Hospital consultants gave the Minister for Health, Ms Harney, six weeks to resolve the impasse over malpractice insurance, after she addressed their annual conference on Saturday. Dr Muiris Houston, Medical Correspondent reports from Kilkenny
In a closed session of the Irish Hospital Consultants' Association conference in Kilkenny, doctors decided to ask the Minister to confirm in writing her earlier statement to them that on insurance claims "no patient and no family will be left without compensation and no consultant will be left exposed either".
However, they warned that if this was not forthcoming, or if a consultant who had been refused assistance by the Medical Defence Union is brought to court by a patient, the association will extend its campaign of industrial action.
Since last February, when the Government unilaterally introduced a State-run system of insurance without clarifying who would be responsible for past liabilities, the association has refused to participate in negotiations on a new consultants' contract. Members of the association have also refused to meet the Medical Manpower Task Force or to participate in the implementation of the Hanly report at pilot sites in the Mid West and East Coast Area health boards. Consultants have indicated that future industrial action could amount to the provision of emergency services only.
Ms Harney, who was greeted warmly by doctors when she addressed the conference, said she genuinely wanted to work with consultants to achieve a world-class health service. "For many years the ministry of health was regarded as a Cinderella ministry . . . but I really wanted the job and I hope in time, not too far from now, that the ministry of health is one that people will really seek out."
In a reference to former health minister Mr Cowen's description of the Department of Health as Angola, she said: "Before there were landmines in Angola there were diamonds." It was only when people fell out over the diamonds that the landmines were laid. This was a time of great potential for the health service.
"I don't like to view things in the context of problems, I prefer to see things in terms of solutions," Ms Harney said about her relationship with consultants.
However, she did not back down from her insistence last week that the malpractice insurance problem must be dealt with in tandem with discussions on a new consultants' contract.
Nevertheless, she signalled that she wanted both issues dealt with quickly.
"It is urgent we fast-track the reforms and we want to deal with everything very quickly. I think we can do this if there is a spirit of co-operation and goodwill."
Earlier the president of the association, Dr Josh Keaveney, said that while consultants were keen to work with the State in reforming the health service, they could only do so on the basis of trust.
Emphasising that the introduction earlier this year of State liability for medical malpractice was a breach of trust, he asked the Minister for Health to re-establish that trust. "That is why we cannot, and I repeat, cannot, under any circumstances enter into any discussions or negotiations regarding contracts, reforms and Hanly until the issue of historic liabilities has been resolved."
Prof Michael O'Keefe, the association's chief negotiator on the insurance issue, told the conference he condemned the Medical Defence Union and the Department of Health in equal measure. "They have treated their members shabbily," he said in reference to the defence union's recent decision not to provide legal assistance to 11 consultants in the Republic.
Speaking from the floor, Mr Chris Pidgeon, consultant neurosurgeon at Beaumont Hospital, called for the association to "make it clear there will be a national consultants' strike the day a consultant has to go into court undefended".
Following a closed session to discuss the issue, Prof O'Keefe said a significant minority of members had sought more action immediately.
He confirmed there was considerable anger among consultants, and there had been a lengthy discussion on exercising what he termed "the nuclear option" of a national strike.