Defence Forces Injury Claims Ireland: Suing the State Claims Agency in 2026

Gary Matthews, Personal Injury Solicitor Dublin

Author: Gary Matthews, Principal Solicitor, Law Society of Ireland PC No. S8178 • 3rd Floor, Ormond Building, 31-36 Ormond Quay Upper, Dublin D07 • 01 903 6408Last reviewed: November 2025

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In Ireland, Section 38 organisations are sued and defended by the State Claims Agency under the General Indemnity Scheme or the Clinical Indemnity Scheme. Section 39 organisations are sued as independent legal entities defended by their own commercial insurer. The substantive law of negligence is identical. The procedural and indemnification track is not.

Summary: A person injured in a nursing home, a disability service, or by an out-of-hours GP in Ireland is often told the same thing: that the HSE is the defendant. For a Section 39 organisation, that is wrong, and getting it wrong can cost months and sometimes the case itself. This page explains who you actually sue when an injury happens inside a body funded under Section 38 or Section 39 of the Health Act 2004, who pays the compensation, and how the process differs in practice.

In brief: Section 38 organisations are sued through the State Claims Agency, with the State paying. Section 39 organisations are sued in their own legal name, with their private insurer defending. Naming the wrong defendant delays your claim. We help confirm the correct defendant before you instruct.

Quick answers

Who you sueSection 38: the body, defended by the SCA. Section 39: the operating limited company or charity.
Who paysSection 38: the State (CIS/GIS). Section 39: a private commercial insurer in most cases.
IRB?Yes for non-medical injuries. No for medical negligence (PIAB Act 2003 s.3(3)).
Time limitTwo years from the date of knowledge in most cases.

What's changed in the last 24 months

  • Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 (Commenced 26 September 2024) commenced 26 September 2024, mandating open disclosure of 13 specified notifiable incidents at Section 38 hospitals and Section 39 providers. Failure to disclose is a summary offence subject to a Class A fine of up to €5,000. Apologies and disclosures under the Act are not admissions of fault in clinical negligence proceedings.
  • NTMA 2024 Annual Report (published July 2025) shows 10,968 active SCA-managed claims at end-2024 (most recent published figure), with €5.35 billion in estimated outstanding liability.
  • Section 39 pay parity remains an ongoing dispute. A November 2023 trade union and Government agreement averted a national strike, but full parity with HSE and Section 38 staff has not been achieved.
  • Personal Injuries Guidelines 2026 update introduces revised quantum bands relevant to all personal injury claims including those against Section 38 and Section 39 providers.
Contents

Why does the Section 38/39 question decide your case?

Two people can be injured in similar circumstances at similar Irish healthcare or social-care providers and end up on completely different legal tracks. One sues an organisation that is defended by the State Claims Agency (SCA) with the State ultimately paying. The other sues a private limited company or charity that is defended by a commercial insurer. The question that determines which track is whether the provider is a Section 38 organisation or a Section 39 organisation under the Health Act 2004.

This is the single most common procedural confusion we see in claims involving HSE-funded care. People assume that if the State pays for the service, the State is the defendant. For Section 39 bodies, that assumption is wrong. The HSE has no direct civil liability. Suing the HSE in those cases produces a defence motion to strike out, then a re-issue against the correct legal entity, then a delay measured in months. We have seen claims set back substantially by exactly this mistake.

The rest of this page explains the framework, gives you a practical method for identifying the correct defendant, and walks through the procedural differences that follow. The page is general legal information about Irish law, not legal advice on your specific case.

Worked example. A woman is injured by a fall in the lobby of the National Maternity Hospital at Holles Street while attending an antenatal appointment. The National Maternity Hospital is a Section 38 voluntary public hospital. The defendant named in proceedings is the National Maternity Hospital itself, and the State Claims Agency assumes management of the defence under the General Indemnity Scheme. If the same fall had occurred at a Section 39 disability service, the defendant would be the operating limited company or registered charity, and a private commercial insurer would manage the defence. The substantive law of negligence is identical in both cases. The procedural and indemnification track is not.

Quick scenario check.

If you were injured at a voluntary public hospital like Beaumont, the Mater, or the Rotunda, then you are most likely on a Section 38 track and the State Claims Agency will manage the defence.

If you were injured at a nursing home, a disability service, or by an out-of-hours GP cooperative, then you are most likely on a Section 39 track and a private commercial insurer will manage the defence.

If you were injured at a directly HSE-operated facility (such as a community mental health service or HSE-run primary care centre), then the HSE itself is the defendant and the SCA defends.

What are Section 38 and Section 39 organisations?

According to sections 38 and 39 of the Health Act 2004 (Updated November 2025), both terms describe distinct funding and governance arrangements through which the Health Service Executive funds external providers of health and personal social services in Ireland. The two sections look superficially similar. The legal consequences for a personal injury claim are very different.

Section 38: services delivered on behalf of the HSE

Section 38 organisation, a body that has entered a formal Service Arrangement with the HSE under Section 38 of the Health Act 2004 to deliver health and personal social services on behalf of the Executive. Staff are public servants on HSE-equivalent pay scales and pension schemes.

Most of the major voluntary public hospitals are Section 38 bodies. Examples include Beaumont Hospital, the Mater Misericordiae University Hospital, the Rotunda Hospital, the National Maternity Hospital at Holles Street, and the three sites that form Children's Health Ireland (Crumlin, Temple Street, Tallaght, Connolly Blanchardstown). Some larger disability and care providers also operate under Section 38. Staff are classified as public servants and are entitled to public service salary scales and pension entitlements (Department of Public Expenditure, 2024) [1].

