Operating and Financial Review 2008
Given the current difficult economic times, you may not expect
Ireland
me to say that 2008 was another good year for your company.
However, it was a good year and membership numbers
The dispute with the Department of Health and Children
continued to grow and our financial position was further
continues. Members will recall that it has as its basis the
enhanced.
problem of historic obstetric liabilities and the imposition by
the Irish Government of the Clinical Indemnity Scheme on
Total membership now stands at over 192,000, representing an
consultants. The MDU’s Board decided in 2004 in the interest
increase of 34% since 2000. This represents in excess of 50% of
of all members, that in some Irish obstetric cases it would
the UK market thereby underlining the MDU’s status as the
decline to exercise its discretion to assist or continue to assist,
UK’s leading medical defence organisation.
and such decisions continue to be made.
The MDU’s assets total £178m and are held almost entirely in
liquid assets, namely cash or near cash. These assets are
The Irish Government has chosen to support litigation to
invested in two global funds where the money is spread across
challenge the Board’s decisions in some cases. The Supreme
approximately 100 banks, all A-rated or better, and where no
Court of Ireland referred the question of jurisdiction as a
holding in either fund exceeds 5%. The Board believes that this
matter of European law to the European Court of Justice.
spread of investments currently provides the best protection
Judgement was given in October to the effect that only certain
for members’ funds, and provided a reasonable rate of return
procedural aspects of the exercise of discretion were subject to
during most of 2008.
Irish jurisdiction. The cases are proceeding.
The balance sheet shows a surplus £28.5m over the total The Irish Government has said that no Irish person who has
indemnity and pension provision of £149.5m. This figure does suffered from a medical mishap would be left without
not represent the potential total liability of our members since compensation and no consultant would be left without cover
it excludes incurred but not reported cases (IBNR), the majority in all reasonable circumstances and in accordance with law.
of which are picked up, as they are notified to us, by the The MDU understands this undertaking has been honoured
insurance policy held by most paying members. The MDU to date.
remains the only UK medical defence organisation which gives
its members the added security of insurance coupled with the The MDU continues to assist with some cases in Ireland and as
advantages of discretion for claims outside the insurance policy detailed in the Financial Review below, made significant
and for all other medico-legal matters. payments of £4.8m (2007: £7.6m) on behalf of members and
During the year further enhancements to services to members
former members in Ireland.
were made.
The Board knows how important it is that members’ calls are
Business Review
answered as quickly as possible and that you get a swift Strategy
response to your letters. We made a significant investment in
The company’s objective is to provide the highest quality of
our membership department to improve the service we
medico-legal support to members at the lowest cost compatible
provide when you contact us. We have increased managerial
with financial security. We do this by providing members with
and staff numbers leading to improved telephone answering
specialist advice from doctors, dentists, lawyers and other
times and more rapid turnaround for correspondence.
professionals who combine an understanding of the realities of
The marketing department has reviewed methods of
clinical practice with medico-legal expertise, and through the
communication with members, leading to new publications for
provision of insurance policies provided by regulated insurers.
practice managers, GP registrars, doctors in the training grades,
As a mutual organisation, fairness and quality are essential to
and for consultants. There are now more GP liaison managers
our reputation.
available to visit GP members in practice. They provide more
free training seminars, which are highly sought after and well
Principal risks and uncertainties
received. Enhancements continue to be made to our GP group
The key challenge for the MDU is to maintain and improve its
schemes. One such change gives group scheme members access
position in the competitive market in which it operates. The
to an employment helpline, which has been well used and has
MDU monitors the market carefully, aiming to provide its
proved very helpful.
members with the highest quality of service for their
The MDU awaits proposals, by the GMC and GDC, regarding
professional needs at a competitive cost, while ensuring
adequate and appropriate forms of indemnity for both
enough subscription income to meet future liabilities.
medical and dental practitioners. The GDC, at the time of
The medico-legal environment is ever changing and the MDU
writing, has embarked upon a period of public consultation.
monitors developments closely, making representations to
It remains your Board’s view that insurance offers the best
protect members’ interests, when appropriate.
guarantee of indemnity for patients and practitioners.
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