Make no mistake about it - the issue here is negligence. It concerns the damage, often catastrophic, inflicted on patients by the mistakes of doctors whose practice is considered substandard.
It is in support of their colleagues being sued for negligence that hospital consultants have threatened to go on strike next month, regardless of the potentially disastrous effect on thousands of patients.
The consultants' naked self-interest is in sharp contrast to the concerns of their fellow healthcare professionals. Nurses, for example, are also threatening industrial action, but their focus is the danger associated with overcrowding in A&E, something which is clearly in the interest of patients.
About 12 years ago, I tried to find out some basic statistics on medical negligence in this country. I wanted to know how many cases were taken each year, how many were won by patients, how many were settled out of court, and how much money was paid out in respect of the negligence of doctors. The Department of Health could not tell me. It did not know.
While it paid up to 90 per cent of the premiums for consultants, it had no control over any aspect of their insurance, or access to information on cases. In other words, the body running the country's health services had no idea how negligent the leading providers of this healthcare were. It transpired that the only people who had this knowledge were two British-based insurance companies. The largest of these was the Medical Defence Union, and it was sharing its knowledge with no one.
Over the years, the MDU developed a clever line of patter: Irish society had become compo-crazy, with cases against doctors spiralling out of control and courts paying huge damages. The MDU continued to withhold the facts, and it neglected to mention that it has always been extraordinarily difficult even to take a case against a doctor, let alone prove negligence. But on the basis of the compo-culture myth, it continuously raised its premium rates, which the taxpayer funded.
The Department of Health had been unhappy with this situation from the early 1990s. It accepted that the lack of accountability in the matter of consultants' insurance was a major problem. Finally, after extensive negotiation, it introduced its own scheme last February, meaning that from that date, all public healthcare workers would be indemnified directly by the State.
The consultants immediately revolted, claiming that this change was a breach of their contract. They referred the matter to the Labour Court, which unceremoniously threw them out last October, saying that the State indemnity scheme was manifestly in the public interest.
Despite this, the consultants continued to attack the Government for breaching their contract. Meanwhile, the MDU is refusing to provide indemnity cover for those cases which pre-date the introduction of the State scheme. Both the Government and the consultants involved in these cases had believed that the insurance premiums they (or rather the taxpayer) had paid through the years had bought indemnity cover in the event of a malpractice suit. The Minister for Health, Mary Harney, has described the MDU as a disgrace for walking away from its responsibilities for these cases.
In the High Court last week, Mr Justice Johnson went even further. Condemning the MDU for pulling the plug on one particular consultant, he said that its behaviour was "appalling, absolutely, utterly unjustifiable", and that its general attitude was "unprecedented".
The MDU is trying to force the Government (i.e. you and me) to cover the bulk of the cost of these so-called historic cases of alleged negligence, many of which concern injuries to babies at birth. Mary Harney is so far refusing to expose the taxpayer in this way.
In an attempt to secure the support of consultants, she has promised that none of them will be 'hung out to dry' in respect of any of these cases. It is difficult to see what more she can do for them, short of caving in to the MDU and agreeing that the Government carry the full cost. But still the consultants continue with their strike threat. They do not appear to care who pays for these negligence actions, so long as it is not the consultants concerned.
It is important to remember that the vast majority of Irish consultants are not negligent. They do their best for patients in a responsible manner, but have to function within a system widely acknowledged to be dysfunctional.
However, as a body, it is these same consultants who have severely disrupted attempts at reform, cynically using the issue of their negligence insurance as an excuse to refuse to negotiate on any other matter.
It is no longer acceptable that such a group be allowed hold the country to ransom in this way. On this issue, it is the Minister for Health who is acting overwhelmingly in the public interest, and it is the consultants who are thwarting both her and the Irish people. She fully deserves the necessary public support to face down the consultants' bullying threats to victimise patients in pursuit of their own selfish interests.