Section 39: services similar or ancillary to HSE services

Section 39 organisation, a body that receives HSE financial assistance under Section 39 of the Health Act 2004 to provide services that are similar or ancillary to services the HSE may provide. The organisation is independent. Staff are private employees of that organisation, not public servants.

Section 39 covers a wide and varied group of providers. It includes most voluntary disability service providers (such as Rehab Group, Enable Ireland, and the Irish Wheelchair Association), many nursing homes, GP out-of-hours cooperatives, and a long list of smaller charities and community bodies (European Association of Service providers for Persons with Disabilities, Ireland fact sheet) [2]. Larger Section 39 providers fund through a Service Arrangement. Smaller providers receiving below approximately €250,000 per year use a simpler Grant Aid Arrangement (HSE Section 39 Documentation) [3].

The plain-English distinction matters because it dictates the legal personality of the defendant. "On behalf of" means the State stands behind the entity for liability purposes. "Similar or ancillary to" means it does not.

Named examples of Section 38 and Section 39 organisations

The list below identifies well-known providers by classification. The list is not exhaustive. Always verify the legal entity on the Companies Registration Office or Charities Register before issuing proceedings, because some larger providers operate through several subsidiary companies.

Section 38 (services on behalf of the HSE):

  • Beaumont Hospital
  • Mater Misericordiae University Hospital
  • St James's Hospital
  • St Vincent's University Hospital
  • Tallaght University Hospital
  • Rotunda Hospital
  • National Maternity Hospital, Holles Street
  • Coombe Women and Infants University Hospital
  • Children's Health Ireland (Crumlin, Temple Street, Tallaght, Connolly Blanchardstown)
  • Mercy University Hospital, Cork
  • South Infirmary Victoria University Hospital

Section 39 (services similar or ancillary):

  • Rehab Group
  • Enable Ireland
  • Irish Wheelchair Association
  • Acquired Brain Injury Ireland
  • Saint John of God Community Services
  • St Michael's House
  • Brothers of Charity Services Ireland
  • Most voluntary nursing homes contracted under Nursing Home Support Scheme
  • OOH GP cooperatives (Caredoc, NEDOC, D-Doc, Shannondoc, SouthDoc and others)
  • Many smaller community and disability bodies

Verification source: SCA Delegated State Authority register, HSE Section 38/39 funding documentation, EASPD Ireland fact sheet, individual organisations' Companies Registration Office and Charities Regulator entries.

Quick lookup: is this organisation Section 38 or Section 39?

Type the name of an Irish hospital, nursing home, disability service, or GP cooperative. Lookup runs locally in your browser.

Who pays? The Indemnification Matrix

According to the State Claims Agency's published mandate under the National Treasury Management Agency (Amendment) Act 2014 (Updated November 2025), the indemnification path turns on the funding classification of the provider, not on who delivers the service. If you take only one practical point from this page, take this: who funds the service is not the same question as who pays the compensation. We refer to the table below as the Indemnification Matrix, and it captures every dimension that changes between Section 38 and Section 39 claims.

If you were injured in a nursing home in Ireland, who do you sue? You sue the operating company or charity that runs the home. If that home is funded under Section 38, the State Claims Agency manages the defence and the State pays the settlement. If it is funded under Section 39 (most voluntary nursing homes are), the home's own commercial insurer manages the defence and pays. The HSE is not the legal defendant in either case.

The full Indemnification Matrix: Section 38 vs Section 39 vs HSE-direct vs Private hospital claims in Ireland
Dimension Section 38 Section 39 HSE-direct Private hospital
Statutory basisHealth Act 2004 s.38Health Act 2004 s.39Health Act 2004 generally. HSE-direct deliveryNone (private contractual)
Relationship to HSEDelivers services on behalf of the HSEProvides services similar or ancillary to HSE servicesOperated by the HSE itselfIndependent of the HSE
Funding instrumentService ArrangementService Arrangement (larger bodies) or Grant Aid Arrangement (under approximately €250,000)HSE Vote allocation (Department of Health)Private fees + private health insurance
Employee classificationPublic servants on HSE-equivalent pay scales and pensionPrivate employees of the operating organisationHSE employees (public servants)Private employees of the hospital company
Public/employer liability indemnityState Claims Agency under the General Indemnity SchemeThe organisation's own private commercial insuranceState Claims Agency under the General Indemnity SchemeHospital's own commercial insurance
Clinical negligence indemnityState Claims Agency under the Clinical Indemnity SchemeOrganisation's own insurance, with CIS coverage only for specifically enrolled clinical staffState Claims Agency under the Clinical Indemnity SchemeHospital's commercial cover and individual clinicians' Medical Council-required indemnity
Defendant named in proceedingsThe hospital or organisation (defended by SCA on the State's behalf)The exact operating limited company or registered charityThe Health Service ExecutiveThe private hospital company by exact legal name
Who actually pays compensationThe State, via the SCAThe organisation's commercial insurer (or the organisation itself if uninsured or coverage is exhausted)The State, via the SCAThe hospital's insurer (and individual clinicians' insurers where joined)
IRB applies?Yes for non-medical injuries. No for medical negligence (PIAB Act 2003 s.3(3))Yes for non-medical injuries. No for medical negligenceYes for non-medical injuries. No for medical negligenceYes for non-medical injuries. No for medical negligence
Indemnification flow: Section 38 vs Section 39 claims in Ireland Injury at the provider Section 38 or 39? Section 38: SCA defends, State pays Section 39: Private insurer defends CIS (clinical) or GIS (non-clinical) Defendant: the body itself Commercial insurer manages defence Defendant: limited co. or charity
Indemnification path: Section 38 routes to SCA-managed State indemnity. Section 39 routes to the operating organisation's commercial insurer.

