Almost half a billion euro has been paid in out-of-court settlements for claims taken against the Health Service Executive (HSE) over the past five years.

The annual total payout involving HSE cases has more than doubled in recent years, figures released by the State Claims Agency (SCA) under Freedom of Information Acts reveal.

The agency refused to release details of individual settlements but said “the majority” are for “clinical care claims which had a subcategory of clinical procedure or birth-specific procedures”.

The SCA said it does not record on its IT system whether a confidentiality agreement has been stitched into an out-of-court settlement.

The work involved in trawling through the individual records for that information would be “unreasonable”, it added.

Ciarán Breen, the agency’s director, recently told an Oireachtas committee there were “perhaps two dozen” medical negligence cases settled over the past 15 years on condition that the patient did not reveal the circumstances involved.

The newly released figures show 806 claims against the HSE last year were settled out of court. The total payout was €139 million. This averages at €172,475 a claim.

Average settlement

In 2013, 462 cases were settled at a cost to the State of €61.5 million, working out at an average settlement of €133,122.

Both the number of cases settled and the total payouts have been rising every year since.

In 2014, 539 cases were settled at a cost of €77.3 million; in 2015 there were 568 cases totalling €77.9 million; and in 2016 some 656 cases amounted to a payout of €92.9 million.

Between 2013 and last year, the State has paid €448,686,570 to settle claims against the HSE out of court.

The HSE was asked a number of questions about the figures but declined to comment.

The Department of Health said “a significant increase” in payouts between 2014 and 2016 was mainly due to an increase in the number of catastrophic injury claims being settled, especially as lump sums, before new laws were enacted on payments.

New legislation last year brought in Periodic Payment Orders, which allow the courts to spread out the payment of settlements to catastrophically injured plaintiffs who require lifelong care and attention.

Landmark ruling

Another factor being attributed to the increase in the cost of claims in recent years was a landmark ruling by the Court of Appeal in 2015 on how damages are calculated.

Prior to the appeal court’s decision, awards were reduced to allow for an assumed 3 per cent interest rate if the sum was invested.

That figure, known as the real rate of return, has since been reduced to 1 per cent.

A Department of Health spokeswoman said: “This resulted in higher awards being made.”

Last month, an expert group headed by High Court judge Charles Meenan was set up by the Government to look at alternatives to the court process for settling medical negligence claims.

It is due to provide an interim report in October and a final report next January.

The Oireachtas Public Accounts Committee has been told the HSE requires a contingent liability of €2 billion to fund medical negligence claims into the future.