OPINION:The new Medical Practitioners Act will help mend strained relations between the profession and patients, writes Dr Colm Quigley.
WITHIN A short time, Irish medicine will be regulated in new ways when a new Medical Council takes up office under the structures of the Medical Practitioners Act, 2007. As this legislation passed through the Oireachtas there was much debate on just one feature - that there would, for the first time, be a built-in non-medical majority on the Medical Council.
The outgoing Medical Council has been in place since 2004. It consists of 21 doctors and four non-medical members (often referred to as lay members). Ten members of the council were elected by the medical profession. The new Medical Council will have a medical minority, with 12 doctors on the council and 13 non-doctors making up the balance. The president and vice-president will be doctors.
Beneath all the rhetoric about the new Act, a central reality has been lost: the 2007 Act requires even greater participation of the medical profession for its effective working.
To every medical practitioner, it is a basic axiom that the good of our patient is our moral compass. The glue in this relationship is trust. That trust has taken a serious battering in Ireland in recent years.
It is the responsibility of doctors to restore that trust, for without it effective medicine is well nigh impossible. The political pressure to reform medical regulation had its roots in recent controversies.
We should note, though, that there has been no serious suggestion that these would have been prevented or responded to in a different way had the Medical Council been constituted any differently.
The really significant features of the new Act lie in how the medical profession will continually maintain the highest standards.
In the past, doctors graduated from medical schools and, beyond their own need to train to become competitive for future posts, there was no legal requirement on doctors to maintain their skills.
Just as importantly, there was no need to demonstrate this to their patients. Henceforth, it will be mandatory for all doctors to maintain their competence and undergo performance assessments over a five-year cycle in order to maintain their ability to practise medicine.
This process will be similar to what is happening in Australia, New Zealand, Canada, the US, the UK and gradually throughout the rest of Europe. Medical doctors will engage in peer review, audit and performance assessment, and will be required to record their involvement in these and related competence assurance activities. This will involve continued engagement and partnership with doctors, the professional training bodies and the profession at large.
We would expect somewhere between 80 and 120 doctors to be involved at any one time with council assessments and other matters. This engagement needs time - a resource in very short supply in the lives of most doctors.
The challenge for the medical profession is to engage actively with the new council, with the training and education bodies and with their medical colleagues to ensure that Irish medical practice is equal to or better than the standard elsewhere in the world.
The new council will only work effectively if doctors are trained and participate in the audit and regulatory processes. This is essential to ensure standards of Irish medical practice continue to improve.
While the council regulates doctors and the Health Information and Quality Authority regulates public premises, there remains a regulatory lacuna on the matter of private medical facilities.
The Commission on Patient Safety reports this summer and I hope the Minister for Health and Children will address this matter then. The Medical Council is entirely funded by doctors. It has invested in considerable resources, including the provision of new premises, to meet its responsibilities under the new Act. The State does not contribute in any way to the financing, apart from monies from the Department of Health for research projects.
Successive presidents of the council have asked for a new legislative framework to allow it to do its work effectively. The new Medical Practitioners Act is the belated but welcome response to that call. Every doctor knows that patients' trust is a necessary prerequisite for effective medicine. I believe the new Act will be seen by doctors and patients as a useful and practical bridge to restoring and strengthening that trust.
Many doctors understandably have concerns about the new Act. The challenge for the incoming council will be not only to have the trust of patients, but also the full co-operation and trust of the medical profession. I wish success for my successor and have every confidence the Medical Council taking up office will serve the public and Irish medicine well.
Dr Colm Quigley, FRCPI, is outgoing president of the Medical Council