THE HEALTH SERVICE EXECUTIVE paid out over €46,735,000 on legal fees last year. This is an increase of more than €10 million on figures for 2011.

In total, since 2005 the HSE has paid out more than €254,692,000 on legal fees.

The HSE confirmed to TheJournal.ie that yearly legal spending figures are:

2012 - €46,735m

2011 - €35,966m

2010 - €40,599m

2009 - €44,574m

2008 – €36,618m

Previously, it was revealed through a parliamentary question, the HSE’s bill for legal fees for 2007 amounted to €30.3 million, while it spent about €20 million in legal costs in both 2005 and 2006.

The HSE’s annual legal bill had significantly reduced in recent years – down from a high of €45 million in 2009, however, the the legal costs for 2012 were at an all time high.

The HSE stated that the figures for 2013 are not validated yet and will be published in the 2013 Annual Report and Financial Statements in 2014.

Health budget in trouble

Last week, it was estimated the HSE will need nearly €200 million in extra funding this year as a result of budget overruns.

With the health budget in trouble, fighting medical negligence cases through the courts at the cost of millions of euros is something that organisations and politicians are saying should stop.

Just last month, the parents of a young boy who suffered catastrophic brain injuries during birth was awarded a settlement of €8.5 million. However, Jean Gaffney and Thomas Hayes said it took them years of battling the HSE and the State Claims Agency to get a result and an apology.

This month, the HSE also agreed a settlement of €790,000 with the family of Dhara Kivlehan who passed away after giving birth at Sligo General Hospital in September 2010, which was another lengthy court case.

Deny and defend

A conference in November on medical negligence said the health service could save millions if the traditional deny and defend policy was replaced.

Speakers at the event said the traditional “deny and defend” method used by hospitals when accused of medical negligence was costing millions to the HSE and that both the States Claims Agency and the Health Information and Quality Authority (HIQA) backed recommendations that a more open, honest and transparent system was needed.

Speaking to TheJournal.ie, one of the key speakers, Dr Timothy McDonald, Professor of Anaesthesiology and Paediatrics at University of Illinois and Chief Safety and Risk Officer for Health Affairs for the University of Illinois, Chicago said that often patients and family of patients just want an apology after a mistake has been made and rarely do they want to be dragged through the courts system.

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He said since the hospital he worked in introduced a candour system they have saved tens of millions of dollars.

Buried in legalities

He said:

A candid approach leads to better learning for our nurses, doctors and surgeons and a quicker resolution can be achieved, one that is a lot more fair for the patient and will ensure that money does not get drained from the health service’s finances and buried into the legal system.

The HSE said the bulk of its legal costs were incurred in relation to its childcare services, about 60-65 per cent. The HSE is legally obliged to go to the High Court whenever a court order is needed to take a child into care.

The HSE added that the delivery of services by solicitors is done through a competitive tender process, which they said since its introduction in 2011 is “delivering better legal outcomes at a lower legal cost”. They stated:

The implementation of this contracting model has reduced both the cost of and demand for solicitors services.

The model for the delivery of legal services involves in excess of thirty law firms all of whom have been qualified by HSE to deliver services through four geographical panels – each panel representing a HSE Administrative Area.

“The law firms on these panels will be used to delivers advice and services across a broad range of legal areas such as Child Care, Environmental Health, Mental Health, Disability etc reflecting the breath of services and activities of the HSE,” said the HSE.

The legal firm of Arthur Cox manages the law panels and acts as the service manager for the contract. They are also tasked with responsibility of “providing HSE with all of its corporate legal advice”.