There should be a system of mandatory mediation to avoid litigation in cases like medical negligence, according to the Attorney General.
Mr Michael McDowell was speaking to a conference on medical indemnity organised in Dublin yesterday by Hayes and Sons, solicitors, who represent a medical insurance company, the Medical Protection Society.
He said the Irish legal community needed to face up to such an agenda. The cost of dealing with medical negligence claims was high, and there was no room for complacency in the legal profession. "Surely the initiative lies with the judiciary, the Bar and the solicitors?" he asked.
Stressing he was speaking in a personal capacity, he said the healthcare system, including doctors, hospitals and health boards, needed to consider its structures and responsibilities.
Studies in the US suggested that one in every 100 patients in an Irish hospital might suffer from medical negligence, according to a Department of Health official, Mr Brendan Phelan. The same US study showed that only one in eight of potential litigants went on to sue, he said.
Mr Phelan is working on the implementation of a medical indemnity scheme in his Department. Under this, the organisation as a whole, usually a hospital, will take responsibility for dealing with claims of negligence.
This would allow public health bodies to reduce costs by obtaining insurance in bulk, and reduce the numbers of legal teams. It would also mean individual doctors would not be faced with litigation.
However, he stressed that risk management was at least as important as reducing costs.
Any new arrangements for medical negligence must lead to a reduction in medical errors, said the Minister for Health.
In 2000 the cost to the Exchequer of medical indemnity cover to doctors and dentists was around £33 million, Mr Martin said. This was triple the amount of 10 years ago.
Prof Denis Cusack of UCD said enterprise liability was only tinkering with a greater problem, that of bilateral mistrust between doctors and patients. Trust had to be restored both at individual and system level. Patients should be able to get explanations for what went wrong.