The Risks of Moving Irish Medical Negligence to Circuit Courts

A Reform Too Far? Justice at Risk in Proposed Overhaul of Irish Courts

In the hallowed halls of the Four Courts and across the regional circuits of Ireland, a storm is brewing. It is not a storm of dramatic courtroom revelations, but one of bureaucratic design, contained within the dry text of the General Scheme of the Civil Reform Bill 2025. Yet, for many legal practitioners and, more importantly, their vulnerable clients, the proposals contained within this bill represent a clear and present danger to the administration of justice. At the heart of the controversy is a seemingly innocuous proposal: to increase the monetary jurisdiction of the Circuit Court. Critics, however, argue that this single change could dismantle years of progress, particularly for victims of medical negligence, and condemn them to a system ill-equipped to handle the profound complexity of their cases.

The proposal, specifically outlined in Head 30 of the General Scheme, aims to raise the general civil jurisdiction of the Circuit Court from €75,000 to €100,000. More alarmingly for personal injury specialists, Head 32 seeks to abolish the existing distinction for personal injury claims, which currently caps the Circuit Court’s jurisdiction at a lower threshold of €60,000. The effect would be immediate and dramatic: any personal injury or clinical negligence case valued between €60,000 and €100,000 would be summarily diverted from the High Court to the already overburdened Circuit Court system. For those on the front lines of litigation, this is not a simple administrative tweak; it is a seismic shift with potentially devastating consequences for litigants.

The Flawed Logic of Inflation

Proponents of the change, speaking anecdotally as no formal justification has been robustly presented, suggest the increase is a simple matter of accounting for inflation. It is a justification that seems logical on its surface but crumbles under the slightest scrutiny. Legal experts are quick to point out that the landscape of personal injury awards has not been subject to inflationary pressures in the same way as the broader economy. In fact, the opposite is true. The introduction of the Personal Injury Guidelines in 2021, a measure designed to standardise and control award levels, led to a significant reduction in the value of general damages across the board.

These guidelines effectively recalibrated the financial worth of personal injury claims downwards. While the Judicial Council recommended an upward revision of 16.7% in 2024 to account for subsequent inflation, this recommendation has, to date, been ignored. The awards remain pegged at their 2021 levels. Therefore, to argue for a 66% increase in the court’s jurisdiction based on inflation, while the value of the very awards being adjudicated has been artificially suppressed and frozen, is not just flawed—it is nonsensical. It ignores the fundamental reality that the financial value of these cases has decreased, not increased. This disconnect suggests the proposal is untethered from any considered policy analysis and fails to acknowledge the unique legislative context governing personal injury litigation in Ireland.

Furthermore, it overlooks the deliberate distinction previously established by lawmakers. When jurisdictions were last reviewed, a conscious decision was made to set a lower limit of €60,000 for personal injury matters, compared to the €75,000 for other civil cases. This acknowledged the unique nature of these disputes, their complexity, and the profound human element involved. The introduction of the Personal Injury Guidelines has only served to reinforce the logic of that distinction, making the current proposal to abolish it all the more perplexing and ill-advised.

A Tale of Two Courts: Why Venue Matters

To the layperson, a court is a court. To a litigant whose life has been irrevocably altered by negligence, the difference between the High Court and the Circuit Court can be the difference between justice served and justice denied. The High Court is structured to manage the most serious and complex civil cases. It operates with a panel of judges, many of whom have deep, specialised experience in areas like personal injuries and clinical negligence. This structure provides a crucial degree of flexibility and resource allocation.

A key feature of the High Court is its ability to specially fix hearing dates months in advance. This is not a matter of convenience; it is a procedural necessity. Clinical negligence cases, in particular, rely on the testimony of expert witnesses—leading consultants, surgeons, and specialists who are often in high demand and must travel from the UK, Europe, or further afield. Their time is exceptionally valuable, and their availability is limited. The High Court’s ability to schedule a case for a specific date allows legal teams to secure the attendance of these vital experts, ensuring the court has the best possible evidence upon which to make its decision.

Moreover, the High Court’s panel system is designed to accommodate the unpredictable nature of litigation. A complex case scheduled for a two-week hearing might settle on the second day. In the High Court, the judge can be immediately reassigned to another case from the list, ensuring judicial time is not wasted. This efficiency is paramount in a system already criticised for its delays. The Circuit Court, for all its vital importance in the Irish legal ecosystem, simply does not possess this infrastructure. It operates on a different model, dealing with a high volume of varied cases in specific locations during designated sessions. It cannot offer the same guarantees of fixed hearing dates far in advance, nor does it have a comparable panel system to manage its caseload with such flexibility. Dropping a cohort of highly complex, evidence-heavy, and time-consuming cases into this environment is a recipe for chaos, adjournments, and spiralling costs.

The Special Case of Clinical Negligence

Nowhere are the dangers of this proposed reform more acute than in the field of clinical negligence. These are amongst the most challenging, emotionally draining, and procedurally demanding cases in the entire civil system. They are not straightforward. They involve intricate questions of medical science, where establishing a breach of duty and, crucially, proving that this breach caused the patient’s injury, requires a mountain of documentation and testimony from multiple medical experts.

