Ireland's high litigation rate has encouraged the practice of "defensive medicine" in hospitals, which is in turn undermining the relationship between doctor and patient, an Oireachtas committee has been told.
In a report to the joint committee on the Strategic Management Committee, the Irish Hospital Consultants' Association said a consultant in Ireland was four times more likely to be sued than a colleague with a similar practice in Britain.
A lack of clarity about complaints procedures added to the problem, the association's secretary general, Mr Finbar Fitzpatrick, said. But he conceded that "regrettably, every complaint regarding the medical management of a patient can be seen by many consultants as having the potential to finish up in the High Court".
Asked by Senator Michael Finneran (FF) why Irish consultants were so much more likely to be sued, Mr Fitzpatrick said the medical experience was not unique, but reflected the increased litigiousness faced by "business and the media" and illustrated by such examples as the Army deafness claims.
With the Government preparing to implement the health strategy announced on Monday, Mr Fitzpatrick confirmed that the State had "either the lowest or the second lowest" ration of acute hospital beds to people in the European Union. Average length of hospital stay was among the shortest; level of bed occupancy among the highest; and ratio of consultants to population was "at the wrong end of the ladder", he added.
In what he called the "paradox" of the hospital services, he said that overcrowding and delays in accident and emergency units must be seen against the fact that up to 20 per cent of attendances there were "inappropriate" to the A&E service. This was equivalent to 150,000 attendances a year, or the total number dealt with by any one of the State's "big three" hospitals.
Other paradoxes included the fact in the summer past that "up to 80 beds" in Dublin's Mater Hospital were occupied by patients who were medically discharged, but had no suitable post-acute facility to go to.
Noting that 18 per cent of complaints to the Ombudsman concerned the hospital services, Mr Fitzpatrick said there were some complaints which could never be satisfactorily explained.
These included "a two- or three-day in-patient stay on a hospital trolley; a wait of up to 10 months for an outpatient appointment; being discharged too early because of pressure on beds; and being on a waiting list for up to 20 months".
