The Republic is facing a medical negligence crisis which is being addressed only in terms of the finances involved, according to Dr Denis Cusack, Professor of Legal Medicine at UCD.
Speaking at a seminar titled: "Medical Negligence - A Case for Reform", at the IMO annual general meeting yesterday, Prof Cusack told doctors that "a more fundamental and worrying cost is the continuing disintegration, if not destruction, of that most basic aspect of health care, the relationship based on trust between doctors and their patients".
He called for more awareness of the high psychological cost of medical litigation.
The barriers to reform of the medico-legal system included: a) inter-professional distrust between doctors and lawyers; b) the vested interests of all stakeholders; c) a mismatch between what medicine could achieve and what patients could expect; d) the misunderstanding inherent in legal and medical language.
Prof Cusack welcomed the proposed introduction of an enterprise liability system, in which a single insurer would cover all medical liability.
The proposed new system, as well as no-fault compensation arrangements for "brain-damaged" babies, were a good start, he added.
"But this is still only tinkering with a seriously diseased system and a much more comprehensive, radical and courageous approach is required. This includes the need to tackle vested interests and mindsets in the medical and legal professions and in the public generally," he said.
While a combination of reforms was the only way to remedy the current situation, Prof Cusack highlighted two areas in particular: the framing of a healthcare bill of rights and the need for a forum of alternative dispute resolution based on a robust and fair complaints procedure.
He explained that the bill of rights would set out the rights and duties of all partners in healthcare, and a new dispute resolution system would include mediation and arbitration procedures to allow for a less adversarial approach.
Referring to the Government's healthcare strategy, he called for the setting up of a healthcare/clinical disputes commission which would include representatives from all healthcare partners and the legal profession.
A general practitioner in the audience described his own experience of being sued: "It is a hugely isolating experience and the psychological costs are enormous."
He also called for statutory limits on the number of hours of continuous practice by doctors.
Mr Brendan Phelan, of the medical indemnity project office in the Department of Health, estimated that the costs to it of medical indemnity, excluding general practitioners and private practice, was more than £32 million last year.