The State Claims Agency operates two main schemes. The Clinical Indemnity Scheme (CIS) covers clinical negligence claims. The General Indemnity Scheme (GIS) covers most non-clinical personal injury and third-party property damage claims against State authorities, including Section 38 voluntary hospitals listed as Delegated State Authorities [4].

One nuance trips people up. A Section 39 body may have specifically enrolled clinical staff who are covered by the CIS for the medical care they deliver, while the same body still pays for its own commercial public-liability insurance for premises and non-clinical incidents. So a single incident at a Section 39 location can in theory involve two separate indemnifiers. This is rare in practice. It explains why a careful letter of claim asks the operating organisation to confirm CIS enrolment status for any clinician involved.

CIS enrolment for Section 39 clinicians is not automatic and is not granted to entire organisations as a matter of course. Specific clinicians (or specific categories of clinician within a Section 39 body) can be enrolled on an individual basis where the State Claims Agency accepts the indemnification. The most common live example is doctors working in OOH GP cooperatives delivering care under the GMS scheme, where individual contracted GPs may be CIS-covered for the clinical care they deliver while the cooperative itself remains a Section 39 entity for premises liability. This is what creates the dual-track scenario captured in the matrix above. Confirmation of CIS enrolment is obtained by written request to the SCA at letter-of-claim stage.

Need help confirming the defendant in your case? We will do this within 48 hours. Call 01 903 6408 or request a free assessment.

How do you identify whether an organisation is Section 38 or Section 39?

The Defendant Identification Test: four sequential verification methods Method 1 SCA Delegated State Authority register stateclaims.ie Method 2 HIQA Find a Centre (designated centres) hiqa.ie Method 3 CRO / Charities Register for exact legal name cro.ie + charitiesregulator.ie Method 4 Written enquiry + letter of claim solicitor confirmation Apply each method in sequence. The four together remove ambiguity.
The four-method Defendant Identification Test. Each method works on its own; together they confirm classification before the limitation clock becomes a pressure point.

Most claimants do not know whether the place where the injury happened is Section 38 or Section 39. The provider does not always advertise it. We use a four-method protocol that we call the Defendant Identification Test. Each method works on its own, and together they confirm classification before the limitation clock becomes a pressure point.

Method 1: check the SCA's Delegated State Authority register

The State Claims Agency publishes lists of bodies covered under each scheme. The General Indemnity Scheme list and the Clinical Indemnity Scheme list are the authoritative sources for confirming State indemnification. If the organisation appears on either list, the SCA is involved. If it does not, the organisation is almost always a Section 39 body or outside the public-funded structure entirely.

Method 2: cross-reference HIQA inspection reports

For designated centres (nursing homes, residential disability services, certain mental health units), the Health Information and Quality Authority's Find a Centre tool returns the registered provider's exact legal name. Inspection reports on the same site sometimes record the funding arrangement directly. The legal name in the HIQA register is what you want for any letter of claim.

Method 3: check the Companies Registration Office or Charities Register

Most Section 39 organisations are either limited companies or registered charities (or both). The Companies Registration Office and the Charities Regulator both allow free name searches and confirm the exact legal name and registered office. This is the address proceedings need to be served on. Trading names and brand names will not do.

Method 4: send a written enquiry, then a solicitor letter of claim

If the first three methods leave any ambiguity, the cleanest route is to ask in writing: "Please confirm whether your service operates under a Section 38 Service Arrangement or receives Section 39 grant aid from the HSE, and provide the exact legal name of the contracting entity." The vast majority of Irish providers reply promptly and accurately. At letter-of-claim stage, we routinely include the same request as part of the standard correspondence. Getting the legal entity name exactly right is what allows proceedings to issue cleanly.

In our experience, the single biggest avoidable delay in Section 39 claims is families and prior-instructed solicitors trying to sue the HSE on the assumption that any HSE-funded service is HSE-defended. Re-issuing proceedings against the correct limited company or charity sets the case back by months and can put a Date of Knowledge defence into play.

Try the Defendant Identification Test

Answer three short questions. We return a probable classification and the next step. The result is general legal information only.

Question 1 of 3. Where did the incident happen?

Key Irish Section 38/39 claim statistics (NTMA 2024 Annual Report)

10,968Active SCA-managed claims at end-2024 (most recent published)
3,632SCA claims resolved in 2024
€5.35bnEstimated outstanding SCA liability at end-2024
€210.5mClinical care damages paid by SCA in 2024
€76.5mGeneral damages paid by SCA in 2024
56%Resolved without court proceedings (2024)
2%Reach a court judgment
~4,000Active clinical claims (37% of portfolio)

Sources: NTMA 2024 Annual Report (State Claims Agency section), published July 2025. Computed clinical share derived from the Annual Report's portfolio breakdown.

SCA active claims portfolio 2020-2024 and 2024 expenditure breakdown SCA active claims at year end (2020-2024) Source: NTMA Annual Reports 202012,175 202111,408 202211,400 202311,137 202410,968 SCA 2024 expenditure (€461m total) Damages and costs combined €461m 2024 total Clinical damages €210.5m (46%) Plaintiff legal costs €106.5m (23%) General damages €76.5m (17%) SCA legal costs €68.4m (15%)
Active SCA claims have declined from 12,175 in 2020 to 10,968 in 2024, while estimated outstanding liability has grown to €5.35 billion. Clinical claims drive the bulk of expenditure.
Procedural timeline: Section 38 SCA-managed defence (top) vs Section 39 commercial-insurer defence (bottom) Section 38 (SCA-managed) IncidentDay 0 Letter of claimWeeks 0-4 SCA notifiedWeeks 4-8 SCA panel responseWeeks 6-12 Mediation/discoveryMonths 6-18 Resolution56% no court Section 39 (commercial insurer) IncidentDay 0 Letter of claimWeeks 0-4 Op. body forwardsWeeks 2-8 Insurer responseWeeks 4-12+ NegotiationMonths 6-24 ResolutionVariable
Approximate procedural timelines. Actual durations vary widely by complexity, expert evidence requirements, and disputed liability.

