Review of patient committals urged


A proper protocol for doctors involved in committing patients to mental hospitals is urgently needed, the Association of General Practitioners annual conference has been told.

The chairman of the AGP, Dr Michael Daly, said this was a "very grave matter" for GPs and needed to be sorted out. A proposed protocol has been drawn up by the association which will be forwarded to the Department of Health.

Dr Daly, from Thurles, said a protocol would be in the interest of the patient, the doctor and the patient's family. "The recent spate of court cases and other reports of the serious worry and injuries suffered by certifying doctors makes implementation of this protocol an immediate and urgent need." Dr Daly also said that a proper fee would have to be paid to doctors to carry out this work. At present, they were paid £2.10 by the health board but they believe it should be a payment of £250. "If someone requires a patient to be signed in for psychiatric treatment, GPs will do so as soon as a protocol is in place and a proper fee paid," he said.

There was a danger, he said, that doctors would carry out this serious work "casually or hurriedly". They have huge powers under the Mental Health Act but very little protection, he said. "I believe the procedure should be as formal as a court of law."

Under the proposed protocol, examining doctors should not be available for any other duty at the time and the patient must be given an "unambiguous statement" of his or her right to a second opinion. Garda protection should be available if required.

In his speech to the conference, Mr Maurice Neligan, cardiac surgeon, spoke of the many difficulties within the health services.

Speaking at the 10th anniversary of the AGP, he said that doctors wishes were being ignored and decisions taken by non-medical people without the experience needed to take such decisions.

Mr Neligan said the current situation with foreign doctors was an excellent example of what was going on. He warned of the impending shortage of non-EU doctors who now had to sit a Medical Council examination before getting temporary registration in the State.

"There are usually 1,300 foreign doctors in Ireland a year. This year only 10 have applied. Ten years down the road, if we have no foreign doctors we will have no local hospitals. Nobody at central level seems to care that we have this crisis looming. If they want the medical profession to look after people in the unselfish manner that they have been for years they must look after us," said Mr Nelligan.

Dr Terry Maguire from Dublin said doctors with GMS patients should have the right to sell their practices if they wish. "But I have been told that the Government has the GMS contract and the patients are really theirs. I can never understand that logic," said Dr Maguire from Dublin.

It was a breach of justice, he said, and a form of robbery by the State of doctors. "Lawyers can do legal aid work but can still sell their practice or pass it on to sons and daughters. Pharmacists within the GMS can sell the building. Even a man who does a paper round has the right to sell his list. Why can't we do the same?"