The last time I wrote about the proposed changes in the policing of the medical profession I was accused by the Irish Hospital Consultants' Association of having "an intense dislike of doctors". This was from Donal Duffy, of the IHCA, writing to this newspaper last month. It is a good old debating trick - deflect the argument by imputing motives of personal malice, writes Mary Raftery
I must hasten to reassure the IHCA that, far from disliking doctors, I - in common with everyone else - have good reason to be grateful to them for curing my own and my family's ills. However, none of that has any bearing on the fact that many of the consultants' objections to the new Medical Practitioners Bill are plain daft.
The IHCA last week produced its response to the proposed legislation. It focused on the powers of the Minister for Health to appoint the members of the new Medical Council (the body which regulates the profession) and to fire them or even dismiss the entire council. It also condemned the authority of the Minister to give general policy directions to the council.
These are described as "extraordinary powers" and the IHCA warns darkly that they fly in the face of the Hippocratic oath and interfere in the doctor/patient relationship.
However, what is thoroughly bizarre about the consultants' objections to these provisions is that they do not appear to have noticed that none of them is new. These "extraordinary powers" they complain of are all contained in the old Medical Practitioners Act, 1978, and have never previously incurred the wrath of the IHCA.
There are some slight differences in wording. The consultants object to the power of the Minister in future to appoint the 25 members of the council. However, it is clearly specified in the new Bill that she must appoint a range of individuals either elected or nominated by particular bodies. This is almost identical to the mechanism defined by the 1978 Act, which stated that "the Minister shall take all steps necessary to secure the appointment of members" who have been either elected or nominated by specified organisations.
As to the Minister's power to remove the council from office, this has always existed. It has never arisen, and can only occur both in the 1978 Act and in the new Bill in a particular circumstance where the council is derelict in its duty. For the past three decades it has been regarded as a normal and uncontroversial provision.
As far as the Minister's new power to give "general policy directions" goes, it is specified that these refer only to "the performance by the council of its functions". Of far greater significance is the provision which allows the Minister to assign additional functions to the council, but this also is not remotely new. It was contained in identical form in the 1978 Act.
There are essentially only two explanations for the strikingly spurious nature of the consultants' assault on the new Medical Practitioners Bill. The first is that they failed to notice that they have lived happily for almost 30 years with legal provisions to which they are now taking such exception. However, it is far more likely that their bluster is a calculated tactic to pressurise the Minister for Health to appoint a majority of medics to the new council. For their own reasons of political advantage, the consultants have represented the new Bill as something in the nature of a takeover of the profession by lay people.
In reality, it is no such thing. A minimum of 12 of the 25 members will be doctors. Given the complex basis of appointments, it is perfectly possible that, in fact, up to two-thirds of the members will be medical professionals. The final decision on this will lie with the Minister for Health. It is likely that the essentially meaningless sound and fury emanating from the IHCA is nothing more than a jockeying for position to maintain self-regulation for doctors.
They lay great emphasis on their own competence to regulate themselves, something which was not in evidence when it came to the barbaric practices of Michael Neary, who needlessly cut the wombs out of dozens of women in Drogheda. It is worth remembering that while the Medical Council did eventually strike him off, no fewer than six of his fellow doctors had previously certified that he was perfectly fit to continue working as an obstetrician.
The IHCA does, however, have a point when it questions the ability of lay people to assess complaints against doctors. There is no particular reason to suppose that the simple fact of being a non-doctor uniquely qualifies anyone for such adjudication.
It is a great shame that Mary Harney did not bite the bullet and put in place a fully professional and independent medical ombudsman's office, similar to that in New Zealand, specifically geared towards the investigation of complaints and potential medical scandals. It is only through such a mechanism that public faith can be properly restored in a profession that has lately taken such a battering.