‘Clear defects’ in hospitals’ approach to hiring junior doctors

The president of the High Court has said the Department of Health must urgently address the “clear defects” in the processes being used for recruiting junior doctors in hospitals nationwide.

The department "must get a grip" on this pattern of defects, which has implications for patient safety, "sooner rather than later", Mr Justice Peter Kelly said.

He made the comments after making orders striking off the medical register here a Pakistani doctor who worked in hospitals in Mullingar and Tallaght. The doctor was found to have forged three “glowing” references from consultants in those hospitals to help him get highly placed registrar positions in emergency medicine.

The judge separately struck off a Romanian doctor recruited by Dublin’s Rotunda Hospital as an anaesthetic registrar in late 2015 on foot of her 2002 qualification for anaesthesia in Romania.

Following an adverse outcome for a patient in the Rotunda, anaesthetic consultants became concerned and they administered a competency test to the doctor, normally applied to first-year trainee students in anaesthesia after their first 12 weeks, which she “spectacularly” failed, the judge noted.

These were not the first such cases before the court to expose defects in recruitment processes and he had previously drawn attention to those defects, he said.

‘Something seriously wrong’

The Department of Health must have a concern about the integrity of the recruitment process because it is “simply not fair” that patients going into hospitals cannot repose confidence in doctors, he said.

There is “something seriously wrong” if references are not validated, he said.

Noting there is a dispute whether a locum agency is required to verify the qualification of doctors on a hospital payroll as well as on the agency’s books, the judge said, when it comes to responsibility for checking references, there is no distinction between doctors.

If a hospital is going to use any doctor, they must verify their competency and references, he said.

Forging references

JP McDowell, solicitor for the Medical Council, who had asked the court to confirm the cancellation of both doctors' registrations, said the council shared the judge's concerns, was in talks with the HSE about the matter, and would ensure the court's concerns were drawn to the department's attention.

The first case before the judge on Monday concerned Dr Syed Basit Ahmed, a doctor from Pakistan with an address at College Hill, Mullingar.

He had worked in hospitals in Mullingar and Tallaght and the council sought to have him struck off after he was found guilty of professional misconduct following an inquiry of the council’s fitness-to-practise committee over forging three references in his favour in the names of three different consultants, one at Mullingar, and two at Tallaght hospital.

Dr Ahmed, who denied forgery, had not attended the inquiry.

The first reference was dated September 2013 and the other two were dated December 2016.

The forgeries came to light after Dr Ahmed applied to Letterkenny hospital for a position in 2017 and an “eagle-eyed” consultant there became suspicious about the terms of the references provided, the judge noted.

All three consultants told the fitness-to-practise committee inquiry they had not provided any reference.

All said they would have been prepared to give Dr Ahmed a reference but not in the “glowing” terms of the references at issue.

The committee found the misconduct was aggravated by Dr Ahmed’s denial he forged the references and his insistence his email containing the references was hacked into.

The second case concerned Dr Eunicia Ursu, of Timisoara, Timis, Romania, who was also found guilty of professional misconduct following a separate committee inquiry held arising from complaints made in July 2016 by three consultant anaesthetists at the Rotunda Hospital.

She did not attend the inquiry and is believed to be back in Romania.

The committee found she was guilty of poor professional performance in that, while employed as a registrar in anaesthetics at the Rotunda between January and July 2016, she failed to demonstrate sufficient skill and/or knowledge as would be expected from a registrar in anaesthetics.

It also found professional misconduct in that she, in applying for the position of registrar in anaesthetics in Cork University Hospital in September 2016, deliberately failed to refer to her period of employment at the Rotunda in circumstances where she knew, or should have known, she was unlikely to get any favourable reference from the Rotunda should it be contacted by CUH.

In his ruling on Monday, Mr Justice Kelly said he fully endorsed the views of the committee that both doctors should have their registrations cancelled for reasons including protection of the public.