The ethical accountability of all doctors registered in the State is to the Medical Council, which is essentially constituted to function as a watchdog of medical standards on behalf of the public. No doctor is ethically accountable to another doctor.
In relation to medical management accountability, the appointment of a director of prison medical services in 1990, which was a newly created position at that time, did not focus on clearly defining the accountability of existing prison doctors to this new medical manager. While this omission is understandable, given the difficulties that occurred in recruiting a suitably qualified doctor to the position, it is clearly time to revisit the relationship between the medical director and the medical practitioners in the prisons.
As a first step, I have asked the director of prison medical services to review his role and make a submission to me on the matter. Among the aims of the proposed common contract for prison doctors, which has been under negotiation with the IMO for some time, is to more clearly define the line management responsibilities of prison doctors to both prison governors and to the director of prison medical services.