The Irish Medical Organisation has expressed disquiet about plans by the Medical Council to assess the performance of doctors on a voluntary basis. It has argued that there is no evidence to suggest the quality of care here is below international standards. That is missing the point.
International experience suggests that between 3 and 5 per cent of medical practitioners may be providing an unsatisfactory service to their patients and may require help or retraining. In extreme cases, they may have to be removed from practice.
The proposed audit is as much about protecting patients as it is about helping doctors. And while nobody enjoys having the quality of their work assessed, an audit is sometimes necessary, particularly within a self-regulating profession. It should operate to the long-term benefit of the medical profession and improve patient relationships. Doctors are, quite properly, held in high regard in this society. But public confidence is a fragile commodity. And it can be undermined if bad medical practice goes unacknowledged and unpunished.
Change is coming to the medical profession. And some would argue that it is not before time. At the moment, professional standards are applied under the Medical Practitioners Act of 1978 which, as the president of the Medical Council, Dr John Hillery, acknowledges, is archaic, inflexible and inadequate. Complaints are investigated and processed on a legal, adversarial basis and a prima facie case has to be established before a doctor can be called to account. Because of that, up to 90 per cent of complaints are dismissed without a formal hearing. And the Medical Council is unable to intervene at an early stage in order to prevent the development of more serious problems.
A new Bill, to be published later this year, is expected to preserve the privilege of self-regulation for doctors but offer increased flexibility in dealing with the complaints of patients, encourage greater transparency and introduce outside experience to the Medical Council. In the meantime, the council proposes to establish a performance committee that will choose 1,000 members on a random basis each year and review their work. There are about 10,000 medical practitioners and the level of voluntary participation in the audit will be crucial.
High-profile medical cases, ranging from sexual assault to generating unrealistic expectations of a cure, have caused public concern. A report into the outrageous activities of Michael Neary at Our Lady of Lourdes Hospital in Drogheda is due to be published this week. Reform is urgently required. If the medical profession resists change, it should be forced upon it.