295 / 448
GAZETTE
OCTOBER 1996
More attention to complaints
would reduce litigation
This article first appeared in a
recent issue of the
Irish Medical
Times
and is reproduced by kind
permission.
by Ken Murphy*
In t he s p e c i al I H C A s u p p l e m e nt last
y e a r, D r B r u c e M i t c h e ll p r o p o s ed that
t he H e p a t i t is C T r i b u n al c o u ld p r o ve
an ideal m o d e l of c o m p e n s a t i on w h i c h
c o u l d act as an a l t e r n a t i ve to a
litigation s y s t em w h i c h h a d n o w " g ot
c o m p l e t e ly o ut of h a n d " . D r M i t c h e l l,
c o n s u l t a nt i mm u n o l o g i st at t he
B l a c k r o ck C l i n ic a n d C h a i r m an of t he
I H C A P r i v a te P r a c t i ce C o mm i t t e e,
c a l l ed f o r t he e s t a b l i s h m e nt of a
c o m p e n s a t i on t r i b u n al to d e al w i th all
m e d i c o - l e g al c a s e s. I h a v e n o w b e en
a s k e d to r e s p o nd to this p r o p o s al a n d to
s u g g e st o t h er w a y s in w h i c h t he
e x i s t i ng m e d i c al l i t i g a t i on s i t u a t i on
c o u l d b e i m p r o v e d.
T h e first t h i ng I w o u l d like to m a k e
a b s o l u t e ly c l e ar is that s o l i c i t o rs w o u l d
b e v e ry m u c h o p e n to a ny r e a s o n a b le
p r o p o s a ls f o r i m p r o v e m e nt in t he
s y s t em t h r o u gh w h i c h m e d i c al
c o m p l a i n t s / c l a i ms a re c u r r e n t ly
c o n d u c t e d. T h e k e y test, h o w e v e r, is
w h e t h e r a n y t r i b u n al s y s t em w o u l d b e
m o r e likely t h an t he c o u r ts s y s t em to
e n s u r e j u s t i ce b e t w e en t he p a r t i e s.
O t h e r, s u b s i d i a r y, tests i n c l u de w h e t h er
in f a ct t r i b u n a ls w o u l d lead to g r e a t er
s p e e d a n d l o w er c o st in r e s o l v i ng
m a t t e rs a n d w h e t h er t r i b u n a ls w o u l d
e n j o y p u b l ic c o n f i d e n ce in t h e ir
i n d e p e n d e n c e.
F o r t he f o l l o w i ng r e a s o ns t h e re m u st
b e s e r i o us d o u b t s that a t r i b u n al s y s t em
w o u l d r e d u ce c o st a n d d e l a y, e n j o y
p u b l ic c o n f i d e n ce or d o j u s t i ce
b e t w e e n t he p a r t i es to t he s a m e e x t e nt
as d o e s t he c o u r ts s y s t e m.
Cost and delay
T h e r i g ht of a c c e ss to t he c o u r ts of
e v e r y c i t i z en is g u a r a n t e ed b y t he
C o n s t i t u t i o n. It c o u l d n ot b e e x c l u d ed
b y t he e s t a b l i s h m e nt of m e d i c o - l e g al
^ ^fllIH
Ken Murphy
t r i b u n a ls e v e n if, w h i c h is o p e n to
d o u b t, r e c o u r se to s u ch t r i b u n a ls c o u ld
b e m a d e an o b l i g a t o ry first s t e p.
It is to b e e x p e c t ed that c l a i m a n ts
d i s s a t i s f i ed w i th t he t r i b u n a l 's d e c i s i on
w o u l d s i m p ly p r o c e ed to litigate t he
m a t t er t h r o u gh t he c o u r t s. In s u ch
c i r c u m s t a n c es t he r e s u lt of i m p o s i ng an
a d d i t i o n al l a y er w o u l d b e to i n c r e a se
r a t h er t h an r e d u ce t he level of d e l ay
a n d c o st i n v o l v ed in d e a l i ng w i th
c l a i m s.
