Hospitals will have to ensure doctors have necessary skills

What determines a ‘fit and proper’ doctor will be part of new healthcare licensing system

The Irish Times reported last summer that a number of doctors working as consultants in public hospitals did not hold specialist qualifications. Photograph: Getty Images

Hospitals will in future have to determine that doctors practising in their facilities are “fit and proper” persons, and have the necessary skills and qualifications to carry out their work.

The Department of Health indicated that the definitions of a “fit and proper” person would be addressed in the months ahead in regulations that will form part of a planned healthcare licensing system.

All hospitals, public and private, as well as other health facilities providing high-risk clinical services will have to obtain a licence under reforms which are expected to come into effect in 2021.

The licensing system will be run by the Health Information and Quality Authority, which would have powers to close down health facilities where it believes it is necessary.


The department said the regulations would also clarify whether a condition of securing a licence would be that consultants working in hospitals would have to be registered as specialists in their field with the Medical Council.

The Irish Times reported last summer that a number of doctors working as consultants in public hospitals did not hold specialist qualifications.


The Cabinet was told last week that the new legislation on licensing, which is being introduced by Minster for Health Simon Harris, would require hospitals to ensure there was evidence that doctors practising in their facilities had the necessary qualifications, skills and experience and were “fit and proper” people.

The Irish Hospital Consultants Association told the Public Service Pay Commission in a submission in December that 81 doctors who were appointed to consultant roles in public hospitals since March 2008 do not hold specialist division registration with the Medical Council.

The association said that appointment of non-specialist doctors, who were not on the Medical Council’s specialist register, to consultant posts posed a safety risk to patients

“The appointment of doctors who are not on the specialist register to consultant posts has become extensive. It is now affecting posts in 13 specialities throughout 20 acute hospitals and 10 mental health service areas, based on most recent information received from the HSE,”it said.

Not acceptable

“The specialities impacted include obstetrics/gynaecology, general surgery, anaesthesia, several medical specialities, urology, orthopaedic surgery, radiology, emergency medicine, paediatrics and all four psychiatry specialities.”

The association says it is “not acceptable” that doctors who do not have the essential specialist training are “purporting to treat patients as consultants in our acute health services”.

The department said last week that the introduction of a system of licensing would ensure that all hospitals, public and private, were operating to appropriate standards and had the requisite governance arrangements in place to enable the delivery of the safest possible service.

Martin Wall

Martin Wall

Martin Wall is the former Washington Correspondent of The Irish Times. He was previously industry correspondent