Clinical Indemnity Scheme.

Dáil Éireann Debate, Thursday - 27 May 2004

Thursday, 27 May 2004

Questions (147, 148, 149)

John Perry

Question:

144 Mr. Perry asked the Minister for Health and Children if, with regard to historic liabilities, the State has agreed to indemnify any Irish consultant who is refused indemnity by a medical defence organisation and who faces an award of damages and costs relating to a claim for medical negligence; the details of such indemnity provided to consultants; if it applies to any award or judgment secured against a consultant; and the cost to the Exchequer for each of the next five years. [15998/04]

Written answers

Minister for Health and Children (Mr. Martin)

The Government has not agreed that the State should indemnify any hospital consultant who is left without an indemnity by any of the medical defence organisations. The Medical Defence Union is the only defence body threatening to leave some of its Irish members without an indemnity. The Government has made it clear to the MDU that it expects the union to honour its obligations to its members who have paid many millions of euro over the decades to purchase indemnity cover. The Government has given a commitment to provide financial support to enable an individual consultant or a group of consultants, in an appropriate case or cases, to challenge a refusal by the MDU to provide an indemnity to a consultant.

John Perry

Question:

145 Mr. Perry asked the Minister for Health and Children the steps he is taking to ensure that the discretionary cover afforded by the Medical Protection Society to Irish doctors in respect of medical negligence claims is capable of being relied upon by Irish doctors, in view of the recent threat by the Medical Defence Union to exercise discretion against indemnifying some consultants; and the nature of the guarantees he has secured or sought in respect of such arrangements. [15999/04]

Minister for Health and Children (Mr. Martin)

The society has repeatedly asserted that it has sufficient assets to meet the estimated cost of all of the liabilities likely to be borne by its members, including its members in Ireland. Unlike the MDU, it does not claim that it will be unable to respond positively to requests for assistance from its members. Early this year, in evidence given to the Oireachtas Joint Committee on Health and Children, the society's CEO stated that it was fully funded to meet the cost of its reported and incurred but not reported liabilities.

The society has just published its annual report and accounts for 2003. They suggest that it is capable of meeting its obligations to its Irish and other members.

John Perry

Question:

146 Mr. Perry asked the Minister for Health and Children if his attention was drawn to the media reports indicating that consultants engaged in private practice and paying subscriptions to the MPS are in receipt of a State subsidy for such private work; the nature of such subsidy and the cost of the subsidy to the Exchequer for each of the next five years; the nature of liabilities that the State is assuming as a result of these arrangements. [16000/04]

Minister for Health and Children (Mr. Martin)

Last February, when personal injury claims against consultants were brought within the scope of the clinical indemnity scheme, concern was expressed that the cost of professional indemnity cover for consultants in private practice might become prohibitive. Due to the important role that the independent hospital sector plays in the provision of health care here the Government wanted to ensure that the cost of indemnity cover should remain affordable.

Particular concern was expressed that indemnity cover for consultant obstetricians in private practice might not be available at any price. The Government decided that a limit should be placed on the amount of cover the consultants were required to purchase. The limit was set at €500,000 for each and every claim taken against an individual consultant. In addition, an annual aggregate limit of €1.5 million per individual consultant was placed on the cover to be purchased. The State accepts responsibility for the cost of claims that exceed these limits. These arrangements are not a subsidy to any specific defence body. They have been put in place for the benefit of the consultants concerned, irrespective of which defence body they wish to join. Alternatively, there are no barriers to a commercial insurer taking advantage of them to offer an appropriate insurance policy to the doctors for whose benefit they have been put in place.

As far as my Department is aware the MPS is the only defence body or insurer that has offered indemnity cover to this group of doctors based on the existence of these arrangements. The annual subscription being charged to each doctor is €100,000. The MPS has indicated that the economic rate that it should charge is €350,000. At present, approximately ten doctors benefit from these arrangements and the notional subsidy to the group of practitioners is €2 million per annum. It is more difficult to estimate the likely future cost of this support as it depends on the number and value of future personal injury claims against them. The number of claims against them is unpredictable and likely to be random because of the small number of doctors involved.

In the case of other specialities a limit of €1 million in each and every case was placed on the professional indemnity cover that consultants in private practice need to purchase. The ultimate annual cost of providing the level of support to these specialities was estimated at €5 million per annum.

I am satisfied that these arrangements are a sensible and pragmatic response to a potentially serious problem that could have arisen if these doctors had been forced out of active practice by prohibitive indemnity costs.