The Minister for Health, Mr Martin, will today be faced with a demand from hospital consultants for a written statement declaring that he will not implement a recent Cabinet order on medical liability.
The written commitment is being sought by an Irish Hospital Consultants' Association (IHCA) delegation which is meeting the Minister in Dublin.
Sources said last night that the level of anger among consultants, following their extraordinary general meeting on the issue last Sunday, is such that a walk-out by the IHCA delegation is likely in the absence of a written commitment from the Minister.
Consultants are upset that an undertaking not to introduce a new system of dealing with patient claims, given by the Minister at a meeting between the two sides on February 8th, was broken last week.
The enterprise liability scheme proposes that the State indemnify consultants and hospitals as a single entity against claims from patients. Until now, consultants have paid a premium to one of two medical defence bodies in return for insurance against malpractice.
As currently proposed, the scheme will not apply to consultants in private practice, some of whom may have difficulty continuing to work as a result.
Department of Health sources have indicated that while it may be possible to include the majority of consultants who practice in both the private and public sector, the 170 specialists who are engaged in purely private practice cannot be facilitated.
The issue of historical liabilities - in particular, those which may emerge in the obstetric sector - is causing difficulty. The Medical Defence Union has indicated that there could be 10 to 12 legal cases every year in the Republic involving babies born with brain damage, with a potential settlement of up to €5 million in each case.
Hospital consultants are also concerned that enterprise liability will mean they are unable to act as advocates on behalf of their patients in situations where they feel that hospital facilities are inadequate or unsafe.
The Irish Times understands that the depth of anger at the IHCA meeting was such that at least two speakers suggested that the organisation should reconsider its founding principle of not engaging in strike action.
While no formal motion was put to the meeting, it was the first time in the 13-year history of the IHCA that direct industrial action, which could affect patient care, was called for.