The Tánaiste and Minister for Health, Mary Harney, has failed to shake the cosy complacency of the medical profession or to introduce sufficiently robust investigative procedures in her draft Medical Practitioners Bill.
A new Medical Council will be dominated by medical professionals, along with two of its three major investigative committees. Only the Fitness to Practise committee will contain a majority of lay persons and they will become involved only after a preliminary investigation has been held by medical people. Provision is also made for patient complaints about professional conduct to be heard in public, but that will not happen if either of the parties objects.
It would seem the medical profession has again dictated the nature and extent of reforms to the Government, in spite of the scandal at Our Lady of Lourdes Hospital in Drogheda where unnecessary hysterectomies were conducted on at least 60 unfortunate women by Michael Neary over a twenty-four year period. Three separate inspections by professional medical bodies failed to identify and deal with that situation. A report by Judge Maureen Harding Clark into those events led the Tánaiste to promise the introduction of regular audits of the work of doctors, along with a requirement that they should undergo further training during their careers. At the moment, a voluntary scheme - which is being resisted by some doctors - is in operation. But, the draft legislation leaves it up to the new Medical Council to establish the formal terms of such a scheme and to operate it, following consultation with the Minister.
There are positive aspects to the draft legislation, which includes measures first published by the former minister for health, Micheál Martin, two years ago. The powers of the council to police its members will be increased. A greater number of lay persons will be appointed to it. Investigations will be speeded up. And unregistered medical charlatans, who set themselves up as experts in the treatment of various diseases, can be prosecuted. Professional standards are currently being applied under the 1978 Medical Practitioners Act, which has been described as "archaic, inflexible and inadequate" by the president of the Medical Council, John Hillery.
Given such administrative neglect and the entrenched positions traditionally adopted by medical professionals, we should not be particularly surprised when Ireland is rated in twenty-fifth place, in Europe, in the quality of healthcare provided to citizens. Reforms should have been introduced years ago. But the medical profession fiercely resisted change and the introduction of regulation by an independent, outside agency. Ms Harney has made some progress. She spoke of enacting the Bill as soon as possible. But, because of pressure from other legislation - and with a general election due next year - this rather anaemic measure could well die with the Government.