Madam, - The Minister for Health and Children, Mr Martin, says (July 9th) that the Medical Council's disciplinary enquiries are perceived as being "far too secretive and held behind closed doors".
In December 1997, Mr Justice Barrington delivered a Supreme Court judgment in which he discussed the Medical Practitioners Act 1978 and relevant Constitutional and European law proceedings on public inquiries. In his judgment, he said that discretion to hold public inquiries was open to the Fitness to Practise Committee "if all parties were agreed and if the committee itself thought it was the proper thing to do".
This judgment requires agreement on whether an inquiry is held in public by the doctor who is the subject of the inquiry. Almost invariably, doctors and their legal representatives at an inquiry choose to have the hearing in private. The Fitness to Practise Committee then has no powers to insist on a public hearing. The registrar's legal team (who bring the case against the registered medical practitioner) has never opposed a decision by the Fitness to Practise Committee to hold a hearing in public.
The Medical Council has long advocated public hearings of certain disciplinary inquiries - clearly, the interests of patients must be protected in some situations by insisting on private hearings. Council has sought public hearings through the courts and through appeals to successive Ministers for Health for legislative reform.
The courts must interpret the existing primary legislation, constitutional imperatives and case law in adjudicating on public hearings.
Mr Justice Barrington's judgment reflects these factors and, in particular, the serious limitations of the primary legislation.
For more than a decade, the Medical Council has sought changes in the Medical Practitioners Act to deal with this issue and others of real concern in order to ensure that the interests of the public are well protected when dealing with registered medical practitioners. To date, these requests have fallen on deaf ears. Amendments to the 1978 legislation have occurred, but only in administrative areas.
The announcement by Mr Martin on Friday last that the Cabinet has approved the draft heads of a new Medical Practitioners Bill, first circulated in December 2003, is welcome. However, if Mr Martin believes that the Medical Council's procedures are "far too secretive", then he and his political colleagues who have refused to act on the basis of repeated requests for change must shoulder the responsibility for this inadequacy. - Yours, etc.,
Prof GERARD BURY, Department of General Practice, University College, Dublin.