Dáil Éireann díospóireacht -
Thursday, 22 Apr 1999

Vol. 503 No. 5

Written Answers. - Non-Consultant Hospital Doctors.

Brendan Howlin

Ceist:

16 Mr. Howlin asked the Minister for Health and Children the action, if any, being taken by him to close loopholes in indemnity provisions for non-consultant hospital doctors which can leave them with no indemnity cover when they become involved in legal actions following adverse incidents; the findings of the report submitted to him on this subject; and if he will make a statement on the matter. [10474/99]

Minister for Health and Children (Mr. Cowen)

All medical and dental practitioners employed in the health service are obliged, as a condition of their employment, to be indemnified against claims for negligence arising out of their work for the public health services.

Since 1992 non-consultant hospital doctors, public health doctors, dentists employed by health boards and some other small groups of salaried doctors have been covered by a group medical indemnity scheme. The scheme was originally conceived as a measure to deal with industrial relations unrest among NCHDs who were dissatisfied with the then existing reimbursement scheme. On the basis that these groups are salar ied doctors and dentists with little or no private practice, it was decided to remove from them the obligation to hold individual indemnity cover and to devise a group scheme to purchase cover for them.

The medical indemnity scheme was never intended to replicate the indemnity cover being provided by the medical defence organisations. Rather, it provides indemnity for the financial consequences of negligence arising from work undertaken as part of the doctors'/dentists' activities in a post approved by the Department of Health and Children in the public health service.

In the years since 1992 the scheme has been amended to deal with problems arising during that period. Originally it did not provide representation at coroner's inquests. This has now been included. It was further amended in 1997 to remove ambiguities relating to cover for needlestick injuries caused to persons other than patients. The medical indemnity scheme does not provide cover for representation before the Fitness to Practice Committee of the Medical Council. It may, in certain circumstances, provide representation in other disciplinary proceedings. The Department is strongly of the view that an employer should not be put in the position of paying for a service such as this. It would not be in the interests of hospitals or doctors that they should do so, as, in certain circumstances, the hospital may be the body initiating a complaint against a doctor. It is in the doctor's own interest that he or she has a source of independent professional advice and representation. NCHDs should also be aware that they expose themselves to risk when they diagnose treat or prescribe for a relative or friend. They need to provide themselves with appropriate cover for this area of their practice.

In 1992 both the Department and the Irish Medical Organisation emphasised the importance of NCHDs and others covered by the scheme taking out supplementary cover for those aspects of their professional lives not covered by the scheme. This is available from the Medical Defence Union, Medical Protection Society and the St. Paul Ireland.