Medical accountability - Suspended doctors free to practise

BEFORE the Medical Council can notify either the Minister for Health or an employer that a doctor is under investigation or even suspended, a fitness to practise inquiry must have been held and its negative finding must have been upheld by the High Court.

This is in line with the concept of justice that presumes everyone is innocent until proven guilty.

But it makes absolutely no sense that a doctor who is under suspension, on the grounds of being a possible threat to the public, can go elsewhere and practise there, while the Medical Practitioners Act 2007 proscribes those who suspended the doctor from notifying the new employers of this suspension.

Surely the first priority should be the safety of patients. If there are grounds for suspending a doctor, the authorities responsible should be allowed to notify health authorities in another area, and there should also be an obligation on the doctor to notify potential employers.

Some flaws have been exposed in the system of hiring locums, where inadequate checks were made into the backgrounds of those hired. The case of a doctor, who served as locum in the Kilkenny area in 2000, raised the most serious questions.

He was hired after he had been suspended from the medical register in Britain pending a full investigation of allegations against him. He was the only applicant for the position of locum in psychiatric hospitals in Clonmel and Kilkenny, so he was offered the job without an interview.

In 1986 he had been “admonished in the strongest terms” by the General Medical Council in Britain.

A case at Tralee General Hospital involved a locum who misdiagnosed a patient suffering from cancer. But people should not be unduly critical of the doctor, because this was just one case and it was well within the margin of error for a pathologist.

It would be grossly unfair to blame the doctor in that instance, because the overall system was at fault. That is a prime example of the need for centres of excellence to be in place — in order to minimise such errors, because diagnosing cancer, especially in the early stages, is very uncertain.

The best that can be achieved is to be right about 95% of the time. This is only achieved by having experts repeatedly check the different diagnoses in search of errors. We need to recognise the difficulties and uncertainties involved in order to rectify the current crisis surrounding misdiagnoses.