A medical negligence legal expert has stressed that patients, and not doctors, should be considered the main victims in medical malpractice cases, and has stressed that patient safety should be the number one priority.

Ernest J Cantillon of the Medical Injury Alliance was responding to comments made by Holles Street Hospital Master Dr Rhona Mahony in a recent interview with irishhealth.com

He said hospitals should cease their 'deny and defend' approach to medial negligence.

Dr Mahony said that when harm was done patients should be compensated, but felt there was an over-emphasis on apportioning blaming health professionals in the current medical litigation system, of which the three 'pillars' were blame, litigation and punishment.

She said not all adverse outcomes in medicine are the result of a person being negligent or careless, so it was very difficult for staff to be faced with the accusations and the personal questions raised about them when they went through a litigation case. These pressures often led to doctors suffering from anxiety or depression, and can lead to clinical staff avoiding high-risk cases or taking early retirement, she said.

Mr Cantillon, in response, told irishhealth.com that while he agreed with Dr Mahony's call for changes in the medical negligence litigation system, which could cause undue hardship, he said the primary concern should rest with the patients who have been the victims of malpractice, rather than the doctors who are being challenged.

"A person who takes a medical negligence action does not do so lightly. They will only do so if they have the support of other doctors who are prepared to criticise and condemn the treatment that has been given. A case cannot be brought unless there is the support of another doctor."

"We frequently come across situations where a patient has an adverse outcome. The patient goes to the doctor, and/or the risk department of a hospital, and asks what happened. They are not told or, in some cases, they are, we regret to say, misled as to what happened. They then come to us. We investigate the matter, and discover that there has been malpractice. We then sue the hospital, or HSE."

Following this, Mr Cantillon said, the hospital or health authority may deny everything and, in some instances, even deny that the patient was in the hospital.

"After some years, and when it comes close to a day of reckoning in court, the hospital and/or doctor, concede that what they did was wrong, and offer to pay compensation. They often seek to 'buy-off' the case on a confidential basis, without having the decency to admit liability, and/or apologise. This comes at a considerable human cost, because grief is being caused to the victims of malpractice in the event itself, but that grief is compounded by the manner in which claims are dealt with."

Mr Cantillon, who is a medical negligence solicitor, said a duty of candour, in which the hospital has a legal obligation to tell a patient candidly what went wrong, and why it went wrong, would prevent 'this unnecessary human cost, as well as significantly reducing financial cost, associated with medical accidents. The focus in every hospital should be on preventing accidents.'

He added that there had been a number of studies carried out in the US which showed that the 'deny and defend' approach taken by hospitals is costly in human and financial terms. "Doctors and hospitals should admit their wrongs, and be frank with their patients."