IMO emergency meeting: A hospital consultant working in the public sector only has said it is "odd" that a new State scheme for insuring medical malpractice will bring most benefit to consultants working exclusively in the private sector.
Dr Christine O'Malley, a consultant geriatrician at Nenagh General Hospital and chair of the Irish Medical Organisation's consultant committee, said yesterday there was a danger this would encourage consultants to leave the public sector to work full-time in private practice.
Her comments appear to conflict with those of other consultants, including the masters of the three Dublin maternity hospitals, who said last weekend they feared the cost of full-time private practice for obstetricians would rise to unaffordable levels. The new State scheme, called enterprise liability, does not cover consultants in full-time private practice. The masters estimated the insurance premia for obstetricians would rise to €135,000 a year and could force private maternity hospitals to close.
Dr O'Malley's comments came at an emergency national meeting of the IMO convened yesterday to discuss the Department of Health's plans to introduce enterprise liability next weekend.
There is widespread opposition to the plan and the IMO and Irish Hospital Consultants Association (IHCA) have threatened not to co-operate with the implementation of the Government's health service reform programme if the new scheme is implemented without agreement. They have also threatened industrial action.
The IMO meeting yesterday heard that the annual insurance premia of full-time private consultants in low-risk specialities such as psychiatry will drop by up to €3,000 when enterprise liability is introduced. This is based on figures quoted by the Medical Protection Society (MPS), one of the two bodies insuring Irish consultants at present.
Dr John Hickey, chief executive of the MPS, said these consultants pay annual premia ranging from €10,894 to €78,622 at present and after enterprise liability the rates will range from €7,925 to €100,000. The higher figure is for those in obstetrics, a high-risk speciality. But he said that without enterprise liability obstetricians in full-time private practice would pay €300,000 a year for insurance.
It is being kept relatively low because the State is prepared to pick up the bill for compensation claims of over €500,000 made against obstetricians in full-time private practice after enterprise liability is introduced.
Dr O'Malley said: "People who are totally outside of the public health system are the ones that will benefit the most, based on the rates that have been quoted to us by the MPS."
The major concern of the consultant bodies, however, is that the State scheme will not cover the historic liabilities of consultants. They are concerned because the other body insuring Irish consultants, the Medical Defence Union (MDU), has said it may not be able to cover all historic liabilities of obstetricians.
The Department of Health has said it will fund any obstetrician who takes a case against the MDU to force it to cover past liabilities. However, an MDU spokeswoman said yesterday it had advice from the Attorney General, Mr Rory Brady, that it had a right to use discretion when deciding whether to cover certain claims. The advice was tendered to it by Mr Brady before he was appointed AG, she said.
The MDU also told the meeting it could not give "a cast iron guarantee" to other specialities that it will cover all of them for past liabilities either.
The Department of Health insists it cannot ask taxpayers to pay up to €800 million for historic liabilities, which it says should be met by the MDU. The new scheme will cut costs, it says.