Judge says health board did not observe fair procedures

Dublin's South Western Area Health Board failed to observe fair procedures when it suspended without pay a consultant orthodontist…

Dublin's South Western Area Health Board failed to observe fair procedures when it suspended without pay a consultant orthodontist in charge of the development of orthodontic services for public patients in the Dublin region, the High Court ruled yesterday.

Mr Justice Kearns upheld a challenge by Dr Catherine McNamara, of Sandymount, Dublin, to her suspension on September 19th, 2000, for alleged misconduct.

The judge said he was dealing with the manner of the suspension only and not with its merits. He found Dr McNamara was entitled to but did not experience fair procedures in the circumstances of her suspension. He adjourned the case for mention to Monday.

The judge said the difficulties between Dr McNamara, who is attached to St James's Hospital, and the health board derived from the huge waiting lists in the Dublin area for orthodontic services. In 1996 some 18,000 patients were on the waiting list. Dr McNamara and her team of nine dentists cut this to 6,600 in 1999, but the figure rose to 11,000 in 2000.

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From 1998 onwards difficulties arose between Dr McNamara and the board over differing approaches to how the case load should be handled.

Dr McNamara was first suspended on November 4th, 1999, because she refused to work a system she considered unsafe. The board argued that suspension was justified because, it claimed, she had withdrawn consultant cover and refused to provide guidance to dental clinicians regarding procedures.

That suspension was lifted in January 2000 on the basis that Dr McNamara agreed to comply with specific duties attaching to her office. However, following her return to work, the same problems arose. She argued that she was being forced, with just two full-time and one part-time dentists, to manage an impossible workload.

The board claimed Dr McNamara failed to meet its requirements regarding treatment of patients, and a decision to suspend her without pay for alleged misconduct was taken by the CEO, Mr Pat Donnelly.

Mr Justice Kearns said it was difficult not to feel a measure of sympathy for both sides, confronted as they were with the relentless problems created by huge waiting lists of patients.

But an allegation of misconduct against a senior consultant was a serious matter, and nothing suggested Dr McNamara was "unfit" for her duties. This suspension was open-ended and non-specific in duration and must be seen as more than the "holding operation" contended for by the board.

Mary Carolan

Mary Carolan

Mary Carolan is the Legal Affairs Correspondent of the Irish Times