Medical Council appeals dismissal of PPP finding against paediatrician

An appeal with important implications for the regulation of the medical and healthcare professions has opened at the Supreme Court.

The five-judge court is being asked to define the proper meaning of "poor professional performance" (PPP) in the 2007 Medical Practitioners Act. It is part of the Medical Council's appeal against the dismissal of a poor professional performance finding against consultant paediatrician Prof Martin Corbally.

Procedure

The Medical Council’s fitness to practise committee made that finding arising from an admitted error in Dr Corbally’s notes concerning the required procedure for a girl (2), then a private patient of his at Our Lady’s hospital Crumlin.

She required an upper labial frenulum but an incorrect tongue tie procedure was carried out by another doctor to whom Dr Corbally delegated the child’s surgery after being called to emergency surgery. Dr Corbally carried out corrective surgery shortly afterwards and the child made a full recovery.

In overturning the finding of poor professional performance and a sanction of admonishment, president of the High Court Mr Justice Nicholas Kearns found the error arose from a systems failure at the hospital for which Dr Corbally was not responsible.

Because the 2007 Act allowed for no appeal against a sanction imposed for PPP, it was appropriate to read the Act as requiring that a single lapse or offence must be “serious”, he said.

This error was not very serious, made no real contribution to the eventual procedure carried out and a non-causative lapse must be seen as less serious than one which causes damage.

The “real problem” lay with hospital systems which did not allow for Dr Corbally’s detailed and correct description of the required procedure on the child’s admission card to be properly transcribed, the judge said.

Meaning of PPP

His judgment involved the first ever court interpretation of the meaning of PPP in the 2007 Act. In its appeal, the council argues his decision means a finding of PPP must be based on assessment of a fair sample of a doctor’s work and cannot be based on a not very serious once-off incident.

The council previously told the Supreme Court many cases where PPP is alleged are based on a single incident and, if the High Court decision was upheld, that would effectively mean no inquiries into allegations of PPP. It said this would have very significant effects for regulation of 18,000 doctors here, plus nurses, midwives and pharmacists.

Opening the appeal, Eoin McCullough SC, for the council, said the first issue the court must address is of general public importance, the proper meaning of poor professional performance . The second issue was whether Prof Corbally was properly found to have displayed poor professional performance by the fitness-to-practise committee .

It is "very important", not just for the Medical Council but also other bodies, to know the exact meaning of PPP, counsel said.

Counsel argued the High Court wrongly read two additional requirements into the definition of PPP, that the matter complained of must be very serious and must be assessed across a fair sample of the doctor’s work. Neither of those is a requirement of the law, he submitted.

The appeal continues.