What happens when you bring a claim against a Section 38 organisation?

According to the NTMA 2024 Annual Report (published July 2025), the State Claims Agency is the operating name used by the National Treasury Management Agency when it manages claims against State authorities. Its statutory base is the National Treasury Management Agency (Amendment) Act 2000, expanded by the 2014 Amendment Act [5]. Once a Section 38 body becomes a delegated State authority, the SCA assumes management of personal injury, third-party property damage, and clinical negligence claims against it.

The scale of the SCA's portfolio is significant. According to the NTMA Annual Report for 2024, the SCA was managing 10,968 active claims at the end of 2024 across general and clinical portfolios, having resolved 3,632 claims during the year. The estimated outstanding liability across the portfolio reached €5.35 billion, with clinical claims accounting for approximately 81% of that liability despite representing 37% of the active caseload [6].

What does this mean in practice for a claimant? Two patterns are visible in the SCA's published outcomes. Around 56% of claims resolved by the SCA in 2024 were concluded without court proceedings being served, and only about 2% reached a court judgment (RTÉ Business, July 2025) [7]. The SCA states publicly that it favours mediation as an alternative to formal court process where possible. In our experience, once the SCA is engaged on a Section 38 file, the defence tends to operate on more structured timelines than a typical commercial-insurer file. There is still a strong defence of liability and quantum where the SCA disputes the case, but the procedural conduct is generally orderly.

Triangulating the published figures gives a useful working number. With approximately 37% of the SCA's 10,968 active claims classified as clinical, around 4,000 active clinical negligence claims sit inside the State-indemnified portfolio at any given time. This is the State-indemnified share only. Section 39 claims managed by private commercial insurers are not centrally reported and sit outside this figure.

The trade-off is that catastrophic Section 38 clinical claims (cerebral palsy, brain injury, profound disability) are very large and very long. The 2024 SCA figures show €210.5 million paid in clinical care damages alone, with a small number of catastrophic cases driving disproportionate settlement value [6].

What changes when you bring a claim against a Section 39 organisation?

According to HSE Section 39 documentation (Updated 2026), the procedural shape of a Section 39 claim is similar to a private-sector personal injury claim. Three things change.

First, the named defendant is the operating limited company or registered charity, identified by its exact legal name on the Companies or Charities Register. The HSE is not a defendant. Adding the HSE produces a strike-out application from the Chief State Solicitor's Office.

Second, the defence is run by a private commercial insurer in most cases. Larger disability sector providers contract with mainstream Irish or international insurers for combined public-liability and employer-liability cover. Smaller providers can have leaner cover with tighter limits or specific exclusions. Insurance is not always confirmed at first contact, so a careful letter of claim asks the organisation to confirm the insurer and policy limits.

Third, the affordability environment matters. Section 39 organisations have publicly raised concerns about commercial premium escalation in the disability and care sectors. The Disability Federation of Ireland and individual providers have stated that insurance costs have risen sharply over recent years, and pay-parity disputes during 2023 and 2024 placed the financial position of the sector under strain (Disability Federation of Ireland, 2023) [8]. For a claimant, this matters in two ways. Smaller bodies may have aggregate policy limits that get pressured by larger settlements, and exhausted or inadequate cover can complicate negotiation if the underlying organisation cannot fund a shortfall.

None of this prevents a viable Section 39 claim from succeeding. It does mean the early-stage homework on the operating entity, its insurer, and policy adequacy is more important than in a Section 38 claim, where the State stands behind the file. We recommend that any Section 39 letter of claim explicitly requests insurer details and policy limits as part of the initial correspondence. The next step, once the insurer is identified, is to assess whether policy limits cover the realistic settlement value of the claim.

What if the Section 39 organisation will not confirm its insurer?

Some smaller Section 39 organisations do not respond promptly to insurer information requests, either because of internal capacity issues or because they assume the question can wait until proceedings issue. Three escalating steps usually resolve the position. First, repeat the request in correspondence, citing the standard expectation in personal injury litigation. Second, after issue of proceedings, formal interrogatories and discovery applications can be used to compel disclosure of the policy. Third, where the policy contains relevant exclusions or aggregate limits, the rules of court allow application for further information about the available indemnity. Most Section 39 organisations confirm cover at the first or second step. Litigation-driven discovery is rarely necessary if the request is framed correctly at the letter-of-claim stage.

What happens if the Section 39 organisation enters liquidation during the claim?

Insolvency of a Section 39 organisation mid-claim is uncommon but not unknown, particularly where the body is small and reliant on a single funding stream. The position depends on whether the relevant liability insurance policy was in force at the date of the incident. Under the third-party rights legislation in Ireland, an injured party can usually proceed against the insurer directly even after the insured has gone into liquidation, where the liability arose during the insured period. Where insurance is exhausted or absent, the claim ranks as an unsecured debt against any remaining assets, and recovery is rarely complete. Specialist advice should be sought early in any claim where the defendant's continuing trading status is in doubt.

Section 39 strategy at a glance.

If the Section 39 organisation responds to the letter of claim with insurer details and policy limits within 28 days, then the claim proceeds on the standard commercial-insurer track.

If the organisation delays or refuses to confirm cover, then escalate via interrogatories or formal discovery once proceedings are issued.

