Such an enormous increase in medical indemnity fees would have to be passed on to patients through higher fees, which would in turn lead to increased health insurance premiums.
And with more than 40% of all non-emergency operations carried out privately here each year, such a move could see the private health system come under even more pressure as consultants choose to work abroad or in the public sector and even more consumers ditch their health insurance cover.
The Medical Protection Society, the only insurance company to provide cover to consultants, is calling for reform of the private consultant insurance scheme. It warned that the number and cost of negligence claims in this country is “spiralling” and that the MPS faces a major challenge to keep the indemnity fund afloat for its Irish consultants.
Up to 1,000 consultants will be affected by the planned increase in indemnity fees — 350 of these are in fully private practice while the remainder have public/private contracts which allow part-time private practice. The fully private doctors will be obliged to pay a greater chunk of the increase with orthopaedic surgeons paying up to €100,000 in insurance per year.
MPS medical director Rob Hendry said the society is “concerned by the increasingly detrimental effect that the cost of clinical negligence claims is having on health professionals and the public purse”.
“We believe that reform is needed and we are working with the Government to address the spiralling costs of claims,” said Dr Hendry.
Irish Hospitals Consultants Association secretary general Martin Varley said this latest proposed fee increase comes on top of previous hikes of between 50% and 67% since 2008, including increases of up to 33% in 2013 alone.
Fine Gael senator Colm Burke said that while full-time private consultants can earn around €250,000 a year, they must run and pay for their rooms, insurance, and administrative and nursing salaries from this figure. If a 42% hike in insurance is agreed, it would mean that some could be better off working abroad or in the public sector, where they could earn at least €116,000 per year.
“The cost of Irish clinical negligence claims is much higher than in the UK,” said Mr Burke. “A major problem is the long period that it takes before Irish cases come to trial. This results in significant increases in awards and in legal costs.
“Legislation is being drafted by the Department of Justice to address various pre-trial aspects of litigation, but the impact of a change in legislation on awards will not be seen for a number of years.”
When a patient takes a legal case against a medical consultant, in most cases it is the consultant or his insurance provider who must pay the first €1.13m of the claim with the remainder paid by the State Claims Agency. The threshold for obstetricians and neurosurgeons is lower with claims paid out once the claim goes over €500,000.
“Consultants and their representatives tell me that insurance costs are reaching unsustainable levels and could lead to consultants quitting Ireland and going abroad where salaries are high and costs are lower. Others may pass on the increase to patients,” said Mr Burke.
Doctors want the threshold to be lowered so that the SCA will pick up claims for all consultants after the first €565,000. Department of Health officials have met representatives of the IHCA and the MPS about the situation.