The ACT has been caught in the crisis over medical negligence insurance.
The crisis began in NSW when the chair of neurosurgery at Royal Prince Alfred Hospital, Professor Michael Besser threatened to resign his public-hospital position because of very steep increases in medical indemnity insurance. He faced an increase of $100,00 a year. At that rate, he said, it was not worth his while to continue public-hospital practice. Other neurosurgeons and obstetricians joined the threat, undermining the whole system of visiting medical officers at public hospitals.
The NSW Government has come to the rescue by offering indemnity coverage for all doctors treating public patients in public hospitals for past, present and future claims. It now seems that the ACT will have to flow suit or face a mass exodus of visiting medical officers from the public hospital system.
The huge increases in insurance have come about after concern in the whole insurance industry about whether premium income is enough to sustain claims. This concern has flowed from the collapse of HIH and the September 11 bombings, but also because of the increase in both the number of claims and the average size of payouts in medical negligence cases, particularly arising from childbirth and brain injury.
The rise in number and size of claims comes from a combination of factions: an increasing litigious society; the reduction of support from the public welfare system and families; a more active plaintiffs’ lawyers groups; a greater willingness by courts to grant claims; a greater tendency for patients and their families to seek someone to blame when things go wrong rather than accepting it as part of the vicissitudes of life.
It was perhaps unfortunate that the current crisis blew up so suddenly, even if the seeds were sown long ago.
A lot of questions remain unanswered. Why didn’t insurance companies and or the doctors give greater notice of the premium rise and the threat to withdraw? Why is it that just the public part of the doctors’ practices seem to be affected by the premiums and there is not need for the doctors to seek a subsidy for private practice? Why haven’t the doctors threatened to withdraw from private practice? Is it perhaps because governments are seen as an easy tough, especially if a medical crisis is generated? Why should the public sector offer the indemnity for the visiting medical officers without anything in return? Surely, if the private insurers have priced themselves out of the market, the public sector should move in, cover the visiting medical officers but then seek a contribution from them in the form of lower fee for service.
Fortunately the Federal Government has called a forum for early next year on the issue. It would have been better if NSW had only offered stop-gap coverage until that forum had a chance to seek other solutions.
The whole episode smacks of doctors and insurers holding the public system to ransom with a very tight deadline set on the demand note.
That said, it seems the test for medical negligence is being set too high by the courts if these claims keep coming. Surely, Australian medical practice is not laced with that amount of incompetence. If courts keep going like this, maybe we should abandon the whole pretence of “”negligence” and opt for a universal compensation scheme whenever medical interventions do not fulfill their promise.