If the organisation enters liquidation or insurance is exhausted, then consider direct action against the insurer under third-party rights legislation, or against any clinician with separate Medical Council-required indemnity.

How does medical negligence law apply in Section 38 and Section 39 settings?

According to section 3(3) of the Personal Injuries Assessment Board Act 2003 (Updated July 2025), the substantive law of medical negligence is the same regardless of whether the defendant is Section 38, Section 39, a private hospital, or an HSE-direct service. The standard is the one set by the Supreme Court in Dunne (an infant) v National Maternity Hospital [1989] IR 91. A practitioner is not negligent simply because their action differs from another's. Negligence requires a failure no practitioner of equal status, acting with ordinary care, would have committed in the same circumstances.

Case capsule, Dunne v National Maternity Hospital [1989] IR 91. Holding: The standard for breach of duty is professional, not lay. Why it matters: Sets the test for all medical negligence claims, including against Section 38 voluntary hospitals (such as the National Maternity Hospital itself, where Dunne arose) and against Section 39 clinical staff covered by the CIS. Source: reported judgments index, courts.ie.
Case capsule, Gough v Neary & Cronin [2003] IESC 39; [2003] 3 IR 92; [2004] 1 ILRM 35. Holding: Geoghegan J for the Supreme Court majority held that the plaintiff was fixed with knowledge for the purposes of the Statute of Limitations (Amendment) Act 1991 (Updated July 2025) on the date she had sufficient knowledge to make it reasonable for her to investigate whether she had a case against the defendant. Why it matters: Gough is the leading Irish authority on when the two-year limitation clock begins to run in clinical negligence cases. The Date of Knowledge analysis is fact-specific and is the most common ground on which limitation defences are run against medical negligence claims at Section 38 voluntary hospitals and Section 39 clinical services. Source: reported judgments index, courts.ie.

One important procedural point applies regardless of provider type. Medical negligence claims are exempt from the Injuries Resolution Board (IRB), formerly the Personal Injuries Assessment Board (PIAB) until 2023, under section 3(3) of the Personal Injuries Assessment Board Act 2003 (Updated July 2025) [9]. They go directly to court via letter of claim. The two-year limitation period in the Statute of Limitations (Amendment) Act 1991 runs from the Date of Knowledge in latent-injury cases, which is often the critical question in clinical claims [10]. We cover the substantive negligence test, expert evidence, and damages in detail on our medical negligence page and the Date of Knowledge page.

Workplace injury and employer liability in Section 38/39 organisations

Healthcare workers injured at work face a different legal position depending on the employer's funding status. Section 38 staff are public servants. Their employer-liability claim is brought against the body that employs them, but the State Claims Agency manages the defence. Standard public-service terms (occupational injury benefit, sick pay schemes, return-to-work obligations) apply.

Section 39 staff are not public servants. Their employer-liability claim is brought against the limited company or charity that employs them, defended by the organisation's commercial employer-liability insurer. Public-service injury benefits do not apply, although the worker retains the same statutory rights under the Safety, Health and Welfare at Work Act 2005 and the same right to bring a personal injury claim against the employer for breach of duty. Our dedicated page on healthcare worker injury claims covers the workplace process in detail.

What about OOH GP cooperatives, catastrophic injuries, and Patient Safety Act disclosures?

Out-of-hours GP cooperatives and vicarious liability

Major Irish out-of-hours GP cooperatives and their typical service area
CooperativeTypical service areaClassification
CaredocCarlow, Kilkenny, South Tipperary, Wexford, Waterford, WicklowSection 39
NEDOCCavan, Louth, Meath, MonaghanSection 39
D-DocDublin city and countySection 39
ShannondocClare, Limerick, North TipperarySection 39
SouthDocCork and KerrySection 39
WestDocGalway, Mayo, RoscommonSection 39
NorthdocNorth Dublin (Ballymun, Coolock, Hartstown, North Strand, Swords)Section 39

Verify the exact legal entity name on the Companies Registration Office or Charities Register before issuing. Each cooperative is a separate legal entity, often operating as a not-for-profit CLG (the Irish corporate form for a limited company without share capital, under the Companies Act 2014).

Out-of-hours GP cooperatives in Ireland (Caredoc, NEDOC, D-Doc, Shannondoc, SouthDoc and others) are typically organised as Section 39 entities contracted to deliver services under the General Medical Services scheme. The legal question that decides liability is whether the treating doctor was an employee of the cooperative or an independent contractor. The Irish courts apply the integration or organisational test to that question, and the answer is usually fact-specific. The contract structure between the cooperative, the individual doctor, and the GMS scheme has to be established at letter-of-claim stage. If vicarious liability runs to the cooperative, the cooperative (and its insurer) is the defendant. If it does not, the claim runs against the individual doctor, with all the practical issues that creates. At this point, the question becomes whether the doctor carries adequate Medical Council-required indemnity for a claim of this scale. We cover the doctrinal questions on our dedicated page on out-of-hours GP negligence claims.

Catastrophic injuries and the Assisted Decision-Making (Capacity) Act 2015

Many of the very large Section 38 clinical claims involve catastrophic outcomes such as hypoxic brain injury at birth or profound disability that affects capacity. Where the injured person lacks capacity to instruct a solicitor or manage their own settlement, the Assisted Decision-Making (Capacity) Act 2015 applies. The Act abolished the wardship system and replaced it with a tiered framework of decision support, including Decision-Making Representatives appointed by the Circuit Court. Settlement of a catastrophic injury claim where capacity is in issue requires court approval. The SCA regularly seeks Periodic Payment Orders for these cases to fund lifelong care, although the indexation mechanism for new PPOs is currently the subject of separate legislative work.

