Regulating doctors - Strong medicine for sick system

ARCHAIC, dysfunctional and legally confrontational. Those damning terms come from Medical Council president Dr John Hillery who used them at a conference yesterday to describe the unworkable system for regulating doctors in Ireland.

Following the scathing report on the activities of rogue obstetrician Dr Michael Neary at Lourdes Hospital in Drogheda, the conference on competence assurance for doctors could not be more timely. As Dr Hillery succinctly put it, the medical profession in this country is at a watershed.

In a dramatic twist, the attitudes and policies of the profession are under the microscope in a root and branch examination of how the system works and especially how it relates to patients.

In a welcome sign of the times, the Medical Council is investigating a number of consultants who gave Dr Neary the all-clear, although he had carried out unnecessary Caesarean hysterectomies on a number of women.

A probe into the modus operandi of the consultants, who produced glowing accounts of Dr Neary’s work, was initiated following Judge Maureen Harding Clark’s damning report. She condemned, in the strongest terms, what went unchecked for years at the hospital where Dr Neary, since then struck off the register, inflicted a programme of sterilisation on more than 100 women, one of whom was only 19.

Underlining the urgency for regulatory reform of the medical profession, Judge Harding Clark’s grave findings and far-reaching recommendations set in motion an unstoppable drive for the Medical Practitioners Act to be radically overhauled.

It is absolutely crucial to ensure such an outrage can never happen again. In a significant step towards this objective, Health Minister Mary Harney has committed the Government to speedily bringing in new legislation to replace the 30-year-old act.

Under the new system, the interests of patients must be paramount. As Dr Hillery pointed out “the reassurance patients need at this time of damaged trust will not be delivered without a modern, properly resourced regulatory structure”.

He believes this can best be achieved through a proper system of self-regulation and holds that the existing system of ensuring the competency of doctors is fails because it was designed to fail.

As he sees it, doctors are more conscious of becoming immersed in legal battles, to deal with damage done, rather than being part of a proactive system geared to actively promote better standards within the profession.

As for the Medical Council, the profession’s regulatory body, the Lourdes Inquiry has irrevocably changed the context in which Irish doctors work and its findings are a wake-up call for doctors nationwide.

The 25-member council’s primary role is to protect patients in their interactions with registered medical practitioners. Any doubts about the need to overhaul the system have been dispelled by the Neary scandal.

The council is seeking a self-regulatory system. However, as underlined by Dr Hillery, any such system must be to the advantage of the patient and include major input from non-doctors.

Doctors who don’t recognise the need for change must wake up or be left out of a crucial debate on the profession’s future role.

The challenge facing Ms Harney is to ensure that the new regulatory measures are sufficient to drag the medical profession into the 21st century and don’t make a bad situation worse.