MDU Statement on Enterprise Liability
The Minister for Health and Children is concerned that a statement to the media released by the Medical Defence Union (MDU) seriously misrepresents the nature and the extent of the cover to be provided to hospital consultants under the Clinical Indemnity Scheme(CIS). The CIS is based on the principle of enterprise liability. Under enterprise liability consultants will be relieved of the burden of being named in claims for personal injury or of having to arrange their own indemnity cover for the vast bulk of their work. All of their work in the public hospital system, whether on behalf of public or private patients, will be covered by the CIS at no cost to them. The coverage of their private practice in public hospitals is a benefit not enjoyed by NHS consultants in similar schemes in the United Kingdom.
Contrary to the impression conveyed in the MDU statement the cover provided by the CIS is all embracing. Furthermore the draft Scope of Cover Document goes into far further detail on the nature of the cover provided by the CIS than does the Memorandum and Articles of Association of the MDU. The MDU statement claims that the CIS does not provide certainty to doctors that they are fully and adequately indemnified. On the contrary the CIS provides a State guarantee that they are fully indemnified for the vast bulk of their clinical activity. This more than favourably compares with the capped claims made insurance cover provided by the MDU. In addition the indemnity offered by the CIS is State guaranteed compared to the discretionary indemnity offered by the MDU to doctors not covered by its insurance policy.
It is not correct for the MDU to state that the current version of this document has more exclusions than earlier versions. For example “administrative negligence” will be covered by the insurance policies held by health boards and hospitals. Many of the other exclusions such as Good Samaritan acts and representation in disciplinary matters, appearances before the Medical Council, representation at tribunals etc. were excluded at the request of the defence bodies and have been the subject of lengthy discussions with them over the past two years. Similarly the cover that the defence bodies would provide to their members in Ireland after the introduction of enterprise liability was the subject of exhaustive discussions with the defence bodies during 2001. Indeed the entire process leading up to the introduction of enterprise liability has been characterised by an extensive consultation process including health service agencies, the IMO and IHCA, the medical defence bodies, commercial insurers and patients’ representatives. It is clearly in the interest of patients and doctors that the existing fragmentary and unstable arrangements are replaced by a State-guaranteed indemnity scheme.
The issue of the historic liabilities of the MDU is a complex one both in relation to how they have been incurred and how they might be treated going forward. A final decision has not been taken on how this matter will be resolved.