Wexford GP accused of professional misconduct over tweets during covid pandemic

Dr Billy Ralph faces six separate counts of professional misconduct at a medical inquiry over comments he posted on Twitter (now X) between October 2020 and June 2022. Picture: Collins/Collins

A Wexford GP has been accused of professional misconduct over social media posts criticising measures and restrictions introduced by the health authorities during the covid-19 pandemic.

Dr Billy Ralph, who runs his own practice at The Ballagh Health Centre in Enniscorthy, faces six separate counts of professional misconduct at a medical inquiry over comments he posted on Twitter (now X) between October 2020 and June 2022.

They included a claim that various public health initiatives to contain the spread of covid-19 were “all bullshit".

The fitness-to-practise inquiry held by the Medical Council heard the allegations relate to tweets by Dr Ralph which were critical of the National Public Health Emergency Team (Nphet) and covid-19 vaccinations, particularly for children.

Other allegations relate to the GP’s promotion of ivermectin as a treatment for covid-19 and his opposition to facemasks and lockdowns as measures to restrict the spread of the virus.

Counsel for the Medical Council, Neasa Bird BL, claimed Dr Ralph made comments on social media which he knew or ought to have known were inappropriate and undermined public health guidelines.

Details of 34 individual tweets by Dr Ralph were outlined to the committee, including a post from November 2021 stating “some children watching the Toy Show tonight will receive the covid jab and will not see another Christmas” which he linked to “lies” by scientists, government, doctors, and RTÉ.

The inquiry heard that two months later, the GP described any parents who signed their child up for a “pointless and dangerous product” as “a vile individual,” while claiming any doctors administering the vaccine “should be brought before the courts if an adverse event occurs".

Other tweets included claims that Nphet was a “liability” which caused a “bigger second wave of cases by introducing masks, social distancing, and lockdowns". 

He separately claimed there was no pandemic but “just a lot of misguided fascist professionals who have lost the run of themselves". 

In November 2021, Dr Ralph suggested that ivermectin — a prescription medicine used to treat parasitic infections such as head lice — could “end this ‘pandemic’ as well as the careers of many doctors, academics and politicians".

GP's arguements

At the outset of the hearing on Tuesday, the GP welcomed clarification that the allegations against him related solely to social media posts and not to any clinical matter.

Dr Ralph argued that disagreeing with Nphet policy did not equate to falling short of the standards expected of medical practitioners, and claimed any allegation of harm or risk he had caused “must be clearly pleaded and proven".

The inquiry heard that Dr Ralph had told the Medical Council in correspondence that his social media posts and other longer publications were “no business” of theirs.

He said his Twitter account stated clearly that his comments were not medical advice and that HSE guidelines during the pandemic should be followed.

Dr Ralph said articles he had published on the Cassandra Voices website were critiques of “accepted wisdom” which in “any sane society would be valued” and not used as examples of “heresy.” 

He stated he would continue to write about what he considered injustices and consensus views “driven by undisclosed conflicts of interest” and anti-science thinking.

The GP said he would not be bullied into “forelock tugging submission” because of a mendacious complaint against him.

The inquiry was also informed that the number of followers of the GP’s Twitter account increased from 4,557 in June 2022 to 5,753 by August 2022.

He told the regulatory body that his practice had grown since April 2021 by 600 patients “fleeing from their previous GPs” — a figure which had subsequently increased to 900.

He stressed that he had given the covid-19 vaccine to all at-risk patients.

However, the GP said his views were always guided by science and “not dogma and scientism".

Dr Ralph told the Medical Council that he wanted the “charade” to be over and claimed he would happily expose its “petty censorship and bullying” in the High Court.

Medical Council's arguements

Ms Bird acknowledged that Dr Ralph had a constitutional right to freedom of expression which included questioning strategies adopted during the covid-19 pandemic.

However, she said it was not an absolute right and was one that is subject to public order and morality.

Ms Bird argued the timeframe of the social media posts by the GP was important and relevant as they were published during a global pandemic when the path of the virus could not be known and when its containment required significant public health interventions.

While she accepted that none of the allegations related to Dr Ralph’s clinical practice, Ms Bird said his tweets were “bound up” in his standing and conduct as a medical practitioner and that he relied on his knowledge as a GP in making such comments.

Mr Bird said the views of a doctor on such matters would also carry weight and influence, while noting that guidelines imposed a responsibility on GPs to use words that were appropriate and which did not undermine public health guidelines.

She also claimed that Twitter was not a forum for “complex discussions on matters of public health". Dr Ralph called on the inquiry committee to ensure that all tweets were read in context as some were responses to other posts, while others were “pouring water on flames".

The inquiry, which is scheduled to last three days, was adjourned and will resume on Thursday at 10am.