Indemnity arrangements for GPs in Ireland during a pandemic flu outbreak

During a pandemic flu outbreak, GPs may be expected to extend their current responsibilities. There have recently been some concerns about indemnity arrangements for GPs during a pandemic.

MPS was reassured by the statement contained in the letter of 8 October, jointly signed by the Chief Medical Officer and the HSE National Director of Population Health, inviting GPs to participate in the Pandemic (H1N1) 2009 (Swine Flu) Vaccination Programme. In this letter it is clearly stated that “The state is providing indemnity to general practitioners for the administration of pandemic vaccine in accordance with the national programme. Accordingly, any adverse events as a consequence of the vaccine will be covered by such indemnity.”

MPS has subsequently received confirmation from the DoHC/HSE that the indemnity has been provided to the vaccine manufacturers “to cover the unlikely event of serious adverse events arising from this vaccine”. In practical terms we are satisfied that this makes no difference to the adequacy of the existing indemnity arrangements for GPs who are members of MPS.

The two commercial vaccines to be used are licensed and, as with other vaccines, GPs should ensure that they store and administer the vaccine in accordance with the terms of the licence.

Indemnity for GPs

Notwithstanding the state indemnity mentioned above, GPs who are members of MPS and working in general practice during a pandemic flu emergency would be entitled to seek MPS indemnity and assistance in the usual way, in the event that they are subject to a clinical negligence claim falling outwith state indemnity, any complaint or other medicolegal matter, including a Medical Council investigation, which might arise. This would apply, for example, if a GP was asked to care for someone at home because the nearest hospitals were full, as we would consider this to be part of their professional responsibilities during a flu pandemic.

We fully expect that GPs may have to take on additional duties as and when the pandemic intensifies.

We see this role as consistent with GPs' professional obligations. Therefore, we anticipate that GPs' current membership with MPS will be entirely sufficient in these circumstances.

Responsibilities of GPs in a pandemic

The Medical Council has issued a press release advising doctors that they be immunised themselves and supporting the HSE statements in relation to the importance of basic infection control and personal hygiene practices. In its guidance, A Guide to Ethical Conduct and Behaviour, it states “It is unethical for doctors who believe that they might be infected with a serious communicable disease not to seek appropriate medical advice. Colleagues who are consulted have a dual role. They must counsel and support the doctor concerned, but they must ensure that the doctor does not pose a risk to patients and others.”

GPs, faced with any emergency situation, are expected to do the best they can in the circumstances. Doctors and other healthcare professionals will bear the brunt of the strain as the current flu pandemic intensifies. With hospital beds at a premium, general practice, and GPs in particular, may be providing more community-based, high-level care than normal to non-flu as well as flu patients. However, GPs, like all doctors, are highly trained professionals who are well used to acting in stressful and demanding situations. GPs will continue to be responsible for their own individual clinical decisions during a pandemic.

Practical advice on managing patient care during a pandemic is available from a number of sources, including the ICGP, HPSC and the dedicated website set up by the HSE, linked to the Department of Health and Children.

Further information

If members have any questions on indemnity or professional obligations in relation to the issues raised in this position paper, please contact MPS on the numbers below:

• Indemnity – 1800 509 441 (MPS membership helpline)
• Professional obligations – +44 113 243 6436 (MPS medicolegal advice line).

The following websites may also be of interest:

• www.icgp.ie
• www.ndsc.ie/hpsc
• www.swineflu.ie.