Mary Henry (Independent)

I welcome the Minister of State at the Department of Health and Children, Deputy Brian Lenihan, to the House. I declare an interest in this issue. The Medical Defence Union and the Medical Protection Society always have a few members of long standing on what are called their Irish advisory committees. I am currently on the Irish advisory committee of the Medical Defence Union.

It is said the benches of this House and the Dáil are very sparsely populated. The last time we debated the role of the Seanad I pointed out that many of us are in our offices watching events unfold in the Houses, which is how the matter I am raising came to my attention. Naturally, I keep a close eye on the Minister for Health and Children, Deputy Martin. Last week, I watched him reply to questions tabled by Deputy Coveney and Deputy Olivia Mitchell concerning the main indemnity bodies operating here. These are the Medical Defence Union and the Medical Protection Society, St. Paul having recently pulled out of medical indemnity worldwide and Medisec, of which Deputy Glennon is a founder and, I believe, chief executive, mainly providing cover for general practitioners.

The huge awards made here against obstetricians have led to a significant increase in subscriptions for medical indemnity. Between 1985 and 2000 annual increases averaged 26%. Early this year an award of €4 million was made in a case of medical indemnity taken against an obstetrician and even in a case which was won the cost in legal fees amounted to some €350,000. This is a very expensive business, particularly for the Department of Health and Children, which pays between 80% and 90% of the fees incurred by obstetricians who are public employees. Private obstetricians must pay their own fees.

The Department has been trying to introduce enterprise liability, whereby the State will cover all the indemnity of the hospitals, including that of junior doctors and consultants. However, consultation is still ongoing, particularly with regard to hospital consultants. Last year a deal was done with the Medical Protection Society to hold the subscription for obstetricians at a certain level, amounting to about a sixth of the level the Medical Defence Union proposed to charge. A request under the Freedom of Information Act found that the Department was subsidising the Medical Protection Society, a practice which has been queried by the Medical Defence Union before the European Commission on the grounds that it breaches competition laws.

While this is not a major concern of mine, I was concerned by the Minister's reply to Deputy Olivia Mitchell in which he stated that one of the main reasons the Department ended negotiations with the Medical Defence Union was that the organisation concentrated on the issue of historic liabilities. The Department should have concentrated more on the issue of historic liabilities because, as the Minister admitted, these are considerable. It is important to note that only about 20% of general medical claims occur after six years, whereas about 40% of obstetrics claims occur after six years. Frequently, these claims are made by young adults. The costs of such claims are currently paid by the Department through the reimbursement of subscriptions to the various medical protection societies.