Medical indemnity insurance: Is it worth it?

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(Image via @australiandr)

Notwithstanding the recent announcement by Senators Nick Xenophon and John Madigan of a senate inquiry into bullying in the health profession, Dr Don Kane asks whether medical indemnity insurance is worth it.

On 2 February, the Senate announced that it will investigate bullying and harassment in the medical profession under a motion co-sponsored by South Australian independent Senator Nick Xenophon and Victorian independent Senator John Madigan.

But the Health Professionals Reform Association (HPRA) is concerned that the terms of reference are too narrow.

The Senate Community References Committee inquiry will examine the roles of the Medical Board of Australia, the Australian Health Practitioners Regulation Agency (AHPRA) and other relevant organisations.

Senator Xenophon, long been outspoken about the medical complaints process for AHPRA, raised concerns about the fairness and transparency of the current process. In a media release issued on 2 February, 2016, Senator Xenophon said:

‘Too many medical professionals have come forward raising serious concerns with my office after I spoke out on this on ABC TV’s Lateline program last September.’

 Senator Madigan added his concerns:

Despite denials by AHPRA, I know of at least seven doctors in Australia who have been hounded from work through bullying and harassment by AHPRA.

An inquiry of this type is long overdue, for the sake of doctors and medical professionals and for the wellbeing of patients who are seeking treatment.

Health professionals pay large premiums to obtain cover for defending alleged malpractice. The indemnity providers appear to have difficulty providing a defence for their members.

There are so many examples where the indemnity providers appear to have been non-providers.

The latest concerns a medical practitioner who was notified to AHPRA and immediately had conditions placed on his registration without any attempt by AHPRA to check the truth of the allegations. The indemnity provider then proceeded to relay requests from AHPRA for information from the accused practitioner.

There followed two separate interviews with different agents for AHPRA and three reviews by separate individuals. All had no special knowledge of the field of medicine which is involved. This strongly suggests that this is an example of sham peer review, an obnoxious practice used to wrongly disadvantage a victim of the system.

The recently formed HPARA has had concerns for the quality of service that has been provided by the indemnity insurers and the legal services they engage. This is one of several things that generated the formation of HPARA. The association is building strength and momentum for obtaining an inquiry into the regulation and administration of health professionals. The quality of the indemnity insurers services is front and centre with the regulator and administrators in that endeavour.

HPARA has had discussions with the indemnity providers and their legal representatives, which has been informative. They have the same difficulties with AHPRA as HPARA. The management of cases by AHPRA presents an impenetrable barrier to obtaining due process and natural justice for these entities.

Meetings with AHPRA representatives fail to make progress on rectifying the situation. AHPRA surely must have processes that ensure due process and natural justice for those professionals who have been notified to it. There is no evidence that such process is followed, see the Queensland Civil and Administrative Tribunal (QCAT) case Vega Vega v AHPRA.

HPARA wishes to work with the indemnity providers to have AHPRA made accountable for its actions. If we can achieve reform of the regulation of health professionals, Medical Indemnity Insurance will be worth it.

The senate inquiry will hand down its report on 23 June 2016. It is important to remember that this is a small step in the right direction but will end in a cul-de-sac like the last senate inquiry that effectively produced no favourable reform. It will be dealt with at the whim of the parliament. The terms of reference are not broad enough to achieve what must be done. HPARA will fully support it bearing in mind the likely outcome.

It will take a judicial inquiry, preferably a Royal Commission, to deal with all the issues involved. A completely independent judicial inquiry is essential as the problems in this area are no less in need of exposure than the troubles in the union movement. The mere fact this involves professions is no reason to absolve them from an inquiry. 

Don Kane, MB BS (UQ), FRACP, FCCP, is chairman of the Health Professionals Australia Reform Association.

If you would like to learn more about HPARA, please email or call 0499 399 081.

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