Paschal Mooney (Fianna Fail) | Oireachtas source

I welcome the Minister, Deputy Varadkar and I too congratulate him on his new appointment as Minister for Health. I know that with his medical background and political acumen he will bring a particular dimension to health matters. I have every confidence the Minister will address the issues and problems in a Department that was referred to by a predecessor who had served in that Department - the former Taoiseach, Brian Cowen - as "Angola". I remember on one occasion when listening to Vincent Browne - who visited the Seanad earlier this morning - when this reference was made on a television programme asking the then Minister for Health, Brian Cowen, what did it mean. It was spelled out to him. Angola, following its civil war was full of landmines all over its territory. Perhaps members of the public were not aware of the situation then, but the analogy has stuck. There is a general sympathy and understanding for the Minister with the problems he is facing, by those in these Houses who know the intractable problem the health Ministry has inherited. I know the Minister will be fighting for money but it is not just about money; I hope he will bring his unique experience to solve the problems in the best interests of everybody.

As the Minister said, this Bill is about protecting the patients' interests and providing public confidence in medical services so that people can go to a competent medical practitioner in the full knowledge that if anything happens they are indemnified against negligence that may arise. I understand that in excess of 99% of medical practitioners are already registered for insurance.

I am sure the Minister is aware of some concerns raised by consultants. During the summer the Irish Hospital Consultants Association expressed its grave concern at the decision by the Medical Protection Society, MPS, to significantly increases its charges for clinical indemnification. It is expected that this will result in a growing number of patients seeking care in public hospitals at a time when these hospitals do not have the capacity to treat more patients due to a lack of front-line resources and an insufficient number of consultants. As I said earlier the Minister will face problems and difficulties in this Ministry in terms of providing resources. The increase in charges for clinical indemnification might result in patients using the public service, which will put extra strain on public services. I had a brief discussion with my friend and colleague, Professor Crown, and he believes that may not be the case. It will be interesting to know whether that could happen or is it scaremongering by the Irish Hospital Consultants Association?

The Medical Protection Society, MPS, which is the main provider of clinical indemnity in Ireland stated that the primary reason for the increase is the growth in the cost of settling claims and the lack of progress in reforming the law relating to medical negligence claims in Ireland in contrast with other jurisdictions.

It stated that the summer increases had come on top of previous increases of between 50% and 67% since 2008, including increases of up to 33% in 2013 alone. These are quite significant increases. Does the Minister have an opinion on whether they will have an adverse impact on what he is attempting to do here?

The society has said that medical indemnification is already a considerable cost for consultants. However, I take my cue again from Senator Crown by saying that it would be foolhardy to suggest that consultants would not have adequate cover - they all do. I am talking about those who come into this country, perhaps, or those who set up in this country, as fly-by-night operators. One of the inspirations behind the original 2007 Bill was issues surrounding the cosmetic surgery industry; questions were raised about the way patients were treated in a particular clinic in Dublin. Also, a number of recommendations were made by the working group on medical negligence, chaired by Ms Justice Mary Irvine, which submitted a report to the President of the High Court and the Minister for Justice and Equality with recommendations on the introduction of pre-action protocols, including the related draft legislation. Perhaps the Minister has an opinion on those recommendations. The consultants are seeking the introduction of these changes and other reforms without delay to ensure the continued availability of care for private patients which would otherwise become financially unviable.

The Minister has already given the background by saying that the previous Government introduced the Medical Practitioners Act 2007, which was about enhancing patient safety and is at the heart of the health reform agenda. It was part of a series of Bills that would also bring accountability to health professionals. The Bill was consistent with the then Government's commitment, as outlined in the health strategy, to strengthen and expand the provisions for statutory registration of health professionals, including doctors. If we are to maintain the trust of patients in the doctors who treat them, we need to demonstrate and maintain quality at all levels. The Minister made a strong reference to this aim in his presentation. Patients want to know the service they receive from doctors is based on evidence of best practice and meets the highest standards.

One of the priorities of this legislation, on which I commend the Minister, is to strengthen and clarify accountability. It aims to ensure that members of the public are guided, protected and informed in order that they can be confident that doctors are properly qualified, competent and fit to practise on an ongoing basis.

Before I finish I would like to pay tribute to my colleague Senator Colm Burke, on his Private Members' Bill, the Medical Practitioners Bill, which we debated extensively in this House. I commend him not only on having the initiative to bring forward the Bill but also on the wide consultation that he undertook, which was quite awe-inspiring. He covered the ground extensively and spoke to everybody and anybody in the health area before drafting the Bill. It is a flaw in the whole system of how legislation works in this country that when a Senator introduced a Bill of this quality, which was highly commended by all sides of the House at the time and debated extensively, the Government, when it reached the critical point of moving it to Committee Stage, said "Sorry, we cannot support it, but we will think about introducing our own Bill." That is exactly what has happened. This Bill is an exact copy of the one Senator Colm Burke introduced. There may be some slight changes here and there. That happens to every Bill that goes through Committee Stage, where it is further improved and expanded. I would put on the record that Senator Burke did a great service not only to these Houses but also to the general public, which has resulted in our having this debate today and will ultimately result in the passing of the Bill. I commend the Bill, and we in Fianna Fáil support it. I would appreciate if the Minister could respond to some of the queries that have been raised. Once again, I reiterate that we on this side of the House wish the Minister well in his new Ministry and have a degree of sympathy for his situation.