned that, while the problem of medical negligence is usually only seen as a financial one, it masks a deeper problem. His worries are that medical negligence cases undermine the most basic core of healthcare – the relationship between doctor and patient. He says that improvements in the structural aspects of healthcare will mean very little in the long run if trust in the healthcare system disintegrates. As a result, he is backing the proposal for medical negligence claims to be dealt with swiftly and under the terms of the proposed PPO.
Using PPO would have benefits for the healthcare system, in that the costs of compensation would be spread throughout the year rather than taking huge chunks out of a healthcare budget all at once. According to Professor Cusack, the average cost of settling a medical negligence claim rose from Â£13,116 in 1994 to Â£24,400 in 1999. In addition, these claims increased by around 40% in the same time period. Making payments under the PPO system would allow claimants to structure their spending and give them peace of mind in the knowledge that regular payments would help meet their financial needs. However, detractors of the proposal argue that making capped payments on a regular basis would put more stress on claimants who find they need expensive medical equipment or treatment to cope with the nature of their injuries. Capped payments may not meet the bills that certain conditions require for immediate treatment. In turn, this could serve to damage doctor-patient trust even further.
The Irish Clinical Indemnity Scheme believes that PPO would give the chance for those found responsible to act swiftly. In a statement, a spokesman for the group said, “It is hoped that any new Rules of Court will promote expediency and efficiency in the management of medical negligence litigation, with specific reference to the implementation of judicial case management.” If the draft legislation is accepted, the PPO system could find itself in operation by November 30th.
With medical negligence claims on the increase in England, the decision to either enforce or reject this proposal will be watched eagerly by the NHS. With its budget currently overstretched, the potential to make payments over a period of time is one that may be very appealing to some hospital executives. However, attention will have to be paid to the advantages and disadvantages offered by the PPO system before following suit, to prevent unnecessary damage to the doctor-patient relationship on which so much of our healthcare depends.