Insurance costs for consultants ‘may force patients abroad’

Patients could in future have to go abroad for some forms of surgery as increasing medical insurance costs are threatening to force consultants out of working in certain areas of practice, the annual conference of the Irish Medical Organisation (IMO) has been told.

The conference heard that some surgical consultants were facing indemnity premiums of up to €400,000 per year.

IMO members at the conference passed a motion calling on the Government to intervene urgently in relation to the cost of medical indemnity for consultants.

Consultants Mick Molloy and Matthew Sadlier warned that if cost rises continued unchecked, it would result in patients having to travel overseas to secure treatment in a timely fashion.

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Dr Asam Ishtiaq, a surgeon in private practice at the Whitfield Clinic, told the annual meeting of the doctors’ trade union that consultants in high risk areas like spinal or neurosurgery were being given quotes of €400,000 to renew their medical indemnity cover.

He said this made no sense as a State clinical indemnity scheme would pick up cost of dealing with cases in such areas above a €500,000 threshold.

He said doctors were finding that claims taken for alleged medical negligence, which they believe should be defended, were being settled by their indemnifiers because it was less expensive than going through the court system.

He called for the setting up of a medical injury board – similar to the personal injuries board – to hear medical negligence claims and reduce costs.

Consultants backed two motions at the conference calling for the Government to intervene on the costs of medical indemnity and also for tort reform on medical negligence.

Dr Molloy, who is an emergency medicine consultant, said if more doctors were priced out of these specialities waiting lists would grow and more patients would have to go abroad for treatment.

The conference also heard on Saturday that the Irish health service needed 500 additional beds per year every year for 14 years to meet population growth.

Former IMO president and emergency medicine consultant Dr Peadar Gilligan said “capacity is the key”

“The patients of Ireland have waited long enough and doctors are impatient with the lack of resourcing of the system.”

UCC economist Dr Brian Turner warned that current capacity constraints in the health service made the implementation of the cross-party Sláintecare plan “hugely challenging”.

He said the health reforms were very important as projections suggested that if the status quo was maintained, a growing and ageing population would see demands for some services increase by up to 70 per cent.

Consultants at the conference maintained that the Government’s plans to increase the number of acute hospital beds by 2,600 over the coming years were insufficient.

Consultants urged that 7,000 additional hospital beds be provided.

Enormous strain

The conference also heard that doctor burnout is placing an enormous strain on the health service and has implications for patient care.

The director of Health and Wellbeing at the Royal College of Physicians of Ireland Prof Gaye Cunnane said the issue of physician health and wellbeing needed to be urgently addressed in the context of patient safety and of workforce retention.

“Burnout is a state of physical, emotional and mental exhaustion caused by long-term exposure to chronically stressful conditions without adequate reprieve. It is not the same as depression, but there are parallels. Burnout is a specifically work-related condition.”

“A recent study by Dr Blánaid Hayes of Beaumont Hospital showed that up to a third of Irish hospital doctors met the criteria for burnout, and up to 10 per cent met the criteria for serious depression or anxiety.

She said these figures were extremely concerning, but were poorly recognised in the health services.

She said they had implications for patient care.

“Doctors in suboptimal health will find it more difficult to look after patients, putting enormous strain on the health service.”

Prof Cunnane said: “Burnout increases in direct correlation to the time spent on non-clinical work. Humans need to feel valued, to know that their voices are being heard and to be part of a community or team. This is true for doctors.

“When health metrics emphasise quantity not quality, when pressure is added to existing workers because of severe staff shortages, when multiple job vacancies exist because the working conditions are not attractive to prospective candidates, burnout increases.”