Madam, - The Minister for Health insists that her Department is an innocent bystander in a dispute between consultants and the Medical Defence Union. The facts are somewhat different. Malpractice insurance in Ireland was traditionally provided by non-profit-making defence societies. The costs had risen steeply in recent years. The Department of Health believed that it could arrange the insurance more efficiently. (Yes, the same Department that gave us our efficient hospital service.)
It is not surprising that the MDU is now trying to avoid carrying the can for these old cases as the change has deprived them of the income that they use to pay settlements. While paying old cases out of current income might be considered commercially questionable, it is exactly the method that the Government will use in the new system.
For patients, the effect is of having an accident with an uninsured motorist. Very few consultants will have the assets needed to pay large damages and legal costs; it is patients who will suffer most.
How did we get into this mess? It was clear to most of us that there was an urgent need to reform the process of recompensing victims of medical accidents or negligence. At present almost all cases are contested and adversarial. A medical recompense board, as operates in some other countries, based on degree of injury rather than blame, could greatly reduce the costs by eliminating much of the legal process and many of the legal fees. What the Department has given us is a system where consultants will be ruined financially, and where lawyers, not patients, will be the beneficiaries.
The Minister has promised that no patient will be left uncompensated and no consultant will be left uncovered. We now know that this promise is not binding on the Government. The Minister has admitted that her Department got it wrong on residential care charges. Can she not admit the error on medical indemnity? - Yours, etc.,
BERNARD McCARTAN, Faculty of Health Sciences, Trinity College, Dublin 2.