Northern Ireland

Medical negligence: £109m paid out in Northern Ireland legal cases

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Image caption Between 2011 and 2014, the five Northern Ireland health trusts settled 570 cases

Almost £110m has been paid out on medical negligence cases and legal fees in Northern Ireland over a three-year period, figures obtained by the BBC have revealed.

Between 2011 and 2014, the five health trusts settled a total of 570 cases.

In many cases, the total amount paid to lawyers and other experts such as architects and accountants dwarfed the settlements to patients.

The total pay-out amounts to about £109m.

About a third of that was paid by the largest trust, Belfast.

In Wales, which has over one million more people than Northern Ireland, £184m was paid out in medical negligence claims over the same three-year period.

The Department of Health in Northern Ireland has defended the figure.

Alphy Maginness, from the department's directorate of legal services, told the BBC that a cap system is in place to ensure barristers employed by them cannot charge excessive fees.

Specialist

The initiative began six years ago, when the legal department within the Business Service Organisation appointed their own barristers who would work for them under agreed terms and conditions.

The Business Services Organisation provides a broad range of support functions and specialist professional services to the health and social care sector in Northern Ireland.

"Part of the terms and conditions we agreed with the appointed barristers is that there would be a cap on fees and the cap relates not only to medical negligence actions but to other cases as well - primarily high value cases," Mr Maginness said.

"So if they are worth several million, for example, the cap kicks in where they earn a certain amount."

The largest number of medical negligence cases were taken against the Belfast Trust, which also carries out some of the most complex procedures.

However, in the three years up until December last year, the Belfast Trust did not have to pay any damages in almost 400 cases taken against it.

In the most recent and significant case, the trust paid out in what was described in court as a "landmark" £8m compensation settlement to a severely disabled teenager after his family sued it for medical negligence.

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The Belfast Health Trust initially contested the case but after several years it admitted liability.

The settlement is believed to be one of the biggest of its kind in Northern Ireland.

Image caption Alphy Maginness said establishing liability in medical negligence cases is often complex

Mr Maginness defended the length of time this and other cases can last.

"That only happens rarely," he said.

"There can be very complex issues involved, particularly with these medical negligence actions - liability is often not clear cut.

"There may be many arguments in response to liability. You have to understand that it is not just about lawyers. In these cases we require the contributions of medical experts, forensic accountants, engineers, physiotherapists - often they are not straightforward."

Honesty

Action against Medical Accidents, the patient safety charity, said the growing scale of pay-outs was of concern.

However, it said the National Health Service should give higher priority to avoiding the lapses in patient safety in the first place, and avoiding legal costs as much as possible by admitting liability earlier.

"The human cost of clinical negligence far outweighs the financial cost, but millions could be saved if there were more honesty and earlier admissions of liability" Peter Walsh, the charity's chief executive, said.

"It is when there are denials and delays that costs escalate. The absence of legal aid and necessity of no-win, no-fee litigation also increases costs."

According to the figures obtained by the BBC, there were 12 settlements exceeding £1m across the five health trusts - eight of which were paid out by the Belfast Trust.

Image caption Rory McShane said teams of various experts were often involved in constructing negligence cases

In addition, the Department of Health paid almost £3m to lawyers to defend medical negligence cases on behalf of the trusts.

In one instance, a settlement in the Belfast Trust, the claimant was awarded over £6,000, while legal costs amounted to almost £72,000.

Complexity

But in 19 cases, lawyers were paid more than £100,000, with one pay-out to legal teams close to £680,000.

In more than a third of cases, the amount of money paid to lawyers exceeded the amount paid to patients.

Rory McShane, of the Law Society of Northern Ireland, the regulatory body for solicitors, said the complexity of many cases was the reason behind some of the legal fees figures.

"It is not the lawyers who are getting these monies and we should stop portraying it as such," he said.

"There are a number of participants in bringing a successful case on behalf of a victim of a medical accident.

"We are talking about a team of experts which can include lawyers, architects, accountants, care consultants, who may be required depending on the circumstances of the individual case."

Mr Maginness said his office has gone to great lengths to protect the public purse and that other costs made up the total amount paid out.

He said there had been considerable savings in the last five years.

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