An agreement between the Department of Health and a British insurance company that claims it has not the resources to cover claims which may be taken against Irish consultant obstetricians for past malpractice is now unlikely to be reached this year, it emerged yesterday.
The company, the Medical Defence Union (MDU), accepted insurance premiums from the consultants over the years but says it did not charge enough to cover the cost of claims. It wants the Department of Health to bail it out. This would cost millions.
It also claims the introduction by the Department of a insurance scheme for consultants in February under which they are all now insured by the State Claims Agency has contributed to its problems as it, as a result, is no longer receiving premiums from Irish consultants to cover claims for past events.
Worries that consultants could be left personally liable for claims as a result prompted members of the Irish Hospital Consultants Association (IHCA) to vote for industrial action for the first time in their history earlier this year. Most elements of the industrial action were deferred, however, when negotiations to seek agreement were opened between the Department of Health and the MDU. In a statement yesterday, the MDU blamed the Department of Health for the delay in reaching an agreement. "One of the reasons that progress is so slow is that the number of requirements and preconditions sought by the Department of Health grow at every meeting. This is making it harder to reach agreement," the MDU's chief executive Dr Michael Saunders said.
"Given the Department of Health's slow pace so far, December now looks decidedly optimistic" as a deadline by which agreement could be reached, he added.
However, both the Department of Health and the IHCA, which represents the majority of consultants in the State, hit back.
A Department spokeswoman said the main stumbling block was the MDU's resistance to having all its books examined by an independent team on behalf of the Department to see what resources it had to meet claims.
Mr Finbarr Fitzpatrick, secretary general of the IHCA, accused the UK-based insurer of deliberately stalling the negotiations. He said the MDU was the major cause of delays in an agreement being reached. "It's a bit rich of them then to be issuing this statement," he said.
"The MDU have created obstacles in relation to the due diligence process which the Department insists must be conducted on the MDU's own books. This is to ensure the MDU can meet all other claims outside of obstetrics. The IHCA has never expected the Minister for Health to write a blank cheque for the MDU. It is his duty to act in the interests of both taxpayers and patients," he said.
"The delaying tactics on the part of the MDU have to cease. In recent weeks, we have become aware of two consultants in the private sector who each paid over €400,000 to the MDU over the past 25 years, but are now facing the real possibility of not being defended in any future actions against them. It is unacceptable that the MDU says people like that could be left uncovered."
The MDU's 2003 annual report, just published, shows its income for the year was €136 million. It paid out €68 million in claims, with €22 million of this being paid out in respect of claims against Irish members. This, it said, was an almost three-fold increase on 2002.