I have experience, over some decades now, of meeting and representing patients who have been catastrophically injured as a result of errors made by medical professionals. In order to establish there was medical negligence, one has to be able to meet the criteria set down by the Supreme Court for medical negligence. 

In short, the patient must be able to show no responsible medical practitioner (of similar standing) would have acted in the manner in which the impugned doctor or consultant acted. If the doctor can show even a small minority would have acted in the way they did, it will not be deemed medical negligence. 

This is a far higher standard than ordinary negligence that would apply, for example in a road traffic accident. It is a high threshold to be met.

It seems obvious the starting point to reduce the costs of medical negligence, then, would be to reduce the number of medical errors that occur.

In his article, Mr Fulton sets out the high costs of these errors between 2018 and 2022, and suggests four new children’s hospitals could be built every decade for that. That is indeed very worrying, and all the more reason to look to his colleagues as to why they have made such errors and how those errors can be reduced.

The article states: "The State is reluctant to allow cases to reach the High Court because the daily costs can run into tens of thousands of euro. Consequently, cases where the State has a reasonable chance of being successful are never heard.”

That has not been my experience. In the first instance, before bringing a case, one has to get a relevant medical expert to confirm there was medical negligence. The State or the hospital involved or their indemnifiers get their own experts and, in my experience, cases only settle when the State or private indemnifiers have reports which are not supportive of their position. They are not settled because of adverse cost fears.

The majority of experts do come from the UK when acting for a patient. This is because there are very few experts in Ireland who are prepared to go against their colleagues. 

This is not necessarily a criticism. The medical community is small, the specialities are smaller still, and it is important medical professionals get on with each other.

My firm has had unhappy experiences of retaining Irish consultants in medical negligence cases. For example, in one orthopaedic case, where we were informed by an Irish consultant there was no negligence, we had a lingering doubt about it, and we checked with two leading consultants in the UK. 

They advised there was a clear breach of duty in the case, which resulted in a devastating injuries to the patient. We brought the claim and the indemnifiers admitted liability.

As for the suggestion that reports from UK doctors are harsher on Irish medical personnel, that's very difficult to stack up. 

Any expert retained by a patient will be subject to having their CV critically analysed by the defendant, and it would indeed be folly for a plaintiff to put up a doctor who was just there to tell the patient what they wanted to hear, rather than what could be stood over. Experts are subject to rigorous cross examination as to their qualifications and opinions.

British doctors speaking in Irish courts are regulated by their own GMC, the UK equivalent of the Irish Medical Council.  If a British doctor, for example, commits perjury, or gives evidence that is clearly incorrect, they can be reported to the GMC.

The suggestion all experts should be registered with the Irish Medical Council is untenable. They are already regulated. 

Furthermore, a number of UK expert witnesses have informed me their UK insurance policies do not provide cover for reports furnished in Ireland.

There are guidelines in place regarding the level of compensation, namely the personal injuries guidelines, which apply to personal injury cases and medical negligence cases. 

Rather than bemoaning the input of UK experts who provide a service to injured Irish patients, it might be more helpful to the Irish health system and those working in it to try and establish why there is such a volume of medical errors causing harm to patients and to figure out what might be done to reduce these errors. 

Where errors occur, it would be life-changing for many of the patients I see in dire circumstances if those who have been negligent accepted and acknowledged the errors and compensated the injured patients promptly. 

While it would be of huge benefit to the injured persons, it's possible it would also save time and stress for the medical professionals involved, too. 

• Karen Kearney is a solicitor at Cantillons, practicing exclusively in medical negligence