Ms Harney has a difficulty in meeting doctors' demands, writes Eithne Donnellan.
It's a bit like Groundhog Day. It's early February and hospital consultants are threatening to take industrial action.
The action, if it goes ahead, could result in thousands of patients having appointments cancelled every week.
Consultants this time last year made similar threats. Now again they are making plans to embark on a campaign of disruption in a bid to force a resolution to the long-running dispute over who will cover them if they are sued for alleged malpractice, arising out of incidents in the past but in respect of which claims have not yet been lodged.
Many of these doctors had been paying annual subscriptions to the British-based Medical Defence Union (MDU) which they believed would cover them if they were sued. However, since the State introduced a new way of insuring their practice on February 1st last year, the MDU has said it does not have funds to cover all consultants - particularly obstetricians - for historic, and as yet unreported, claims.
Consultants are concerned that, as individuals, they could face financial ruin if sued. They want the Department of Health, which they claim broke their contract by introducing the new insurance scheme 12 months ago without agreement, to sort the mess out.
Almost a year ago to the day members of the Irish Hospital Consultants Association (IHCA) at an extraordinary general meeting of their organisation voted for the first time in their history to take industrial action.
The IHCA represents the majority of consultants in the State and its 1,700 or so members were two weeks into a campaign of industrial action last year, during which they withdrew from co-operating with the National Treatment Purchase Fund, when the then minister for health, Mr Martin, appealed to them for time to allow him negotiate a resolution with the MDU. They postponed all but one element of their action, continuing to boycott a number of groups including the group which was due to draw up a plan for rolling out the Hanly reforms on hospital reorganisation across the State.
The main difference between now and a year ago, they say, is that a number of consultants have actually been refused assistance or cover by the MDU.
The MDU insists it is not an insurance company and while consultants who paid it subscriptions can come to it and seek "assistance" if sued, it has the discretion to decline assisting them.
Over the past year some 25 consultants - not all obstetricians - have been refused MDU assistance. They include a 79-year-old retired consultant who was a member of the MDU for 40 years and who was recently turned down when he sought the assistance of the MDU after being sued.
Mr Finbarr Fitzpatrick, secretary general of the IHCA, says there is no way consultants will step back from industrial action this time unless a cast-iron guarantee is given by the Tánaiste and Minister for Health, Ms Harney, that no consultant will be left uncovered if sued.
The consultants are also in a stronger position on this occasion as they are now also backed by the 600-plus consultant members of the Irish Medical Organisation who voted by a margin of 89 per cent in favour of industrial action on Friday.
Ms Harney has made her views about the MDU well known. She has accused them of having "behaved disgracefully" towards Irish consultants, words which prompted the MDU to withdraw from talks with her Department on Friday. Some believe they are looking for an excuse to walk away from historic liabilities in the Republic that could amount to €400 million.
Ms Harney has said she will not allow them walk away and that they will be pursued through the courts if necessary. She says she cannot expose Irish taxpayers to their historic liabilities.
Furthermore, she has reiterated that no consultant will be left uncovered if sued. Her letter giving this guarantee however is not legally binding, the IHCA and IMO claim, and this is why they are resolute that they will not postpone industrial action, due to begin in March.
There is, however, a small degree of hope. Ms Harney has said lawyers from the State Solicitor's Office will meet with solicitors for the consultants' representative bodies this week in an attempt to give them the type of guarantee they are seeking about insurance cover.
If that happens plans for industrial action will be scrapped. If it doesn't the result will be chaos, with patients whose procedures are cancelled likely to end up in already overcrowded accident and emergency departments.
Ms Harney, however, is in something of a quandary. If she gives the consultants what they want, then the MDU could be off the hook, which is precisely what she is trying to avoid.