Neonatal brain injury cases represent some of the most sensitive and complex claims within the field of medical negligence. These matters arise when it is alleged that a brain injury occurred around the time of birth, often leading to lifelong consequences for the child and significant emotional and financial challenges for the family. The legal, medical, and human dimensions of these cases require a particularly careful and considered approach.
In Ireland, families pursuing such claims have traditionally relied on the standard litigation process for medical negligence, which can be lengthy, costly, and adversarial. Disputes over medical records, expert opinions, and causation often lead to years of proceedings before resolution is reached. During this time, families may face uncertainty regarding the child’s future care and the financial resources needed to provide it.
Against this backdrop, the Government’s Programme for Government 2025 has included a commitment to create a court supervised, mediation-based process dedicated to neonatal brain injury claims. The commitment first appeared in the government’s draft programme on 21 January 2025 and is now being implemented.
What the new process aims to achieve
The proposed new process has several key objectives in mind. These aims reflect both the need to resolve disputes more efficiently and the importance of supporting families in highly distressing circumstances.
- Achieving earlier resolution so that families have clarity and access to resources without years of delay
- Reducing legal and expert costs for all parties involved, including the State
- Minimising the adversarial nature of proceedings to protect the well-being of families
- Ensuring that compensation and support are tailored to the child’s long-term needs
- Promoting a culture of openness and constructive dialogue in the handling of medical negligence claims
Key features of the proposed system
Although the detailed framework has yet to be finalised, the proposal indicates that the process will include several distinctive elements designed to address the specific challenges of neonatal brain injury claims.
- Judicial oversight to ensure progress, fairness, and adherence to timelines
- Mediation as the primary mechanism for resolving disputes before trial is considered
- Engagement of mediators and experts with specialist knowledge of neonatal brain injury
- A structured exchange of information to clarify the medical facts early in the process
- Flexibility to agree on remedies that may include structured settlements or other tailored arrangements
Relationship to existing court powers on mediation
In April 2025, the High Court introduced new practice directions for clinical negligence proceedings, which include stronger powers for judges to direct parties to consider mediation and a requirement to confirm whether mediation has been offered when seeking a trial date. These changes apply to all clinical negligence cases and aim to encourage earlier settlement.
The proposed neonatal brain injury scheme would build upon these general provisions by creating a dedicated pathway for this specific category of claim. It would offer a more structured process with judicial oversight from the outset and mediators experienced in the unique medical and evidential issues these cases present.
Anticipated benefits for stakeholders
The introduction of the new process has the potential to bring tangible advantages for all parties involved.
For families of affected children
- Earlier access to financial resources for medical care, therapy, and daily living needs
- Reduced stress and emotional strain through a less adversarial process
- Greater opportunity for constructive dialogue with healthcare providers
For healthcare providers and the State Claims Agency
- Lower legal costs through reduced reliance on prolonged litigation
- Improved relationships with patients and families by fostering transparency and cooperation
- Quicker resolution of cases, freeing up time and resources for patient care
For the court system and the wider public interest
- A reduction in the length and complexity of High Court medical negligence lists
- Better allocation of judicial resources to cases requiring formal adjudication
- Increased public confidence in the fairness and efficiency of the legal process
Potential challenges and considerations
While the proposed process offers clear potential benefits, its successful implementation will depend on careful planning and adequate resourcing. Legislative changes may be required to give the courts the authority to oversee and direct such a specialised scheme. There will also be a need to ensure that mediators have the necessary expertise and that both sides have timely access to relevant medical evidence. Without these foundations, the process could struggle to deliver the intended improvements in efficiency and fairness.
Further questions about these changes?
If you have any questions about neonatal brain injury claims or how the proposed court-supervised mediation process might affect your case, the medical negligence team at McCarthy + Co Solicitors can provide clear, expert guidance. Contact us today for a confidential, no-obligation consultation to discuss your options and protect your rights.






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