Second Opinion: Medical council’s effectiveness depends on the work of others within the health system

Later this week, the Medical Council will publish its Annual Report for 2012 which will reflect another busy and challenging year for the organisation. It will also publish the term report of this council which ends after five years. The regulatory landscape both in Ireland and worldwide has changed much over the course of this council's term of office.

Best practice internationally is moving to "right touch regulation", a term coined by the head of the UK's Professional Standards Authority, which advocates an approach that is proportionate, consistent, targeted, transparent and accountable. The council's role has changed immensely in recent years and our work has focused on being true to such values.

Not least among the noteworthy elements of the five years was that the Irish Medical Council became the first in the world to comprise a majority of non-medical members.

In 2008, for the first time, the Medical Council had a majority of non-medical members. The concerns raised in advance of the introduction of a lay majority have not been realised and I believe that the council is strengthened by their involvement.

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The role of the Medical Council is to protect the public by ensuring the highest professional standards by doctors. It is right that the public interest should form the majority on health regulatory bodies, including the Medical Council.

Finding the "right touch" has involved putting patients first, while sometimes making decisions which have been difficult for the profession.

Big change
For many, the big change during this Medical Council has been the introduction of public fitness to practise inquiries and the attendant media coverage.

While some would prefer for such processes to be carried out behind closed doors, this change has undoubtedly increased transparency in the handling of complaints while media reporting has provided an educational value for both patients and doctors in underlining the standards of care patients should expect from their doctor. It has also ensured that the council is held to account to a greater degree as our response to complaints is subject to increased scrutiny. Doctors now have a legal obligation to keep their knowledge and skills up to date to ensure a continuing commitment to the safety of patients.

Last year was the first full year of legally obliged professional competence activities. This is a tremendously important part of the changes for the Irish medical profession and a key to future patient safety. This system is in its infancy, but its development in the coming years will allow for a targeted approach to addressing areas of risk among the profession.


International standards
New standards for the education and training of doctors in Ireland have been established which benchmark favourably against the highest standards internationally. We know that doctors who display unprofessional behaviour at medical school are more likely to continue to demonstrate such behaviour throughout their careers, so it's been an area of focus for the council to ensure that the standards we set at undergraduate level are laying the foundations for lifelong good and safe practice.

The council’s effectiveness is contingent on the work of others within the health system. While we are an independent statutory organisation, our ability to ensure the continuing safety of patients would be significantly restricted without close collaboration with the wider health service.

Over the course of the council's term, we have agreed memoranda of understanding with the HSE, Pharmaceutical Society of Ireland, Irish Medicines Board and Hiqa.

Knowledge and information sharing is something that all healthcare organisations must continue to improve on to streamline processes and improve care.

While historically, many organisations have valued independence above all else, vested interests benefit no one in the long term, and organisations must ensure a cohesive, collaborative approach to do what is best for patients.

The greatest challenge for the next council will be to ensure that the public interest remains at the forefront of all decision making. Guided by the public interest and working with doctors and other stakeholders, it will consolidate a health system which prioritises patient safety above all other concerns.


Prof Kieran Murphy is a psychiatrist and has been President of the Medical Council since 2008. He steps down this year.