Hospital consultants are set to review their patient workload and withdraw from administrative duties if the Minister for Health, Mr Martin, does not give the Irish Hospital Consultants' Association a written guarantee that their common contract will be respected.
The decision follows an extraordinary general meeting in Dublin yesterday, attended by 300 consultants, to discuss the introduction of a new system of indemnity against claims for medical malpractice.
The Cabinet decided last Tuesday to sign into law a statutory order giving the State Claims Agency the right to defend both doctors and institutions accused of patient mismanagement.
The new enterprise liability scheme means that the State will indemnify consultants and hospitals as a single entity. Until now, consultants have paid a premium to medical defence bodies - the Medical Defence Union and the Medical Protection Society - in return for insurance against malpractice claims.
As proposed, the scheme will not apply to consultants in private practice, who will face considerable difficulty in paying for malpractice insurance.
Some may have difficulty in continuing to work in private practice.
Consultant leaders see the move as a breach of the consultants' common contract. Dr Colm Quigley, president of the IHCA, said: "The introduction of enterprise liability is bad for the profession and bad for patients.
"It leaves consultants in a position where they will be unable to defend themselves and their medical decisions. The State will now control how these claims are defended and so will rob consultants of their clinical independence," he added.
The meeting mandated the IHCA national council to take legal action against the Minister for Health to prevent him from imposing enterprise liability when the dual system of malpractice runs out and to levy each member €500 to fund that action.
The council was also asked to draw up a programme of action which would not directly affect patient care and to adopt a common position with the Medical Protection Society and Medical Defence Union.
It is one of the founding principles of the IHCA not to engage in strike action.
Dr Michael Saunders, chief executive of the Medical Defence Union, said that if the parallel system was left in operation for any length of time, it would result "in the worst of all possible worlds".
The Minister for Health is to meet with the IHCA next Wednesday. His spokeswoman said last night: "Enterprise liability has been Government policy for some time.
"The Minister has always been committed to ongoing discussions on the issues of key concern to consultants - historical liabilities and private practice."
The Irish Times understands that the Department of Health will be happy to see both the old and new systems running in parallel for some time.
However, Department sources are adamant that enterprise liability ultimately offers savings of up to €100 million a year to the State.