More than one fifth of the cost of managing resolving claims under the State's Clinical Indemnity Scheme (CIS) last year went on legal services and other costs, the Comptroller and Auditor General has found.

It spent €76.5m (21%) on such services and costs.

The CIS is operated by the State Claims Agency (SCA) which manages personal injury claims including for clinical negligence for the State and certain agencies.

The SCA also runs the General Indemnity Scheme which deals with third party property damage claims on behalf of the State.

Since 2012, there has been a four-fold upward increase in outstanding clinical liabilities from €1.1 billion to €4.5 billion by the end of last year, the C&AG said in his report on 2021.

Claims related to maternity services accounted for just under 61% or €2.07 billion of the estimated outstanding clinical liability at the end of 2021.

Within this specialty, cerebral palsy claims - while representing just 4.5% of the total number of claims - accounted for around 40% of the estimated outstanding liability or €1.4 billion.

There were 163 active cerebral palsy claims related to maternity services at the end of 2021.

At the end of December, CIS claims comprised almost 32% or 3,626 of total claims, but accounted for over 75% or €3.4 billion of the total estimated outstanding liability.

The cost of managing and resolving CIS claims last year was €357.4 million, of which €76.5 million or 21% related to legal services and other costs.

Since 2012, the average time taken to finalise a clinical claim has increased by 17% from 4.26 to 4.97 years.

The largest increase at 59% was in respect of surgery related claims, which in 2021 were taking 5.25 years.

For maternity services related claims, the average processing time increased by 39%, from almost four years in 2012 to almost 5.4 years in 2021.