Medical insurer warns of insufficient funds

ONE of the two medical insurers providing cover for hospital consultants has warned it will not be able to afford payouts to victims of medical negligence under a Government plan to take over the handling of claims.

The Medical Defence Union (MDU), which insures about half the country's 1,600 consultants, says if it loses customers, it will have not have sufficient funds to honour awards for claims already before the courts or still to be lodged. It is calling on the Government to take responsibility for such claims known as historic liability but the issue is extremely contentious as the awards involved are likely to run into hundreds of millions of euro.

The MDU has said its only alternative would be to impose massive premium increases on consultants doing private hospital work who will be excluded from the Government scheme.

In a document presented to consultants last November, MDU managers warned: "We estimate that 40% of consultants will pay a higher subscription at once; 30% will pay at least a quarter more, and 15% will pay double what they are currently paying."

The Irish Hospital Consultants Association (IHCA), which is threatening to boycott the new scheme, said increases of that scale would make it unaffordable for consultants to do private practice.

IHCA general secretary Finbarr Fitzpatrick said many of the 150 consultants doing solely private work would be forced into early retirement, while the 700 who do private work in addition to their jobs at public hospitals would have to give up their private patients. "A surgeon pays 40,000 a year in insurance cover and a neurological surgeon much more than that - if that doubles, he's not going to stay in practice very long and that will have a major knock-on effect on public waiting lists.

"If the surgeon increases his fees to cover his insurance, he becomes too costly for the VHI and again people will be forced into the public health care system."

The new Government scheme is aimed at cutting the costs of medical negligence in the public system. Consultants currently take out insurance with either the MDU or the Medical Protection Society and are fully reimbursed by the State if they work only for public hospitals or are reimbursed 80-90% of the cost if they also work in a private capacity.

Under the new system, the Clinical Indemnity Scheme (CIS), the State Claims Agency will become the insurer and assume liability for all claims against public hospitals, health boards and health employees.

Mr Fitzpatrick said as a cost-cutting mechanism the scheme was flawed. "As it stands, if there are three separate insurers in a case involving, say a hospital and two consultants, the three insurers apportion liability between them and one legal team fights the case.

"It is not correct to say that there will be substantial savings. It will be marginal at best."

The IHCA has a meeting with the minister for justice on Monday week to discuss the issue and will meet the minister for health later in the month. They are also seeking a meeting with the minister for finance.