Paul Connaughton Snr (Galway East, Fine Gael)

I highly commend my colleague, Deputy James Reilly, on introducing this Bill. I hope that due consideration will be given to what is a complex area.

Since it does not often occur, it is no harm to mention that an Opposition spokesperson like Deputy Reilly can bring his great expertise in the medical profession to the floor of the House. This procedure is good for Parliament and I hope that, when the Bill has been put together, we will have fine legislation.

This is an important Bill because many people would be surprised that insurance cover for medical practitioners was not mandatory. I must admit that I did not know it. From my research today, I understand that most doctors are covered. However, it is not an inexpensive business, with an ordinary practising doctor's premium amounting to €4,000 or €5,000 per year or a part thereof. I am surprised that the Department of Health and Children does not know how many doctors are not insured, but there is no register. This is difficult to understand, but I am told that as many as 40 or 50 people are not insured or have inadequate insurance. Some may be based outside the country yet working in Ireland, although I am not just referring to that cohort as such.

When people digest this debate, there will be an element of worry. I can only speak as a lay man, but doctors are rightly held in high esteem in society. In polls taken over the years, this esteem does not seem to have diminished and I know why. When one is a sick patient, one is in the doctor's hands. Given that the majority of people with whom I have had contact down the years, although thankfully not on a personal basis, have reason to be grateful to doctors, it is a fine profession.

Like every other profession, however, there are always problems. Everyone finds it difficult to say "Sorry" and that they have made a mistake. It is a personal failure among many of us, but it is certainly a failure in medicine. Through the years, I have found this to be the case where obvious mistakes had been made. Mistakes will always be made, but I will discuss that later during the few minutes at my disposal.

Many families have told me that they knew whether their loved ones had been wronged by hospital procedures. The problem is proving it in a court of law. The Minister of State will know as well as any other Deputy that once an issue enters the realm of law, one can certainly take it that the issue will not be patient-centred. Everyone else seems to make more out of it than the patient. This is a significant problem and I hope that something like this Bill will eventually overcome the culture of secrecy. I do not know why that culture has remained, but I suppose it is because ordinary people can be bamboozled by medical jargon. This is understandable. It is against this background that this Bill and related Bills - the Bill before us cannot solve all problems - will overcome that situation. Many people would be less afraid to take on the medical profession, hospital authorities and so on to get their rights.

Now that I know not all doctors might be insured, I have noticed something else. In a car accident involving a driver who, like many people, is not insured, it is bad news for the injured party, but at least there is another stage, in that a case can be brought before the motor bureau for compensation. While this takes many years, it provides some safety. There is no safety in respect of the medical profession. For this reason, a practical provision needs to be introduced and, as such, Deputy Reilly's thoughts will find favour across the country.

I cannot claim to be a professional, but another matter must be considered in this Bill or the eventual legislation. A practising doctor may be duly covered by insurance now, but we all know that, if certain procedures go wrong, problems might not manifest until several years later. There would be no trouble in legally and medically pinpointing which procedure caused a long-term illness. Would it not be the patient's hard luck if the doctor, who had been covered at the time, was no longer covered because he or she had retired or had not bought cover for subsequent years? The jargon in this respect is run-off insurance. This matter is important and I can well imagine the difficulties with an insurance company indemnifying people after a long period. As the Minister of State knows well, the case of a car accident is different. Whatever the injuries, they are caused on that day and any subsequent illness will come about as a direct result. Not so with inappropriate medical procedures, the effects of which might not arise until years afterwards. Have I much time remaining?

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