In a landmark development, the President of the High Court established a dedicated Clinical Negligence List in April 2025, acting on the recommendations of the 2020 Meenan Report. This was a progressive and welcome reform. It ensures that these sensitive cases are overseen by a dedicated judge and heard by judges with proven experience in the field. The list also benefits from a sophisticated case management system, designed to streamline proceedings, narrow the issues in dispute before trial, and facilitate the efficient hearing of evidence. This specialised list is a testament to the recognition that clinical negligence litigation requires a unique and carefully managed approach.

The government’s new proposal would effectively gut this specialist list. A vast number of clinical negligence claims, due to the constraints of the Personal Injury Guidelines, fall precisely within the €60,000 to €100,000 valuation bracket. These are not minor cases. They are cases of delayed diagnosis leading to life-altering consequences, surgical errors requiring corrective procedures, and failures in care that inflict profound physical and psychological trauma. To remove them from a bespoke system designed for their complexity and transfer them to a generalist court without the necessary expertise, case management, or scheduling capacity would be an act of profound institutional negligence.

The Human Cost: Aoife’s Story

To understand the real-world impact, consider the fabricated but representative case of Aoife, a 48-year-old teacher from County Cork. For six months, Aoife was a regular, and increasingly desperate, visitor to her local hospital’s A&E department. She complained of a sharp, recurring pain in her chest, shortness of breath, and a debilitating fatigue that made her job impossible. Despite her clear and worsening symptoms, she was repeatedly diagnosed with anxiety or muscular strain and sent home with painkillers. Her GP, concerned by her deterioration, referred her back on three separate occasions, only for the hospital to dismiss her concerns.

Finally, after collapsing at home, she was admitted and a junior doctor, suspecting something more serious, ordered an echocardiogram. The result was immediate and shocking: Aoife was suffering from severe, untreated pericarditis, an inflammation of the lining around her heart. The nine-month delay in diagnosis had caused significant scarring, leaving her with a chronic condition that permanently increased her risk of heart failure and recurrent, painful episodes. She lived with the constant fear that every twinge in her chest was a prelude to a fatal heart attack.

Aoife’s legal case was valued at approximately €85,000. It was not a simple matter. To succeed, her legal team needed to prove not only that the hospital staff had been negligent on multiple occasions, but that this specific negligence directly caused the long-term damage to her heart. This required expert testimony from a leading cardiologist in London to explain the progression of the disease, and a consultant psychiatrist from Dublin to detail the severe psychological trauma and anxiety disorder she had developed. The trial was estimated to last six days.

Under the current system, her case would be managed and heard in the High Court’s Clinical Negligence List. Her solicitors could secure a fixed date for the London-based cardiologist to fly in. The case management process would ensure that medical records were exchanged efficiently and that the core issues were agreed upon before the trial began. Under the proposed reforms, Aoife’s case would be relegated to the Circuit Court. There would be no guarantee of a fixed date, creating a logistical nightmare for securing her key expert witness. The case would be listed alongside debt collections, licensing applications, and family law matters, before a judge who may have no specific experience in adjudicating complex medical evidence. The risk of her case being adjourned multiple times, causing costs to spiral and prolonging her distress, would be immense. For Aoife, and thousands like her, the proposed reform is not an administrative change; it is the potential theft of her right to a fair and efficient hearing.

The Forgotten Victims

The damage would not be limited to clinical negligence cases. Another profoundly vulnerable group of litigants would be caught in the crossfire: families bringing wrongful death actions. These are cases taken by the dependents of a person who has died as a result of another’s negligence. The law places a statutory cap on the damages that can be awarded for mental distress, or solatium, in these tragic circumstances. Consequently, the total value of many of these claims, even those involving catastrophic failures of care, falls squarely within the proposed new €60,000-€100,000 jurisdiction of the Circuit Court.

These are families grappling with the most immense grief imaginable, forced to navigate the legal system to seek accountability and financial security following the loss of a loved one. Justice for them demands a process that is not only robust but also sensitive, efficient, and timely. The structures developed in the High Court, particularly around the Clinical Negligence List, provide a degree of this. To force these grieving families into an overburdened Circuit Court system, with all its inherent delays and lack of specialisation, would be to compound their suffering and add unforgivable insult to their injury.

A System in Reverse

This proposal is being tabled at a time when the Irish courts are already under intense scrutiny for their inefficiency. Reports consistently place Ireland as one of the slowest judicial systems in the European Union, with litigation taking significantly longer than the EU average. In this context, enacting a reform that will knowingly take a large volume of the most complex cases and place them into a court system not designed to handle them is incomprehensible. It is a retrograde step that runs contrary to all modern principles of judicial administration, which favour specialisation and efficient case management.

The result will be a judicial bottleneck of epic proportions. The Circuit Court will become clogged with cases it cannot process efficiently, leading to longer delays for all litigants in that court. At the same time, the expertise and resources of the High Court’s specialist lists will be underutilised, and the victims of medical negligence and other serious personal injuries will find themselves trapped in a legal purgatory. This is not reform; it is regression. It is a policy that prioritises a flawed and unsubstantiated administrative theory over the tangible needs of the most vulnerable people in our society. It is an unforgivable dereliction of the state’s duty to provide a functioning and accessible system of justice for all. The legal community has a duty to stand firm and insist that this disastrous proposal be abandoned before irreparable damage is done.