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Dáil Éireann debate -
Tuesday, 5 Dec 1995

Vol. 459 No. 3

Ceisteanna—Questions. Oral Answers. - Allegations Against Medical Practitioners.

Máire Geoghegan-Quinn

Question:

18 Mrs. Geoghegan-Quinn asked the Minister for Health the response and inquiry system that is operated by health boards and his Department in relation to reports regarding medical practitioners in view of the recent allegations against doctors; and the plans, if any, there are for changes to the Medical Practitioners legislation. [18152/95]

(Limerick East): The procedures to be used to investigate complaints or allegations against medical practitioners vary according to the category of doctor involved. In the case of medical practitioners, other than medical consultants, who are employees of a health board, sections 22, 23 and 24 of the Health Act, 1970 apply. In the case of medical consultants, the disciplinary and complaints procedures attaching to their contracts, in addition to sections 22, 23 and 24 of the Health Act, 1970 apply. In the case of medical practitioners who are participating in the general medical services scheme, paragraphs 30, 31 and 32 of the agreement for the provision of services apply.

In addition to the above, the Medical Council has statutory responsibility which it exercises through its fitness to practice committee to inquire into the conduct of a registered medical practitioner, whether he or she is an employee of a health board or otherwise, on the grounds of alleged professional misconduct or on the grounds of unfitness to practice by reason of physical or mental disability. Where the questions of fitness to practice of a registered medical practitioner arises, it is statutorily therefore a matter for the Medical Council to investigate. I might add that where allegations of a criminal offence are made against a registered medical practitioner, this is a matter for the Garda and the appropriate prosecuting authority.

The Medical Practitioners Act, 1978 has now been in force for almost two decades. An examination of the operation of the Act has revealed the need for substantial amendment of several of its provisions. As indicated in reply to previous parliamentary questions, I hope to circulate the heads of the new legislation to my colleagues in the Government for their observations in the near future. A Bill to amend the 1978 Act will be published shortly thereafter.

I have had copies of these various provisions made available to the Deputy.

As regards the case in Drogheda and the one in Cork when were complaints made and to whom?

(Limerick East): I understand both cases are the subject of investigation by the Garda. I will not put information on the record of the House relying solely on memory because it might be prejudicial to the interests of individuals. If the Deputy tables specific questions on the two cases I will reply to them.

I regret the Minister does not have the information on file. Any Minister reading my question would realise that the two most recent outstanding cases were those in Drogheda and Cork. In the normal course of events, to whom is a complaint made and what happens when it is made?

(Limerick East): The Deputy tabled a general question. She asked about procedures. If it had been indicated that the question would deal with specific cases I would have had the information to hand. If the Deputy tables such questions I will answer them. Sometimes complaints are made to the Garda, or to the hospital authority or a health board. We do not have a high incidence of complaints of alleged criminal offences committed by doctors.

What arrangements are in place to ensure that when a complaint is made to one authority it communicates the complaint and whatever statements are made to the Garda? Does that happen immediately? Is there such a provision? What procedures are in place to prevent somebody against whom such a complaint is made from leaving the jurisdiction?

(Limerick East): If there is a criminal offence certain obligations arise but if it is a question of unfitness to practice as a result of mental or physical disability the procedures are different. As regards somebody leaving the jurisdiction when they are the subject of investigation, the same procedure would apply as applies to anyone who is the subject of a Garda investigation.

In the case of a complaint of unfitness to practice where there is suspected criminality, is there a procedure whereby that complaint is communicated to the Garda? If such an individual has left the jurisdiction is there anything to prevent this jurisdiction requesting his or her extradition to this State?

(Limerick East): Extradition could be sought in the normal way. However, it would depend on the offence and on the extradition arrangements with the other country. Cases of unfitness to practice are frequently due to mental or physical disability and would be adjudicated on by the Medical Council as it is the body with statutory responsibility for such issues. If it were a criminal offence there would be a parallel approach. The Garda would conduct a criminal investigation and the Medical Council would adjudicate on whether the person is fit to practice regardless of the outcome of the Garda investigation.

We have devoted more than half the time available to these two questions, the Deputy must be brief.

I appreciate that. Does the Minister agree that it is time to set down clear guidelines on how these matters should be dealt with in each health board area? I know the Minister shares public concern in regard to recent cases in the North Eastern Health Board and the Southern Health Board areas. Such guidelines would help allay that concern.

(Limerick East): There are procedures laid down under different sections of the Health Acts and under the contracts with consultants and medical practitioners. It is time to update the Medical Practitioners Act, 1978. As regards guidelines it depends on the incident which leads a party to believe that a medical practitioner is unfit to practice. In the case of child sexual abuse the Minister of State, Deputy Currie, is proceeding to establish guidelines, for example, reporting to the Garda, and so on. We have commenced an overview in the Department to ensure that there are standardised and easily understood procedures in place in areas where health services are delivered. Medical practitioners are one group of professional services providers but we must focus more widely than that as there are many service providers who would have contact with children both in care and living at home.

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