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New laws proposed to protect patients
The aim of the Medical Practitioners’ (Professional Indemnity) (Amendment) Bill 2009 is to ensure that no doctor will be able to practise medicine in Ireland without medical indemnity cover. Although this is a private members bill it has been endorsed by Mary Harney who has hinted that she may use the Bill as the basis for the government’s own measures in this area. Medical indemnity cover is defined within the Bill as being an agreement between a practitioner and any approved body, whereby the practitioner will be compensated in the event that he/she suffers loss by means of civil liability, arising out of medical negligence or alleged medical negligence in the practise of medicine. The majority of doctors are responsible and ensure that they have in place the necessary medical indemnity cover. However, as in all professions, there may be a small proportion who may not have the appropriate level of cover, a fact they simply may not be aware of. While the Irish Medical Council (IMC) states that doctors must have adequate cover, there is no formal system or national strategy for checking to make sure practitioners have cover or adequate cover. The Bill aims to close this loophole.
The Bill provides that the IMC shall have the necessary power to determine what level of medical indemnity cover is required by different classes of practitioners. As a result, all doctors who wish to practise in Ireland must produce evidence of indemnity cover. More importantly, this means that any doctor who does not produce evidence of the appropriate level of indemnity cover, either when registering or whose cover lapses while registered, will not be entitled to be on the register of medical practitioners. It is the indemnity provider’s obligation to notify both the practitioner and the IMC where a practitioner’s cover has lapsed for any reason. Failure to hold medical indemnity cover will be an offence. If a doctor’s indemnity cover has lapsed for more than 30 days, the IMC is obliged to notify the Preliminary Proceedings Committee. The penalty is a fine which may vary from €5,000, on summary conviction to €120,000, on indictment and/or imprisonment for six months to one year. The Bill faces some challenges. It appears to be aimed at a small percentage of doctors who not only do not have appropriate indemnity cover, but who also work wholly independently. Although these doctors may not have the appropriate indemnity cover, they tend to be part of a partnership which essentially means that the patient may still obtain redress as the partnership may be sued. There is also an issue as to whether certain doctors, such as full-time academics and retired doctors, should be obliged to carry indemnity cover at all.
Medical Indemnity Cover includes cover provided by Mutual Defence. Organisations as well as Insurance Companies. Section 4A of the Bill, which amends section 43 of the Medical Practitioners Act 2007. Section 4J of the Bill