The decision by hospital consultants to defer their strike action must be welcome news for patients.
Already this week consultants in the Irish Hospital Consultants' Association were refusing to treat public patients who had waited for very long periods and whose care was to be funded by the National Treatment Purchase Fund. IHCA members had further threatened to withdraw from all non-emergency treatment from next week.
While it is welcome that the IHCA has chosen to draw back from the brink, it must be asked whether the association had sufficient justification for subjecting patients to such uncertainty. Given that the Irish Medical Organisation, which also represents consultants, was seeking a resolution to the consultants' dispute with the Minister for Health through the machinery of social partnership, the IHCA's action seems precipitate. If it is prepared to abandon its ban on strike action - one of its founding precepts - and adopt the weapons of trade unionism, it must realise that such weapons should not be used lightly.
IHCA members seem to have been carried away by their fear of undefended exposure to historic liabilities, following the intimation by their traditional insurer, the Medical Defence Union, that it might not indemnify Irish obstetricians. In this complex three-sided dispute, the Minister for Health has argued that the consultants' action was undermining his ability to negotiate with the UK-based MDU to ensure that Irish doctors should remain covered for past liabilities without exposing the Exchequer to the MDU's unquantified deficit. Although consultants and the Department of Health may each suspect the other of sabre-rattling in advance of negotiations on the consultants' contract, in reality both parties have become embroiled in a crisis caused by the inability of medical defence bodies internationally to meet the rising cost of claims.
No party to the dispute argues against the introduction of a new state system of enterprise liability insurance, which will end the spectacle of teams of lawyers representing medical colleagues and their employer in a single case for compensation. The Minister's new system offers some hope of turning the rising tide of litigiousness and legal costs which is the root cause of this crisis. While the IHCA would have liked the Minister to settle the issue of historic liability before introducing his scheme, for the Minister to have continued to reimburse doctors for premiums paid to the MDU, when that body was threatening to walk away from its historic liabilities, would have been a questionable use of Exchequer funds.
The Minister should have the support of both medical organisations in his efforts to reach a deal with the MDU. It may be that as in Australia an element of the solution will be a levy on doctors to meet unfunded liabilities. Whatever formula is eventually agreed, however, there is no justification for consultants continuing to threaten to deny patients treatment. The IHCA should not merely defer, but rescind, its strike threat.