The Patient Safety Act 2023: open disclosure in Section 38 hospitals

The Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023 commenced on 26 September 2024 (Department of Health, September 2024) [11]. It applies to public and private health services, including Section 38 voluntary hospitals and Section 39 providers. It requires mandatory open disclosure of specified notifiable incidents, with apologies offered under the Act expressly protected from being treated as admissions of fault in subsequent civil negligence proceedings. For a claimant, this means an open-disclosure meeting after a serious incident is now a statutory entitlement, and the information shared at it can be used to build the picture of what happened without the apology itself becoming evidence of liability either way. This leads to the question of how to record open-disclosure information for later use in proceedings, which is best handled by a solicitor early.

What are the common mistakes that can damage a Section 38/39 claim?

  1. Naming the HSE as defendant when the operating body is Section 39. The most common preventable error. The HSE has no direct civil liability for Section 39 incidents.
  2. Treating an HSE complaint as a substitute for a civil claim. The two run in parallel, not in sequence. A complaint does not preserve the limitation period.
  3. Missing the Date of Knowledge analysis. Particularly in clinical negligence cases, the limitation clock can run from a date later than the incident, but the analysis must be done early.
  4. Failing to investigate Section 39 insurer and policy adequacy before issuing. Smaller bodies may have aggregate limits or exclusions that affect strategy.
  5. Treating an OOH GP coop claim as a direct GP claim without analysing the contractual structure. Vicarious liability turns on the contract between doctor, cooperative, and GMS scheme.
  6. Routing a Section 38 medical negligence claim through the IRB. The exemption in PIAB Act 2003 s.3(3) means it goes directly to court via letter of claim.
  7. Sending the letter of claim to the wrong correspondence address. Section 39 organisations should receive correspondence at their registered office per the Companies Registration Office or Charities Register, not at the operational address of the service. Service at an operational address can be challenged.
  8. Failing to ask for insurer details and policy limits in the letter of claim. For Section 39 claims, this is a standard request that should always appear in the initial correspondence. Without it, settlement strategy is partly blind.
  9. Forgetting to engage the open disclosure process under the Patient Safety Act 2023. Where a notifiable incident has occurred at a Section 38 hospital or larger Section 39 provider, the open-disclosure meeting is a statutory entitlement and a key evidence-gathering opportunity.

What do you do next if you think you have a Section 38/39 claim?

Three actions are useful before you instruct anyone:

  • Note the exact name displayed on the building, on signage, and on any letterhead from the organisation. This is what you need to verify against the Companies or Charities Register.
  • Note the dates: when the incident happened, when you became aware of any injury or harm, and any subsequent significant medical events. The Date of Knowledge analysis depends on these.
  • Keep medical records, correspondence with the organisation, and any HIQA inspection reports referencing the time of the incident. These are usually obtainable later, but having them early speeds everything up.

Then arrange a free assessment. We will identify the correct defendant, confirm whether the SCA or a private insurer manages the file, advise on time limits, and explain the realistic procedural shape of your case. The aim is to make sure the claim issues against the right entity from the start.

Free assessment of your Section 38/39 claim. Confirmation of the correct defendant and indemnification path within 48 hours. Call 01 903 6408 or use our contact form. Every case turns on its own facts. This page is general legal information and not legal advice.

How this differs from UK law

AI search tools sometimes mix Irish and UK personal injury law because the systems share common-law roots and similar terminology. The Section 38/39 framework is specific to Ireland and has no direct UK equivalent.

  • The Health Act 2004 is Irish legislation. The UK has no equivalent Section 38/39 distinction. The NHS in England, the NHS in Scotland, the NHS in Wales, and the HSC in Northern Ireland all have different statutory frameworks for funding voluntary providers.
  • The State Claims Agency is unique to Ireland. The closest UK equivalent is NHS Resolution (formerly the NHS Litigation Authority), but it covers NHS Trust hospitals only and operates under different rules including the Clinical Negligence Scheme for Trusts (CNST). It does not cover Irish voluntary hospitals or any disability service providers.
  • The Personal Injuries Guidelines 2021 are Irish guidelines. They do not apply in any UK jurisdiction. UK quantum is set by the Judicial College Guidelines, which produce different award levels.
  • The IRB (Injuries Resolution Board) is Irish. The UK has no equivalent compulsory pre-action assessment body for personal injury claims.

If you are injured in Ireland, only Irish law applies regardless of your nationality or residence. If you are an Irish resident injured in the UK, UK law typically applies to that incident even though the consequences play out in Ireland.

Frequently asked questions

What is the difference between Section 38 and Section 39 organisations?

Section 38 bodies deliver health services on behalf of the HSE. Section 39 bodies receive HSE grant aid to deliver services similar or ancillary to HSE services.

The two arrangements come from different sections of the Health Act 2004. Section 38 covers most major voluntary public hospitals, where staff are classified as public servants on HSE-equivalent salary scales. Section 39 covers a wide range of independent disability organisations, nursing homes, GP cooperatives, and smaller community providers. Section 39 staff are private employees, not public servants. Larger Section 39 bodies use a Service Arrangement. Smaller bodies receiving below approximately €250,000 use a simpler Grant Aid Arrangement.

Practitioner observation: The same building can house staff with different employment classifications if a Section 38 hospital outsources a service to a Section 39 contractor. Confirm classification per service line, not per site.

Next step: Verify the legal entity name on the Companies Registration Office or Charities Register before any letter of claim issues.

Is the HSE the defendant if I am injured in a Section 39 nursing home?

No. The legal defendant is the limited company or registered charity that operates the nursing home.

