Age definition of child sought by doctors at conference

Doctors have called on Government departments to establish a clear definition of a child for treatment in the health system.

A patient aged under 16 is classified as a child for medical treatment while the age threshold in mental health services is 18 years, the Irish Medical Organisation annual conference heard. In some hospitals, children cannot access paediatric services after the age of 14 years, according to delegates.

Under the Mental Health Act, patients are treated as children until the age of 18 (unless they are married), psychiatrist Dr Matthew Sadlier pointed out.

Mental health teams were often “vilified” for admitting “children” to units when the vast majority of patients involved were aged over 16 and would be treated as adults in other parts of the health system, he said.

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Clear guidelines were needed because of the "confusing" set of definitions in use. Doctors have called for radical changes to the Medical Council that would lead to disciplinary hearings against members of the profession being held in private.

The identity of doctors under investigation by the council should remain protected until such time as an adverse finding is made against them, according to a motion passed at the conference in Galway.

Fitness to practise

The motion says a “tiered” complaints process should be introduced so that complaints against doctors are categorised according to their level of severity. Fitness-to-practise hearings, mostly held in public at present, should in future be held in camera.

North Dublin GP Ray Walley said the current system of disciplinary hearings effectively treats doctors as guilty until proven innocent, in contravention of natural justice. Hostile media coverage of fitness-to-practise hearings were a factor in greater medical emigration and may be contributing to doctor suicides, he said.

Cathal Ó Súilleabháin described the experience of received notice of a complaint from the council as “incredibly stressful, even when you know the complaint is rubbish”. The pendulum had swung away from protecting doctors in recent years and change was needed.

Last year, the council received 411 complaints against doctors, the conference heard. Of the 155 complaints against GPs, 11 were sent forward to the fitness-to-practise hearing.

Oversight committee

Delegates also supported a motion calling for the creation of an oversight committee for the Medical Council, made up entirely of doctors to ensure it is delivering a cost-effective service. The council is funded by annual fees of registered doctors.

Proposing the motion, Matthew Sadlier questioned whether the council needed to have its offices in Dublin city centre and whether it was being run cost-effectively. It was unfair that doctors were the only group in society funding an organisation over which they had no control, he said.

Doctors also supported a call for the Department of Health to establish an independent regulator to ensure health-service managers are held "to the same level of regulatory oversight as doctors".

A doctor in a managerial role can be sanctioned for an error while a regular manager is not subject to any disciplinary process, the conference heard.