Medical Council inquiry
Eithne Donnellan,
Health Correspondent
Misconduct by doctors on the scale engaged in by the Drogheda obstetrician Dr Michael Neary could still be happening, the Medical Council said yesterday.
The council's president, Prof Gerard Bury, said this was because no system was in place to check on GPs, consultants or other specialists who operated independently. He urged the Government to immediately show its commitment to the introduction of a competence assurance system for doctors, which the council has been advocating since 1998.
Under the scheme doctors would have their practice checked by peers and would have to show they were competent enough to remain on the medical register every five years.
Prof Bury made his comments at the official publication in Dublin yesterday of the report of the Council's Fitness to Practice inquiry into Dr Neary. Details of the report were published in yesterday's Irish Times. It showed Dr Neary carried out one Caesarean hysterectomy for every 20 Caesarean sections. The rate at the Coombe Women's Hospital was one per 600. This, Dr Bury said, was "extraordinary".
Prof Tom O'Dowd, chairman of the council's Education and Training Committee, said the report showed the medical profession had "its own bad eggs".
"If a doctor wants to do damage like Shipman or Neary the system is still of such a nature, because it operates on trust, that it is possible for a doctor to actually start off doing an awful lot of damage.
"Its that nature of a job and the art and trick of the thing is to actually pick them up early. And where there is data available its got to be scrutinised and sought and there's also got to be peer review and audit," Prof O'Dowd said.
The first the Medical Council knew of concerns about Dr Neary was when it read media reports in late 1998, Prof Bury said.
"Individual members of staff or patients may have approached the management of Our Lady of Lourdes, Drogheda, itself or individual members of staff within Our Lady of Lourdes, Drogheda, but no mechanisms seem to have existed to pick up those concerns or those complaints and act on them in the hospital," he said.
He said, however, that the council's powers did not extend to exploring structures within the hospital or how the hospital responded to these issues.
The council's powers were confined to exploring Dr Neary's performance. "This is one of the core reasons why we need an effective and prompt examination of the systems in place in Drogheda to find out how this continued to happen," he said, adding that the council supported a broad inquiry into "the tragedy".
He said he was baffled that it was doctors who were pushing for a system to have their profession monitored.
"We absolutely believe that a system of monitoring must be in place and we are prepared to take responsibility for that system of monitoring. We have been pressing for it for years.
"It is totally and completely absent at the moment. It is so profound that it has to be said again and again. There is no system whatsoever to oversee how doctors are performing once they become consultants or GPs or specialists working in independent practise.
"So my lifetime of independent practice of 35 or 40 years can go by without any requirement to report to a colleague, to discuss with management how I am performing or to look at my patients and see how I'm doing by comparison with others.
"The profound and complete absence of those structures is baffling," he added. Legislative change was required for this.
Asked if he knew why Dr Neary behaved as he did, he said he couldn't answer that.
"I think, genuinely, the members of council and particularly members of the inquiry team are left struggling to find an explanation for this behaviour because it is so far outside the norms of acceptable behaviour for an individual, never mind a professional, that we can find no rational simple reason to explain it," he said.
"Faced with all of this evidence it seems extraordinary that he continued to refuse to accept that there was a problem here," Prof Bury said.