Public confidence
W h o w o u l d sit o n t h e se t r i b u n a l s? If
t h e y w e r e c o m p o s e d m a i n ly of
m e m b e r s of t he m e d i c al p r o f e s s i o n,
t h e n t h ey w o u l d b e likely to e n j o y f ar
less p u b l ic c o n f i d e n ce in t h e ir
i n d e p e n d e n ce a n d c r e d i b i l i ty t h an d o e s
t he c o u r ts s y s t e m.
Justice
A l t h o u gh m e d i c al n e g l i g e n ce c a s es
s h a re s p e c i al c h a r a c t e r i s t i c s, t h ey
r e m a i n e s s e n t i a l ly a f o r m of p e r s o n al
i n j u ry c a s e. P r e s u m a b ly t he m o t i v a t i on
in p r o p o s i ng t r i b u n a ls in p l a ce of
c o u r ts is, at least in part, t he h o p e that
t r i b u n a ls m i g ht b e l e ss likely to f i nd in
f a v o u r of c l a i m a n ts a n d i n c l i n ed to
m a k e l o w er a w a r d s w h e r e t h ey d id so.
N e g l i g e n ce is a legal c o n c e p t, n ot a
m e d i c al o n e. Is it t he i n t e n t i on of
p r o p o n e n ts of t he t r i b u n al that t he test
of p r o of of n e g l i g e n ce s h o u ld b e
stricter w h e r e m e d i c al n e g l i g e n ce is
a l l e g e d? If so, t h en I h a v e to s ay it
w o u l d b e w r o n g in p r i n c i p le a nd
a b s o l u t e ly u n j u st that a d i f f e r e n t,
l o w e r, s t a n d a rd of c a re f o r o t h e rs
s h o u ld a p p ly to d o c t o rs t h an a p p l i es to
t he rest of s o c i e t y.
U n l e s s a n d until t he p r o p o n e n ts of a
t r i b u n al s y s t em c a n s a t i s fy t h e se
c r i t i c i s m s, t he c u r r e nt ( a l b e it
i m p e r f e c t) s y s t em m u s t c o n t i n u e.
T h e b e st a n d e a s i e st c h a n g es w h i c h
d o c t o rs a n d h o s p i t a ls c o u l d i n t r o d u ce
t o c u r b t he level of m e d i c al n e g l i g e n ce
c l a i ms a n d r e d u ce t h e ir c o st w o u l d b e
t o c h a n g e t he c u l t u re w h i c h still
d o m i n a t es all t o o o f t en t he h a n d l i ng of
c o m p l a i n ts f r o m p a t i e n t s.
D o c t o rs a n d m e d i c al i n s t i t u t i o ns n e e d
t o b e m o r e o p e n. T h e y s h o u ld d i s p l ay a
g r e a t er w i l l i n g n e ss to d i s c u ss p o t e n t i al
p r o b l e ms w i th p r o p o s ed t r e a t m e n ts a nd
t h e r e a s o ns f o r u n s a t i s f a c t o ry o u t c o m es
w i th p a t i e n ts p r o m p t l y, a n d to
a p o l o g i se w h e n m a t t e rs h a v e n ot g o n e
right. S t a t e m e n ts g i v en o r r e p o r ts o n
i n v e s t i g a t i o ns c a r r i ed o ut i mm e d i a t e ly
f o l l o w i ng an i n c i d e nt s h o u ld b e
d i s c l o s ed to an a g g r i e v ed p a t i e n t.
M a n y s u ch p a t i e n ts c o m e to s o l i c i t o rs
a n d l i t i g a t i on e n s u e s w h e n m a t t e rs
c o u l d h a v e b e e n r e s o l v ed by m e a n s of
an e x p l a n a t i on or a p o l o gy t o g e t h er
w i t h, in a p p r o p r i a te c a s e s, an e a r ly
o f f e r of r e l a t i v e ly s ma ll l e v e ls of
c o m p e n s a t i o n.
•
*Ken Murphy is Director General of the
Law Society of Ireland. The views
expressed in this article are his
personal views and not necessarily
those of the Law Society.
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