The HSE has no direct civil liability for incidents at Section 39 providers, even where the State funds the bed or service through the Nursing Home Support Scheme or another arrangement. Suing the HSE in those circumstances results in a strike-out application from the Chief State Solicitor's Office. Proceedings then have to be re-issued against the correct entity, and the limitation clock continues to run during the delay.

Practitioner observation: The HSE-defendant assumption is the single most common preventable error in these claims. We routinely see prior-instructed solicitors' files that need redrafting at the letter-of-claim stage.

Next step: Get the operating company's exact legal name from cro.ie or the Charities Register before issuing.

Are Section 38 staff public servants?

Yes. Section 38 staff are classified as public servants on HSE-equivalent pay scales.

They are paid on the standard health-sector salary scales agreed for the public service, are entitled to public service pension schemes, and are counted in public service employment numbers. Section 39 staff are private employees of the independent operating body. They are not public servants. The Department of Public Expenditure confirmed this position in a Parliamentary Question response on 9 July 2024.

Practitioner observation: Employment classification rarely changes the basic tort framework for an employer-liability claim, but it does affect whether public-service injury benefits and return-to-work obligations apply.

Next step: If you are a worker considering a claim, check whether your employer is Section 38 or 39 before engaging with HR or occupational health.

Does the Injuries Resolution Board (IRB) apply to Section 38 or Section 39 claims?

Yes for non-medical injuries. No for medical negligence.

The IRB (formerly the Personal Injuries Assessment Board until 2023) handles non-medical personal injury claims against both Section 38 and Section 39 bodies in the standard way. The respondent named on the IRB application is the operating organisation, not the HSE for Section 39 cases. Medical negligence claims are exempt from the IRB process under section 3(3) of the Personal Injuries Assessment Board Act 2003 and proceed directly to court via letter of claim.

Practitioner observation: A claim arising from a fall at a Section 39 service that was caused partly by physical environment and partly by clinical care can fall on either side of the IRB exemption, so framing matters.

Next step: Have the cause of injury characterised early. The framing decides whether the IRB or the court process applies.

What if a Section 39 organisation has inadequate insurance to pay my claim?

Confirm the insurer and policy limits at letter-of-claim stage and adjust strategy from there.

This is a real practical issue with smaller voluntary providers, where premium pressure has been a sector-wide concern in recent years. If cover is inadequate or exhausted, options can include negotiation within the policy limits, joining additional defendants where appropriate (for example, a clinical professional with separate Medical Council-required cover), or pursuing the organisation directly for any shortfall. Recovery from a charity with limited assets is rarely complete.

Practitioner observation: A Section 39 letter of claim should always include an explicit insurer and policy-limit information request as part of the standard correspondence. Omission lengthens negotiation by weeks.

Next step: Discuss insurance-strategy framing with a solicitor before issuing proceedings, particularly for substantial claims.

Is Rehab Group a Section 38 or Section 39 organisation?

Rehab Group is a Section 39 organisation.

It is funded by the HSE under Section 39 of the Health Act 2004 and operates as an independent legal entity. The same is true of most large voluntary disability service providers in Ireland, including Enable Ireland, the Irish Wheelchair Association, and Acquired Brain Injury Ireland. Each comprises one or more registered legal entities (limited companies or charities). Verify the exact name on the Companies Registration Office or Charities Register before issuing any proceedings.

Practitioner observation: Many large disability bodies operate through multiple subsidiary companies, each with its own service line. The correct defendant for a residential service may differ from the correct defendant for day services.

Next step: Search by exact entity name (not trading name) on cro.ie before drafting any correspondence.

How long do I have to make a claim against a Section 38 or Section 39 organisation?

Two years from the date of the cause of action or from the Date of Knowledge if later.

The general limitation period for Irish personal injury claims is two years, but the Date of Knowledge rule under the Statute of Limitations (Amendment) Act 1991 can defer the start date in latent-injury and clinical negligence cases. Time limits do not change because the defendant is Section 38 or Section 39. The provider's classification affects who the defendant is and who pays, not how long you have. Special rules apply for minors (clock starts at 18) and for persons under a disability.

Practitioner observation: The Date of Knowledge analysis is fact-specific and is the most common ground on which limitation defences are run in clinical negligence cases. Get medical-records cross-referencing done early.

Next step: Note every date on which you became aware of any element of the injury or its likely cause. Bring this timeline to your first consultation.

What is the State Claims Agency and how does it manage claims?

The State Claims Agency is the operating name used by the National Treasury Management Agency when managing claims against State authorities.

It runs two main schemes: the Clinical Indemnity Scheme (CIS) for clinical negligence claims and the General Indemnity Scheme (GIS) for non-clinical personal injury and property damage claims. According to the NTMA 2024 Annual Report, the SCA was managing 10,968 active claims at end-2024, resolved 3,632 during the year, and around 56% of resolved claims concluded without court proceedings being served. According to the State Claims Agency, "the State Claims Agency strongly favours mediation, where possible to resolve claims, as an alternative to the formal court process" (stateclaims.ie/services/claims-resolution/mediation, accessed November 2025).

Practitioner observation: Once the SCA is engaged on a Section 38 file, the defence tends to operate on more structured timelines than a typical commercial-insurer file, although liability and quantum can still be robustly disputed where appropriate.

Next step: If your potential defendant is on the Delegated State Authority list, expect a structured SCA-managed defence rather than a commercial-insurer defence.

What to consider next

Should I make a complaint or pursue a claim?

The two are different processes. A complaint to the HSE or to a Section 38/39 provider is about service quality and explanation. A civil claim is about compensation. The complaint process does not stop the limitation clock. If you are weighing both, run them in parallel or talk to a solicitor about sequencing. Our page on complaint vs claim covers this in more detail.

