Obstetricians driven from private practice, says consultants group

IHCA warns of impact of insurance costs as surgical specialties come under pressure

The IHCA report said  more than 20 consultants ceased private practice in 2014 because of the unaffordable cost of indemnity. Photograph: Anthony Devlin/PA Wire
The IHCA report said more than 20 consultants ceased private practice in 2014 because of the unaffordable cost of indemnity. Photograph: Anthony Devlin/PA Wire

There are no obstetricians working exclusively in the private sector, the Irish Hospital Consultants Association (IHCA) has said.

In its annual report, the IHCA said clinical indemnity cover for a consultant obstetrician in full-time private practice would be about €340,000 a year.

The organisation, which is holding its annual conference this weekend, also said the financial viability of surgical specialties was under extreme pressure with clinical indemnity costing up to €106,000 a year in some cases.

The IHCA said this represented an increase of more than 100 per cent in recent years.

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“The IHCA has outlined to the Minister for Health and the [Oireachtas] Joint Committee [on Health] that there is an urgent need to reform the law relating to medical indemnity.

“Over 10 years ago it was recognised that €100,000 was the limit of affordability for obstetricians. The annual charge for surgeons was about €30,000 at the time.

“Accordingly, the current indemnity costs are in excess of three times the levels that were regarded as affordable over a decade ago.”

Unaffordable

The IHCA report said it was estimated that more than 20 consultants ceased private practice in 2014 because of the unaffordable cost of indemnity.

“More consultants have ceased practice in 2015. If unaddressed, the current situation will result in fewer patients being treated in private hospitals at higher costs. As a result more patients will be forced to seek medical care in public hospitals, which will increase the already growing waiting lists and chronic overcrowding.”

The IHCA report said that a shortage of specialist doctors in hospitals across the country was “making it impossible to continue to provide safe high-quality care to patients and it is impacting adversely on patient care and safety”.

It argued that revised pay terms for new entrant consultants put in place earlier this year by the Government failed to restore international competitiveness in recruiting consultants.

“The revised terms will perpetuate consultant vacancies and continue to undermine the provision of timely care for patients.

“The revised terms are driving potential new consultants abroad who expect parity with their colleagues because they have the same demanding responsibilities for the delivery of high-quality patient care.

Patient safety

“This is a major concern for acute services which had in excess of 300 consultant vacancies that could not be filled in acute hospitals in late 2014 based on HSE figures.

“Further significant consultant vacancies exist in the mental-health services.

“All hospital and mental health services throughout the country continue to have a large number of consultant posts vacant in specialties, many of which already had low numbers of consultants on a per capita basis to start with.

“This is making it impossible to continue to provide safe high-quality care to patients and it is impacting adversely on patient care and safety.”

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.