IT IS likely in the future that a patient will sue a health authority or hospital for failure to provide treatment for financial reasons, a seminar for hospital consultants has been told.
Mr Roderick Bourke, a solicitor, was speaking at a seminar on clinical independence on Saturday organised by the Irish Hospital Consultants' Association and the Pharmaceutical Healthcare Association.
"It is foreseeable that some patients and their families will sue hospitals, health boards, insurers and possibly consultants to obtain treatment where the hospital or insurer says that the treatment is not available for economic reasons," he said. Restrictions on treatment for economic reasons amounted to interference in the clinical independence of doctors.
He pointed out that in recent years there had been a number of cases in the High Court where litigants had successfully forced public bodies to provide money for a particular service.
"Health boards have a statutory obligation under the 1970 Health Act to provide in patient services and out patient services for eligible persons. The extent of the services is not spelt out in the legislation. It must be likely that an eligible person is going to sue a health authority or hospital for failure to provide services.".
He said that a particularly strong case would be where a person's life was at risk, and it was argued that his or her constitutional right to life was being impaired by the State's failure to make provision for adequate health treatment.
However, he stressed that it was important that consultants as employees of the hospital or health boards did not actively induce or canvass patients to sue in order to obtain increased resources for their treatment.
The consultant was an advocate for his patient, but he was also an employee of the hospital or health authority. However, he should not allow his rights as an advocate for his patient to be overridden by circulars or instructions from the hospital or health board (for example, on confidentiality) to which he had not agreed, or which were not a part of his contract.
Dr James Masterson, president of the IHCA, said health cuts tended to come back to haunt the wider community and the health services themselves "as diseases thought to have been banished forever begin to reappear in the community; as ailments and disabilities which might have responded favourably to treatment if tackled earlier prove more intractable and vastly more expensive to treat; and as waiting lists get longer and complications set in".
"The health care system in this country is not to be made the territory for glib reasoning, usually comfortably ignorant of the practical realities, by well meaning economists and other numbercrunchers.
One example of this, which interfered with the clinical independence of practitioners, was the introduction of "indicative drug budgeting" which did not just raise ethical questions, but was riddled with false economies.
He drew delegates' attention to a parliamentary question in the Dail last week on the national cost of depression. "The point of the question was that drug cutbacks on anti depressant drugs, from which doctors can earn bonuses, may prove disproportionately costly in other areas such as increases in hospitalisation, work absenteeism and greater demand for sickness benefits."