The way in which the medical profession is regulated in future will be radically changed if the provisions of a new Bill published yesterday are enacted into law. The Bill also proposes stronger sanctions for those found guilty of misconduct.
Under the Medical Practitioners Bill 2007 the majority of the Medical Council's 25 members will be lay people. There will be 12 doctors and 13 lay people on the council.
Some of the lay people are likely to be representatives of patient groups, but there will also be representatives of the nursing profession, the Health Service Executive, a representative of the Health Information and Quality Authority, a representative of the Independent Hospitals Association of Ireland and a representative of the Health and Social Care Professionals Council.
There will also be an individual nominated by the Minister for Education. Five lay people will be nominated by the Minister for Health.
Until now, the majority of the council's members have been doctors and the medical profession wanted this to continue.
Furthermore, under the new Bill, which will be debated in the Dáil next month and which Minister for Health Mary Harney expects to be law by April, the majority of those on the Medical Council's fitness to practise committee will be lay people.
In addition there will be provision for the first time for fitness to practise inquiries into the behaviour of doctors to be held in public.
The Bill states that fitness to practise inquiries will generally be held in public but that they may be held in private if either the doctor being inquired into or the complainant apply to have them held in private.
If an application is made for an inquiry to be held in private, the fitness to practise committee will decide whether it is in the public interest to accede to the request.
Ms Harney said she did not accept that it was therefore likely most inquiries would be held in private.
"The doctor can make an application but the committee might not accede. I think they will normally be in public . . . remember it will be a lay majority on the fitness to practise committee and I think that committee will have a huge responsibility to make a fair decision in each case," she said.
The sanctions which can be imposed on doctors found guilty of professional misconduct are also greater.
They can now face not just censure, but censure plus a fine of up to €5,000.
The Bill also provides for the council to refer complaints initially to a new preliminary proceedings committee.
This committee may decide the complaint is more appropriately dealt with through mediation or by the HSE rather than by the fitness to practise committee.
Ms Harney said the most fundamental change was the fact that the Bill required doctors to continue to be involved in lifelong education and training to keep up to date and to remain on the register.
"I think that is the huge change from the patient safety perspective," she said, adding that this was among the recommendations of the Lourdes Hospital Inquiry report.
The Medical Council will get State funding to enable it oversee this new system of competence assurance.
The Bill provides for information disclosed as part of a professional competence scheme to remain confidential.
It also says unlawful disclosure of this information could incur a fine of up to €5,000 and/or imprisonment for six months.
Also under the Bill, the Medical Council may investigate any case of an individual who is not registered but is suspected of practising medicine or of claiming to be a registered medical practitioner.
It will be an offence to represent oneself falsely as a registered doctor.
The maximum fine for this offence on summary conviction is €5,000 and/or six months' imprisonment.
The maximum fine on indictment for a first offence is €130,000 and/or five years' imprisonment.
The Bill also provides for the minister for health of the day to give general policy directions to the council, but the minister will not be able to interfere in fitness to practise inquiries.