The Minister for Health, Mr Martin, last night told the hospital consultants that he wished to introduce a new system of medical malpractice insurance from July 1st.
The Irish Times understands that following a lengthy meeting with the Irish Hospital Consultants Association (IHCA), both sides agreed to continue discussions this evening.
The change, from a system of individual insurance for consultants to one in which the State insures hospitals and doctors as a single entity, will not directly affect patient care. Although the Department of Health has signalled its intention to change the insurance arrangements for some time, doctors representative groups are unhappy that the new scheme will take effect with less than a week's notice. It was unclear last night whether an enforced implementation would be interpreted as a breach of the consultants' common contract with the potential for industrial action by the Irish Medical Organisation. The Irish Hospitals Consultant Association has a no strike clause as one of its founding principles.
At present, hospital consultants are insured against claims by patients by the UK-based insurance bodies, the Medical Defence Union (MDU) and the Medical Protection Society (MPS). The Government reimburses 90 per cent of the cost of premiums to all consultants employed in the public health service.
Last February, amid allegations from the Irish Hospital Consultants Association (IHCA) of "a breach of faith and a breach of contract" by the Minister for Health, the Government signed a statutory order giving effect to the new medical insurance arrangements. However, Mr Martin subsequently gave a commitment to consultants that the State would continue to reimburse consultants' individual premiums to the medical defence organisations, while working towards a new system of enterprise liability.
Under enterprise liability, both consultants and hospitals are indemnified by the State as a single entity. However, doctors are concerned that the new system does not cover private practice and that it deprives them of clinical independence. The President of the IHCA, Dr Colm Quigley, has described enterprise liability as a system that "leaves consultants in a position where they will be unable to defend themselves and their medical decisions".
However, in an e-mail to members yesterday, the IHCA Secretary General, Mr Finbarr Fitzpatrick, states that "as a result of a \ meeting [between the IHCA and the MDU/MPS] it now seems that we will not be successful in our efforts in devising an alternative to Enterprise Liability".
The Irish Times understands that there has been intensive discussions between the Medical Defence Union and the Department of Health within the last month in an effort to finalise a financial package to cover future claims against consultant obstetricians prior to the formal introduction of enterprise liability.
Obstetrics is the speciality causing most concern because of the high number of claims and the large amounts awarded in cases where a baby suffers permanent damage during child birth. It has been estimated that there could be 10-12 legal cases every year in the Republic involving babies born with brain damage, with a potential settlement of up to €5 million in each case.