Dáil Éireann debate -
Tuesday, 2 Mar 1999

Vol. 501 No. 3

Written Answers. - Hospital Doctors.

Pat Rabbitte

Question:

84 Mr. Rabbitte asked the Minister for Health and Children the action being taken by him to close loopholes in current indemnity provisions for non-consultant hospital doctors which can leave them with no indemnity cover when they become involved in legal actions following adverse incidents; and the timeframe envisaged for the completion of such action. [5950/99]

Minister for Health and Children (Mr. Cowen)

All medical and dental practitioners employed in the health service are obliged, as a condition of their employment, to indemnify themselves against claims for negligence. Indemnity normally gives the individual unlimited cover for claims made against them arising out of their work for public hospitals, from their private practice or from good Samaritan acts. Indemnity is normally taken out through membership of one of the two medical defence organisations which operate in Ireland.

Since 1992, non-consultant hospital doctors, public health doctors, dentists employed by health boards and some other small groups of salaried doctors have been covered by a group medical indemnity scheme. The scheme was originally conceived as a measure to deal with industrial relations unrest among NCHDs who were dissatisfied with the then existing reimbursement scheme. On the basis that these groups are salaried doctors and dentists with little or no private practice it was decided to remove from them the obligation to hold individual indemnity cover and to devise a group scheme to purchase cover for them.

The medical indemnity scheme was never intended to replicate the indemnity cover being provided by the medical defence organisations. Rather, it provides indemnity for the financial consequnces of negligence arising from work undertaken as part of the doctor/dentists' activities in a post approved by the Department of Health and Children in the public health service.

In the years since 1992 the scheme has been amended to deal with problems arising during that period. Originally it did not provide representation at coroner's inquests. This has now been included. It was further amended in 1997 to remove ambiguities relating to cover for needlestick injuries caused to persons other than patients. The medical indemnity scheme does not provide cover for representation before the Fitness to Practice Committee of the Medical Council. It may, in certain circumstances, provide representation in other disciplinary proceedings. The Department is strongly of the view that an employer would not be put in the position of paying for services such as this. It would not be in the interests of hospitals or doctors that they should do so as, in certain circumstances, the hospital may be the body initiating a complaint against a doctor. It is in the doctor's own interest that he or she has a source of independent professional advice and representation. NCHDs should also be aware that they expose themselves to risk when they diagnose, treat or prescribe for a relative or friend. They need to provide themselves with appropriate cover for this area of practice.

In 1992 both the Department and the Irish Medical Organisation emphasised the importance of NCHDs and others covered by the scheme taking out supplementary cover for those aspects of their professional lives not covered by the scheme. This is available from the Medical Defence Union, Medical Protection Society and St. Paul.

I therefore, do not accept that there are loopholes in the scheme given its express purpose. In any event the operation of the scheme is kept under regular review.