Published Tuesday, 23 October 2012
The report said incidents are still being under-reported. (© UTV)
Since 2007, £77m in damages and £39m in legal costs has been paid out by the department, and it estimates it will spend a further £136m to cover unsettled cases.
The Northern Ireland Audit Office (NIAO), who collated the figures into safety across NI Health and Social Care Trusts, said the final bill was harder to estimate as the cost of additional patient treatment had to be included.
Around 83,000 "adverse incidents" of potential harm to the patient are recorded across the trusts each year, but many more are going unreported.
Comptroller and Auditor General Kieran Donnelly said overall, there were high standards of care but that reducing incidents is a core task for the Department of Health, Social Services and Public Safety and HSC Trusts.
"Two factors are crucial to this," he said. "The establishment of a culture in which incidents can be reported easily, honestly and without fear of blame and the ability to ensure that lessons learned from these incidents are successfully taken on board by HSC staff.
"Whilst reporting of adverse incidents has improved at the local level, the Department accepts that under-reporting of incidents continues.
"At the regional level a reporting and learning system exists for serious adverse incidents but a regional system to ensure the effective evaluation of numbers, types and causes of all adverse incidents has still to be introduced."
The report also recommended developing a resolution process to offer patients an alternative to legal action, as auditors found that in some smaller cases legal costs exceeded the amount of damages ultimately paid out.