The president of the Medical Council has called on the Government to introduce legislation to make doctors legally obliged to report colleagues about whom they have concerns.
Dr John Hillery said he was concerned that doctors were not adhering to ethical guidelines obliging them to make known unusual behaviour of medical colleagues.
Speaking at the Church of Ireland Lenten lecture series in Rathfarnham last night, Dr Hillery said he shared the disbelief that the practices of obstetrician Dr Michael Neary could continue under the eyes of other doctors without any of them questioning what was happening or trying to stop it.
"There are issues of an ethical nature as regards our responsibilities to patients and our duties to the profession that need to be addressed immediately and with maximum honesty and force. Otherwise the trust that is the cornerstone of therapy and the patient relationship may vanish. That will be a disaster for the profession but also a damaging event for the public interest at large."
Dr Hillery said the council's guidelines set out two ethical imperatives for doctors: that doctors must maintain their competence and that if there is a concern about a colleague's competence, the council must be notified.
"I remain concerned that doctors still may not be addressing this issue thoroughly enough. Recent evidence in fitness to practise inquiries and anecdotal narrative suggests to me that despite the stated ethical responsibility, unusual behaviour in a colleague, though always a cause for concern, may still be responded to with uncertainty and procrastination by doctors."
He said the medical profession had to press for a "new beginning" in its self-regulation.
"This must include a hierarchy of interventions to ensure that all practising doctors are competent and manifesting that competence to peers and non-doctors through critical review.
"Most importantly, however, I think that the time has come for the statute governing doctors to make it obligatory to communicate to the Medical Council any concerns about a colleague so that robust and fair assessment procedures can be brought into play," Dr Hillery added.
Meanwhile a retired public sector computer specialist has maintained that a system scrapped by the government in the 1980s had the potential to identify anomalies in hospital services such as the high number of Caesarean hysterectomies carried out by Dr Neary at the obstetric unit at Our Lady of Lourdes's Hospital in Drogheda.
In a letter to The Irish Times, Derek Lambert said the Central Data Processing Service had worked on the development of a computer system for the Medico-Social Research Board which would maintain a database of records for everyone admitted to hospital, noting details of the consultant concerned, the diagnoses made and the treatments - including operations administered.
However, Mr Lambert said the Medico-Social Research Board was abolished in 1987 by the then minister for health, Barry Desmond.