Indemnity costs ‘may close hospitals’

Doctors from four private hospitals in Cork, Kerry and Waterford held a "crisis meeting" in Cork yesterday over the threat to private practice from soaring medical indemnity insurance costs.

The hospital consultants warned that private hospitals will be forced to close and hundreds of jobs will be lost if the issue is not dealt with by the Department of Health.

They fear “a perfect storm” is brewing because of rising indemnity premia, a 25% drop in fees in the past six years, reduced activity because of the recession and soaring practice costs.

At the meeting, which was convened by the Irish Hospital Consultants Association, the fully private consultants agreed to seek immediate indemnity cover from the State Claims Agency for which they would pay “a reasonable premium”.

At present, the Medical Protection Society is the only organisation to provide medical indemnity cover to hospital consultants working in the private sector in Ireland. Due to an increasing number of medical negligence claims, it wants to increase its premium by 42%.

According to one hospital consultant: “Many surgeons in private practice must now pay €100,000 per year for litigation cover. Because virtually all consultants are contracted to accept fees determined by the health insurers, such as VHI, Laya, Aviva, we are therefore unable to raise fees to meet these soaring costs. Indeed, the insurers have recently announced further decreases in consultant fees.”

Maxillofacial consultant, Maria Cashman from the Mater Private Cork called for “an overhaul” of the Irish litigation system.

“The Irish system appears to give rise to substantially more claims against doctors than in the UK. This means that the premium for orthopaedic surgical medical indemnity in the UK up to recently was approximately €13,000, while in Ireland similar orthopaedic cover cost €63,000 and is about to rise to €97,500,” said another hospital consultant.

“Not unlike what happened with obstetrics, the future of certain surgical specialties in private hospitals is in significant doubt,’ said Peter Ryan, consultant urologist and chair of surgery at Bon Secours Cork.

About 40% of all non-emergency operations are carried out privately each year. If the private sector was to falter it would see the numbers seeking access to the public hospital system rise substantially.

The Medical Protection Society, the only company to provide indemnity cover to consultants, wants reform of the scheme for fully private hospital consultants. It warned it faces a major challenge to keep the fund afloat for Irish consultants.