Sir, - As a result of the rise in medical litigation, the Medical Defence Union has had to increase subscription rates for professional indemnity substantially to £68,665 per obstetrician. We were sorry to see the knock-on effect this has had within the profession when The Irish Times reported (July 8th) that Dr Leonard Condren, medical editor of Forum, has advised GPs to avoid home births. Happily, at present we would advise our GP members to continue to practise in their usual way as the position with home births is not quite the same as it is for hospital births. In the absence of change, only time will tell.
Quite clearly, in the interest of doctors and their patients, something has to be done to contain the dramatic increases in litigation. It is our belief that one of the key areas to address is the legal system itself. There are measures of tort reform which could help to alleviate the problems in the long and short term and we are actively pursuing these in conjunction with a number of organisations.
We are also committed to using our vast claims experience and the database we have been operating since 1985 to help doctors avoid risks to their patients in the future. We have invested heavily in risk management and contributed recently to a study entitled "Providing good standards of care in obstetrics and gynaecology", published by the Institute of Obstetricians and Gynaecologists, which was sent to alert obstetricians to the major risk areas.
Our message is not quite so gloomy. Change is necessary to deal with the dramatic increase in size and frequency of litigation, but we are doing our best to help all our members in Ireland ensure that the availability, quality and type of care they give to patients is governed by patients' needs rather than the fear of litigation. - Yours, etc.,
Dr Michael Saunders, Chief Executive, The Medical Defence Union Limited, Devonshire Place, London W1.