Reforming Medical Negligence Claims in Ireland: What’s Changing — and Why It Matters

Medical negligence claims in Ireland have long been flagged for being slow, costly, and emotionally draining, both for patients and for clinicians. Earlier this year, a landmark announcement provided a glimmer of hope: significant reforms to the clinical negligence claims process are expected to come into force in early 2026. These changes promise faster access to critical medical records, more efficient court procedures, and a fairer system overall.

Understanding what’s ahead and how it affects you can make all the difference if you’re considering or already pursuing a medical negligence claim.

What Exactly Is Changing — Key Reforms to Watch For

1. Faster Retrieval of Medical Records

One of the most frequently cited frustrations in medical negligence claims is how long it takes to obtain patients’ medical files. According to the State Claims Agency, claimants can currently wait up to two years to receive crucial records. These delays can stall expert evaluations, prolong legal proceedings, and leave claimants in limbo, sometimes even long after the clinicians involved have retired or left the country.

Under the new rules being introduced, there will be clearer protocols to ensure that medical reports are obtained more quickly, making the entire claims process more humane, efficient, and predictable.

2. Reviving Periodic Payment Orders (PPOs)

Another major reform under discussion is the return of Periodic Payment Orders (PPOs). These would allow compensation to be paid in instalments over a person’s lifetime instead of as a lump sum, a model especially beneficial in cases of catastrophic injury.

PPOs were paused in 2019 over concerns about how well they kept up with inflation and rising care costs. But now, reformers argue this payment method is essential. As Professor Rhona Mahony, who chaired the expert working group, put it:

“It’s a much better way of compensating patients … particularly in catastrophic brain injury … different units will have different monetary requirements.

3. Smarter Case Management in Court

Another big change comes from the court system itself. As of April 2025, the High Court introduced two new Practice Directions (HC 131 and HC 132) to overhaul how clinical negligence cases are managed.

• HC 132 creates a dedicated Clinical Negligence List, giving such cases specialist judicial oversight.
  
• HC 131 requires the early exchange of expert reports, witness lists, and a structured approach to scheduling trials, plus an early commitment to mediation.

These reform steps aim to break the so-called “trial by ambush” culture, where important evidence only surfaces at the last minute, causing delays, cost blowouts, and emotional stress.

4. Greater Use of Alternative Dispute Resolution (ADR)

Mediation and other forms of Alternative Dispute Resolution (ADR) are expected to become a more central feature in medical negligence claims. Under the new Practice Directions, once a trial date is set, parties must formally consider mediation.

This is not only more cost-efficient, it can also be more emotionally supportive. ADR gives patients and clinicians the chance to engage directly, acknowledge harm, and explore fair solutions without the full weight of litigation.

Why These Reforms Matter for People Making a Medical Negligence Claim

So, what do these changes mean for someone thinking about or already pursuing a medical negligence case? There are several clear benefits:

• Quicker Access to Medical Records: With more efficient record retrieval, the early parts of your case (like expert assessments) can move faster, shortening the overall timeline.
  
• Less Stress, More Certainty: Faster case management and structured pre-trial steps should reduce surprises, helping you know where your case stands.
  
• Fairer Compensation Structure: Reintroducing PPOs means that in very serious, lifelong injury cases, you can receive regular, predictable payments — rather than a single lump sum that might not reflect future care needs.
  
• More Inclusive Resolution Options: Mediation and ADR offer alternative pathways to settlement that can feel more collaborative than adversarial court battles.
  
• Reduced Legal Costs: With earlier case management and ADR, there may be fewer skyrocketing fees, making claims more financially sustainable for claimants.
  
• Judicial Expertise: A dedicated High Court list means that judges who are more familiar with medical negligence can handle your case, making proceedings more efficient and predictable.
  

Risks and Challenges: What to Keep in Mind

While the reforms are promising, there are a few caveats to be aware of:

• Implementation Gaps: Not all reform recommendations have been fully enacted yet. For example, pre‑action protocols (PAPs), which many believe are crucial, are still pending.
  
• Liability Still High: Ireland’s outstanding healthcare liabilities remain massive (in the region of €5 billion) and could grow further if reforms don’t curb risk.
  
• Legal Costs Remain Steep: Even with reforms, legal costs per claim in Ireland have historically been among the highest globally.
  
• Burden on Claimants: Legal and medical experts must engage early, which could require upfront coordination and possibly cost, underscoring how helpful a specialist solicitor is.
  

Why You Should Speak to a Medical Negligence Solicitor Now

If you believe you have a medical negligence claim, or are already navigating one, now is a critical time to get expert legal advice. A medical negligence solicitor can:

1. Explain How the Reforms Affect Your Case
   An experienced solicitor can help you understand how these changes (like the new practice directions or PPOs) apply to your case and how they might improve your claim’s trajectory.
   
2. Manage Records and Expert Reports
   With faster protocols coming in, a solicitor will assist in obtaining your medical documents more efficiently and working with expert witnesses to build your case early on.
   
3. Explore ADR and Mediation
   Your solicitor will guide you through mediation options, helping you decide whether ADR is suitable for your case and negotiating on your behalf.
   
4. Calculate Long-Term Needs
   Particularly for catastrophic injury cases, a solicitor can help assess whether a PPO (periodic payment order) might be appropriate, taking into account future care, inflation, and evolving medical needs.
   
5. Navigate the Court System
   With the new High Court Clinical Negligence List, having a solicitor who understands specialist case management (and the new Practice Directions) is more important than ever.
   
6. Manage Cost Risk
   Medical negligence claims can be expensive, but an experienced solicitor will help you understand cost structures, risk, and possible funding options (including no-win-no-fee or other arrangements, depending on your situation).
   

Final Thoughts

The reforms coming into Irish medical negligence law represent a welcome and long-overdue modernization of a system many argue has long favoured delay and expense over timely justice. If you or a loved one has suffered harm in medical care, these changes offer real hope: faster access to your records, smarter litigation, fairer compensation, and more opportunities to resolve without bitter court battles.

That said, navigating these reforms isn’t something to go it alone. A specialist medical negligence solicitor will be your strongest ally, helping you understand your rights, prepare your case effectively, and make the best decisions for your circumstances.

Whether you’re just starting to investigate a potential claim, or you’re already mid-process: now is a strategic moment to get informed, get supported, and get ready to make your case count in a changing legal landscape.