The unprofessional behaviour of Dr Paschal Carmody and the questionable activities of Mr William Porter in their promotion of the healing qualities of photodynamic therapy (PDT) for people who are terminally ill have been well documented in this newspaper. Dr Carmody, whom the Medical Council subsequently found guilty of professional misconduct and struck off the medical register, ran a general medical practice in Co Clare. Both he and Mr Porter, an American doctor who is not registered to practise medicine in the Republic, promoted the "benefits" of PDT in the treatment of a wide range of cancers.
The Medical Council - which met again this week to consider further complaints against Dr Carmody - is the statutory body charged with maintaining standards in medical practice. One of its key functions is to assess an individual doctor's fitness to practise and to investigate allegations of professional misconduct. However, it continues to operate under the 1978 Medical Practitioners Act, a 26-year-old piece of legislation that is no longer sufficient to protect the public. Medical Council president, Dr John Hillery, said recently that Dr Carmody should not have been in practice, and added: "under the current Medical Practitioners Act, we cannot reach out to individuals like him". In other words, where doctors become concerned about the activities of a medical colleague, there is no mechanism for the council to initiate an on-site assessment of that person's practice. Another gaping hole in the 1978 Act is the absence of a definition of "the practice of medicine". The value of such a definition goes beyond that of regulating doctors; it would make it more difficult for individuals to offer highly questionable treatments such as the use of PDT in terminal cancer.
Alternative health practitioners must also be regulated in tandem with a new Medical Practitioners Act. And while it would not be right to outlaw specific alternative practices, well crafted and complementary legislation covering both conventional and alternative medicine would ensure an enhanced level of public protection.
Following the publication last autumn of the Medical Council's fitness to practise report into obstetrician Michael Neary, the Minister for Health stated that the heads of a new bill would be published within weeks. He made a similar promise in the spring. To shore up the current legislation, his Department said earlier this week that he had signed a statutory instrument preventing unregistered doctors working here. But yesterday it said he had not done so.
The question must be asked: how many scandals need to be uncovered before the Minister delivers a new Medical Practitioners Act?