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Dáil Éireann debate -
Tuesday, 8 Apr 2003

Vol. 564 No. 5

Public Liability Insurance.

The proposed withdrawal of public liability insurance cover by health boards from funeral directors and embalmers amounts to an off-loading of insurance costs from the health boards to those professions. Health boards are, in effect, acting as insurance agents for the insurance companies. They have, traditionally, borne this cover in their overall public liability insurance. It appears that public bodies have to work with the level of cover previously provided, while the cost of insurance continues to rise and the level of cover is reduced. Health boards now regard funeral directors and embalmers as outside contractors. The concept of contractual arrangements with the health boards is being pushed too far. Embalmers will, apparently, have to bear the brunt of those costs. I am not aware of any insurance company in Ireland providing this type of cover to the embalming profession. Funeral directors and embalmers are now to be considered as outside contractors, on the same basis as building contractors, plumbers, electricians or carpenters.

I understand the necessity for public liability for such people, as there are risks involved in the type of work they carry out. Can anybody tell me the level of risk involved in removing a dead person from a mortuary to the point that one needs cover ranging from €6.4 million to €12.7 million? We are starting to lose the run of ourselves.

One reasonable expectation would be for the health board to insist on its insurers accepting this level of liability under a hospital's insurance policy. Health boards are effectively complicit in helping insurance companies extend their tentacles into new areas. What other Departments will follow suit? Will we see the Department of Education and Science insisting on national school pupils bringing public liability indemnity documents to school with them? We are seeing the development of a sinister practice.

Having to shoulder the burden of increased insurance costs, funeral directors and embalmers will inevitably have to pass it on to bereaved families. By offloading these costs, health boards will be targeting these families at a most vulnerable time. People are traditionally reluctant to query funeral expenses. While I could understand the development of this new practice if undertakers had made many claims against hospitals or health boards, I have seen no evidence of this. It seems a florist who delivers a wreath to a mortuary will have to pass on a public liability insurance document stating he or she is covered to do this kind of work. It is a dangerous practice. Will visitors have to do the same kind of thing?

This is a national issue that is about to surface. Health boards and hospitals will soon be demanding that people have policies offering cover ranging from €6.4 million to €12.7 million. We should insist that this practice stops now. The insurance industry is destroying our small business sector and is now starting to gets its tentacles into health services. It is a dangerous practice and could be the thin end of the wedge.

I welcome the opportunity to address the House on this issue. I will outline for the Deputy the current arrangements regarding public liability cover in health boards and the Eastern Regional Health Authority. It is my understanding that public liability insurance cover is currently obtained through Irish Public Bodies Mutual. Given the importance of risk assessment, and recognising best practice in managing such risk, the health boards were advised that when placing contracts for services, including service contracts for such services as cleaning, maintenance, etc., they should be conscious of the need to require such operators to maintain independent public liability cover up to a minimum financial level.

The necessity to require contractors to have the necessary personal cover is considered by health board insurers as representing the insurers best professional advice and seeks to transfer the risk to the appropriate party. In this way health board premiums properly reflect the cost of appropriate cover and this is important, not alone from the perspective of possible litigation, but also in the context of value for money and good practice. My understanding is that the present public liability cover does not provide for indemnifying independent contractors, nor has this ever been the case. Therefore, the question of withdrawal of cover is not an issue for such contractors, including contractors mentioned in the Deputy's statement and the question of offloading premium costs from health boards to providers does not arise.

I am sure the Deputy is aware that the cost of public health liability cover to the boards has increased significantly in the last two to three years. In terms of the overall compensation for non-pay inflation included in the overall health Estimates, health boards were required to seek substantial efficiencies within their non-pay budgets to allow them meet these increasing premium costs. It is estimated that public liability premiums recorded increases of up to 40% year-on-year between 2000 and 2002. It is clear that health boards need to ensure that public liability cover reflects their needs but cannot include excesses in cover which otherwise would be appropriate to independent contractors. In this manner boards are not in any way placing an improper burden on such contractors, rather, they are merely applying what is standard practice to the process of placing contracts for services.

It is incumbent on health boards to follow best procurement practice when seeking to place contracts for goods and services. When professionally advised by their insurers that they should seek evidence of independent cover from contractors, I think the Deputy will agree it is reasonable to act on such advice. I have no doubt that in acting in this way boards would bring a level of practicality to bear on the process of procuring services, given the mix of requirements and the value of contracts. In following the professional advice given and best practice in the procurement process, health boards are not in any way withdrawing public liability cover, as this was never provided for within health boards public liability arrangements.

The Dáil adjourned at 8.55 p.m. until 10.30 a.m. on Wednesday, 9 April 2003.

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