Figures obtained by the Mercury under freedom of information legislation reveal that the district finalised 103 claims from October 1, 2016 to October 1, 2018; with an average payout of about $230,000.

More than half of the total amount paid was for claims for obstetric or neonatal issues; with 25 claims in that area of practice and just over $12.9 million paid out.

The health district would not provide information for individual hospitals, yet Wollongong and Shoalhaven are the only hospitals in the region with maternity units.

The figures - provided to the Mercury under the Government Information (Public Access) Act - also showed than more than $3 million was paid out to 16 patients for treatment failure.

There were also 16 claims for diagnosis errors, costing the district - and ultimately the taxpayer - just over $2.5 million.

Meantime $1.8 million was paid out for mistakes in procedural or surgical issues; and $1.9 million for non-procedural, non-surgical issues.

The district also paid out more than $1.1 million for other, unspecified claims, from Treasury-managed funds in the two-year period.

NSW public hospitals are covered for all legal liabilities by the NSW Government's self insurance scheme, icare or Insurance for NSW.

According to icare, claims finalised by the ISLHD from October 1, 2016 to October 1, 2018, do not indicate the number or seriousness of incidents which occurred in that period.

They indicate the claims and payments which were finalised in that time - by agreed settlement or court verdict - and so may relate to incidents which occurred in previous years.

Wollongong-based law firm, Foye Legal, specialises in personal injury law, including medical negligence.

CEO and lawyer Diana Foye said for the vast majority of people, claims were not just about money.

"People make claims because they want the doctor or hospital to be held accountable; they want a change in policy and procedure and because they don't want it to happen to anyone else," she said.

"For many it's also an opportunity to be heard, to have their case investigated ... as patients are rarely believed."

Money of course was a factor, especially for those who'd lost their ability to work or who were burdened with huge medical costs - some for the rest of their lives.

This was one of the reasons medical negligence was an extremely complex area - and could take several years to resolve.

"The typical medical negligence claim for an adult takes on average around 18 months to two years," Ms Foye said. "Yet for some it can take many years.

"For instance - and this is why you see huge claims paid in the area of obstetrics and neonatal - it can take many years to see how the medical negligence will manifest, how it will affect a person in the years to come.

"With claims for children, parents cannot just decide to settle, the court's got to approve that settlement and be satisfied that the child is stabilised and that it's known what their future is going to hold."

Ms Foye takes on cases from patients affected by medical negligence at hospitals across NSW. She said the number of - and seriousness of - claims for birthing issues, affecting both mother and child, were high statewide.

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But there were many other areas of medical negligence, including surgical, diagnosis and treatment errors.

"You see cases where doctors have operated on the wrong parts of the body - for instance the wrong levels of the spine," she said.

"You see delays in diagnosis and treatment because people are turned away without the proper investigations.

"And there's incorrect administering of medication - people given the wrong dose or the wrong medication altogether."

Ms Foye said while health professionals for the most part did an exceptional job, she believed systemic issues in the state's health system had a part to play.

"Although hospitals have mandated staff ratios in many departments, they're still short staffed," she said.

"You've got nurses and doctors working under immense pressure and working ridiculous hours.

"It's only human that mistakes are going to arise and manifest themselves through to patients in some form of negligence.

"If some of these systemic issues were able to be fixed, many of these mistakes could be avoided."

Ms Foye said as well as making a claim, those "aggrieved and upset" by medical mishaps could take their concerns to the NSW Health Care Complaints Commission (HCCC).

ISLHD Chief Executive Margot Mains said many of the claims outlined were historical, dating back many years.

"The safety of patients in the care of the local health district is our highest priority, and we sincerely regret any circumstance where standards have not been met," she said.

"Our hospitals treat more than 250,000 patients each year, and while one medical incident is one too many, they are a relatively rare occurrence."

Ms Mains said the district was continuing to improve patient safety in all its health facilities.

"We are developing programs, training and other initiatives that meet safety recommendations," she said.

"We have achieved improvements in medication safety, anaesthetic safety and enhanced treatment pathways for certain medical conditions."

The district was also implementing improvements to birthing safety through programs overseen by a specialist group, including local consumers.

The group had reviewed and recommended changes at all levels of midwifery and medical services over the past two years.

Meantime Ms Mains said the health district must adhere to strict NSW Health policies around the timely and appropriate management of any incident.

That included a thorough internal investigation, open discussions with families and referral to external organisations including the NSW Clinical Excellence Commission, which reviewed all clinical incidents.

"These investigations deliver recommendations for improvements, and lessons are shared with clinical teams to reduce safety risks in the future," she said.