John Browne
Question:4 Mr. Browne (Carlow-Kilkenny) asked the Minister for Health his views on the concept of a State indemnity scheme in respect of medical liability.
Ceisteanna — Questions. Oral Answers. - Medical Idemnity Scheme.
Richard Bruton
Question:14 Mr. R. Bruton asked the Minister for Health whether the inter-Departmental Committee on Medical Negligence has reported to him; if so, when he intends to publish the findings of the Committee, so that there can be an informed public debate about the cost of medical negligence insurance in both public and private practice.
I propose to take Questions Nos. 4 and 14 together. I have reported in this House on a number of occasions that the inter-departmental working group on medical indemnity has completed the first phase of its remit and has submitted its interim report to me.
A revised medical indemnity scheme has been introduced for non-consultant hospital doctors, dentists and community doctors, as a consequence of the first phase of the group's work.
The group is now proceeding with the second phase of its remit and will be examining other aspects of medical indemnity including the feasibility of a State indemnity scheme. I will await the presentation of the group's final report before deciding on any particular course of action and on whether the group's reports should be published.
(Carlow-Kilkenny): In view of the increase in the number of claims for medical negligence and the fact that a consultant who paid £120 for insurance cover in 1981 is now paying £21,000 for the same cover, does the Minister not think it is time to set up a medical review panel which would go through some of these claims in advance and weed out any frivolous ones? Would this not help to save costs?
The Deputy's suggestion is one of a number of suggestions being considered by the review group at present. One entire category of medical personnel — the non-consultant hospital doctors, the community care doctors and the dental staff employed in public health services — are covered under the existing scheme. The cost to the Exchequer of running this scheme is very significant. The Deputy referred to the high insurance costs paid by consultants. Between 80-90 per cent of this amount is recouped from the public purse. The total cost of medical indemnity to the Department of Health is approximately £16 million. I am anxious to do something about this. A number of options for dealing with this problem present themselves, including the one to which the Deputy referred. During the debate on the Estimates and in reply to questions I have outlined the other range of options being studied.
(Carlow-Kilkenny): Would the Minister not agree that the cost to the State of this scheme, £16 million, would provide many medical services which is all the more reason consideration should be given to ways of cutting down costs?
A working group is considering all the options. There are no easy options. Other countries have tried different schemes, some of which have cost more than the original schemes. I do not want to go from the frying pan into the fire. Some of the options being looked at are a State indemnity scheme, a select no-fault compensation scheme, an expert panel or tribunal, a change in social welfare codes to balance benefits to victims and a combination of all these options.
A range of options is being studied and I hope to have the report sent back to me at an early date for decision.