In a decision which could affect women taking legal action against consultant obstetricians for alleged malpractice, one of the main medical defence bodies said it may not now be in a position to defend its members for past liabilities.
The Medical Defence Union (MDU), a British-based medical indemnity organisation, last night called on the Department of Health to "pick up the cost of medical negligence claims" arising from work done in public hospitals here before March 2001.
It is the first time in its 120-year history the organisation has said that any group of doctors, either here or in Britain, may not be indemnified by it for past work. In 2001, all consultant obstetricians in the State became members of the rival Medical Protection Society under a Department of Health-sponsored response to a crisis over the cost of obstetrics insurance.
At the time it was estimated that the true cost of an annual malpractice premium for a consultant obstetrician was between £300,000 and £400,000 (€380,921 and €507,895). All obstetric liabilities from March 2001 have effectively been covered by an enterprise liability scheme in which both the doctor and the hospital are considered to be a single "enterprise" and insured as such.
However, the Department of Health's decision did not specifically deal with historic liabilities - those claims arising from past obstetric care and legal cases from the past that have yet to be initiated.
Dr Michael Saunders, MDU's chief executive, said: "The difficulty for the MDU and our members has been that the Department of Health has been unwilling, to date, to address the obstetric historic liabilities."
He said that with settlements in cases of cerebral palsy costing up to €5 million, excluding legal costs, the MDU needed to protect the interests of all its members.
"We are a membership-based organisation and must protect the interests of our membership as a whole. By taking this step, we are safeguarding the interests of our other members by ensuring they are free to practise without the burden of paying for the obstetrics crisis," Dr Saunders said.
"It is unfair that the Department of Health expects doctors in other specialities to pay for a crisis which is not of their making and over which they have no control."
Asked what he estimated the overall cost of past obstetric liabilities might be, Dr Saunders said in crude terms, a sum in the region of €150 million would need to be invested today to cover the estimated liability.
However, it has been estimated that it could cost up to €40 million a year in today's prices to cover the cost of major obstetric claims involving brain damage to babies.
The Irish Medical Organisation and the Irish Hospital Consultants Association expressed disappointment with the decision.
"We are very concerned at the MDU decision - concerned for the members of the medical profession who will not now be defended and concerned that patients may not now be covered if they have a reasonable case of malpractice to pursue," said Mr Finbarr Fitzpatrick, secretary general of the consultants association last night.
A medical organisation spokesman said consultants were alarmed at the threat. "Many have been MDU members for decades and are entitled to expect cover for historical liabilities. This move will not serve anyone well, whether litigants or medical professionals."
A Department of Health spokesman said it had only just been notified of the move and that the matter was under consideration.