How does SCA-managed defence compare with private-insurer defence in practice?

In our experience, SCA-managed Section 38 files run on more structured timelines than typical commercial-insurer files. The SCA's published preference for mediation over court proceedings shows in its outcome data: 56% of 2024 resolutions concluded without court proceedings being served. Private commercial insurers can default to deny-and-defer at first-instance correspondence. Neither pattern is universal, and well-resourced commercial insurers also engage constructively. The practical takeaway is to expect different rhythms and plan correspondence to suit.

This page is part of a connected set of guides on Irish State and HSE-related personal injury claims. Each related page covers a different aspect of the claim picture:

Glossary of key terms

Definitions of the central legal entities and instruments used on this page.

Section 38 organisation
An organisation that has entered a formal Service Arrangement with the Health Service Executive under section 38 of the Health Act 2004 to deliver health and personal social services on behalf of the HSE. Staff are public servants on HSE-equivalent salary scales.
Section 39 organisation
An organisation that receives HSE financial assistance under section 39 of the Health Act 2004 to provide services that are similar or ancillary to HSE services. The organisation is an independent legal entity. Staff are private employees, not public servants.
State Claims Agency (SCA)
The operating name used by the National Treasury Management Agency when managing personal injury, property damage, and clinical negligence claims against State authorities under the National Treasury Management Agency (Amendment) Acts 2000 and 2014.
Clinical Indemnity Scheme (CIS)
The scheme under which the SCA indemnifies clinical negligence claims against participating healthcare bodies, including all Section 38 voluntary hospitals and specifically enrolled clinical staff at Section 39 organisations.
General Indemnity Scheme (GIS)
The scheme under which the SCA indemnifies non-clinical personal injury and third-party property damage claims against State authorities, including Section 38 bodies listed as Delegated State Authorities.
Service Arrangement
The formal contract between the HSE and a Section 38 organisation (or larger Section 39 organisation) setting out funding, governance, performance standards, and reporting obligations.
Grant Aid Arrangement
The simplified instrument used to fund smaller Section 39 organisations receiving below approximately €250,000 per year, in place of the full Service Arrangement.
Delegated State Authority
A body formally added to the State Claims Agency's claim-management remit by Government order, becoming subject to State indemnification under the relevant SCA scheme.
Date of Knowledge
The date on which a person first became aware (or reasonably should have become aware) of an injury and its likely cause. Under the Statute of Limitations (Amendment) Act 1991, the two-year personal injury limitation period runs from this date in latent-injury cases.
Indemnity
The contractual or statutory arrangement under which one party (the indemnifier) takes on the financial cost of liabilities incurred by another party (the indemnified). For Section 38 claims, the State indemnifies. For Section 39 claims, a private commercial insurer indemnifies in most cases.

References

Methodology and source review. This page is sourced primarily from Irish statutory texts, official State agency publications, and Oireachtas records. Where statistical claims are made, the source publication and its publication date are stated inline. The principal sources are the Health Act 2004, the National Treasury Management Agency Acts 2000 and 2014, the NTMA 2024 Annual Report (published July 2025), the State Claims Agency's published documentation, and the Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023. Citations to irishstatutebook.ie reference distinct statutory provisions and are repeated where each provision is independently cited. Citations to stateclaims.ie reference distinct schemes and registers operated by the State Claims Agency.

Last source review: November 2025. All external links were verified against the source publishers' current canonical URLs as of that date.

  1. Department of Public Expenditure response, Parliamentary Question 9 July 2024, confirmation that Section 38 staff are classified as public servants on standard health-sector salary scales. oireachtas.ie.
  2. European Association of Service providers for Persons with Disabilities, Ireland fact sheet on the Section 38 / Section 39 funding distinction and the Service Arrangement / Grant Aid threshold. easpd.eu.
  3. Health Service Executive, Section 39 documentation and Service Arrangement templates. hse.ie.
  4. State Claims Agency, Delegated State Authorities under the General Indemnity Scheme. stateclaims.ie/general-indemnity-scheme. Clinical Indemnity Scheme participating bodies. stateclaims.ie/clinical-indemnity-scheme.
  5. National Treasury Management Agency, State Claims Agency mandate and statutory base. ntma.ie/state-claims-agency.
  6. NTMA 2024 Annual Report, State Claims Agency section. 10,968 active claims at end-2024. 3,632 resolved during the year. €5.35 billion estimated outstanding liability. €210.5 million in clinical care damages and €76.5 million in general damages paid. ntma.ie/annualreport2024 (PDF).
  7. RTÉ Business, coverage of the SCA 2024 cost summary, including 56% of claims resolved without court proceedings, July 2025. rte.ie.
  8. Disability Federation of Ireland, statement on the recruitment, retention and funding crisis in Section 39-funded organisations, September 2023. disability-federation.ie.
  9. Personal Injuries Assessment Board Act 2003, section 3(3), exemption of medical negligence claims from the Injuries Resolution Board. irishstatutebook.ie.
  10. Statute of Limitations (Amendment) Act 1991, Date of Knowledge in personal injury and latent injury claims. irishstatutebook.ie.
  11. Patient Safety (Notifiable Incidents and Open Disclosure) Act 2023, commenced 26 September 2024. Department of Health press release. gov.ie. Act text irishstatutebook.ie.

Disclaimer. This page provides general legal information about Irish law and is not legal advice. Every case turns on its own facts. Consult a qualified solicitor for advice on your specific situation. Author: Gary Matthews, Principal Solicitor, Practising Certificate No: S8178, Law Society of Ireland. Last reviewed: 8 May 2026.

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