Marcella Corcoran Kennedy (Offaly, Fine Gael) | Oireachtas source

I am very pleased to be here today at the resumption of the Committee Stage of this important Bill. The Bill, which has been passed by the Seanad, will make it mandatory for medical practitioners to provide evidence of minimum levels of indemnity cover to the Medical Council, on registration with the Council and on annual renewal of registration. There is currently no legal obligation on a medical practitioner to have medical indemnity insurance cover. As a result, some patients and the users of medical practitioners' services may find they are unable to seek redress in the event of a medical mishap or negligent care from a medical practitioner. Given the high cost of litigation and the long-term consequences of some adverse events, this legislation is to be welcomed as patient-focused and progressive.

The main purpose of the original Medical Practitioners Act 2007 is to protect the public and to have a proactive system of robust registration and regulation of the medical profession, in order to minimise the risk to the public and safeguard the health and well-being of people accessing health services. Under the Medical Practitioners Act, the Medical Council must register every medical practitioner who practises in Ireland. In anticipation of the enactment of this Bill, the Council already asks medical practitioners on application for registration and on annual retention of registration whether they have indemnity cover.

On the enactment of the legislation medical practitioners will not be registered to practise unless evidence of adequate indemnity cover is provided to the Council. This development can only be to patients' benefit. The Bill requires that the State Claims Agency would specify the minimum levels of indemnity required for medical practitioners in different medical specialties. The State Claims Agency has the relevant competence and expertise in the area of managing clinical claims and it also has close links with medical indemnifiers and so is well placed to specify what the minimum levels of indemnity should be.

This policy change requires that a new function be given to the State Claims Agency under section 8 of the National Treasury Management Agency (Amendment) Act 2000. There are currently 58 medical specialties on the Medical Council's register and practising in some would be higher risk than practising in others. Within different specialties too, there could be a higher risk attached to certain types of practice. It is important to point out that all doctors who work in the public health system are provided with medical indemnity insurance under the State's clinical indemnity scheme. Likewise, private consultants who practise in public hospitals are also covered by this scheme.

However, doctors who are engaged in wholly private practice must purchase private indemnity insurance cover. There is a wide range in the cost of cover for consultants engaged in wholly private practice. For example, a consultant practising dermatology, based on figures from medical indemnifiers, would be considered low risk and the annual premium for this practice would be around €16,000. Nevertheless, a spinal surgeon may have to pay over €100,000 for annual medical indemnity insurance cover, reflecting the much higher risk involved in that practice. The cost of this private cover increased by approximately 42% for private consultants in 2014 and this was mainly due to the high cost of awards for clinical negligence.

We will now examine the Bill, which includes three minor technical Government amendments. The amendments are needed because the original text of sections 45 and 50 of the Medical Practitioners Act 2007 were amended by Regulation 95 of the transposing regulations of the European Union (Recognition of Professional Qualification) Regulations 2017, that is SI 8 of 2017. I will explain the implications of these textual changes on sections 7 and 8 of the Bill as we examine those sections.