by Mary Hough July-22-2015 in Healthcare Law
In a report on the cost of medical indemnity insurance published in June this year, the Oireachtas Joint Committee on Health and Children (the Committee) identified key concerns and made recommendations to the Ministers for Health and Justice, the HSE and other stakeholders.
Cost of indemnity cover
In relation to the rising cost of cover for consultants in private practice, the Committee indicated that more than 40% of all non-emergency operations are carried out privately each year and if these consultants were to pull out of private practice it would put further pressure on the public health system. It also found that there is no evidence to date that consultants with a strong risk profile or a history of malpractice are charged differently to other consultants. The Committee noted that they had not received a detailed breakdown of the premia to fully examine whether there is a link to risk levels. It was however of the view that premia should be designed to incentivise learning and the elimination of medical errors and recommended that the Minister for Health, the Irish Medical Organisation and the Medical Protection Society should examine ways to link the premia to data on consultant performance and accredited standards of medical institutions.
In an effort to ease the indemnity burden on private consultants, the Committee also pushed for the caps on medical indemnity to be reduced to €250,000 for the lower cap and €500,000 for the higher cap. The caps allow the state’s Clinical Indemnity Scheme to cover claims over a certain amount for private consultants.
Duty of candour
The Committee noted that lack of resources in the Health Service, be it on the ratio of consultants to patients or general resource levels, contributed to the incidence of errors occurring. It referred to a 2014 survey of HSE employees where 45% witnessed workplace errors that could have hurt patients. In this regard the Committee stressed the need for a duty of candour for all Irish health professionals. The Committee made reference to the fact that some medics perceive that they may be constrained from openly discussing mistakes with patients from a legal and administrative perspective. While the HSE has piloted such a policy in a number of small hospitals the Committee recommends implementation in all public hospitals.
Periodic Payment Orders
In relation to the long awaited legislation to allow for the making of Periodic Payment Orders (PPOs), the Committee stressed the need for these to be introduced. It welcomed the recent publication of the heads of the Civil Liability (Amendment) Bill which introduces a framework for PPOs.
Rising costs of medicolegal claims
The Committee was concerned at the increase in the costs of medicolegal claims. They recommended introducing sanctions on legal representatives where there is evidence of inappropriate joining of parties to proceedings. It advised that the government work with stakeholders, the Law Society and the Bar Council to apply Pre-Action Protocols to all medical negligence cases.
Mediation
Finally, the Committee noted that a significant number of claims are made to ascertain what actually happened and not necessarily to seek compensation. It noted that mediation at an early stage in such cases should be considered and that the HSE may need to consider introducing a standardised complaints resolution service.
For further information on this report, please click here.
Back to Full News
Share this article:
About the Author
Mary Hough
Mary is a partner and Head of the Healthcare team at Hayes solicitors. She specialises in professional indemnity defence litigation and in particular dealing with high value clinical negligence claims. Mary has extensive experience in civil litigation, acting for insurance companies, indemnifiers and plaintiffs.