New plans by the Medical Council to randomly audit the practices of up to 1,000 doctors a year have been met with scepticism in some medical circles.
Dr Martin Daly, chairman of the Irish Medical Organisation's GP committee, said he believed the medical council, in an effort to bolster public confidence in the system of self-regulation of the profession, had possibly overreacted.
"This is a sledgehammer to crack a nut because there is no evidence to show that the quality of Irish medicine as delivered by individual doctors is in any way below the expected international standard," he added.
Under the new plan the council hopes to audit the practices of a cross-section of doctors every year. These will include GPs, hospital consultants and public health doctors. Around 10,000 doctors will be eligible to be audited.
Going on international experience, the council says it expects the audits will show "low-level" concerns in about 300 to 500 cases a year and "high-level" concerns in about 50 cases a year.
Low-level concerns would include personality issues or not responding to a call, according to the council's director of competence assurance, Dr Lynda Sisson.
High-level concerns would include reports of a doctor having a drink or drug problem or having a high level of complications among patients.
Questionnaires will be sent to the medical and non-medical colleagues of doctors being audited as well as their patients. These would be kept confidential and would never be released under the Freedom of Information Act, council president Dr John Hillery said.
The questionnaires will be assessed by a committee, and a summary of the findings will be sent to the doctor and the Medical Council.
If concerns are raised they will be dealt with by a performance committee of the Medical Council chaired by a non-medic. Actions which could be taken on concerns raised would include interviewing the doctor, assessing performance over a number of days, referring the doctor for counselling or retraining or, in the case of serious concerns, referring them to the council's fitness-to-practise committee.
Taking part in the audits, due to begin in the summer, will be voluntary. Dr Hillery said he hoped the audits could be made mandatory under the new Medical Practitioners Act, due later this year.
Dr Daly said making audits mandatory would "produce a siege mentality amongst the profession, many of whom already feel under a lot of pressure from very high expectations, both from politicians, citizens and the media".
He also said he could see individual doctors mounting legal challenges against the process if they were being coerced into taking part. The IMO, he added, would be seeking clarification from the Medical Council of its plans.
However, the Irish Hospital Consultants' Association welcomed the planned audits. "We see it as a good thing and a way of maintaining public confidence in the profession," secretary general Finbarr Fitzpatrick said.
Dr Seán Murphy, a consultant at Mullingar Hospital, said: "I would say, in general, a system that promotes an open relationship between the medical profession and the public is a good thing."