The Irish Times view on medical recruitment: A clear and present danger

The decision by the president of the High Court to voice his concerns about "defective" procedures for recruiting doctors to work in hospitals in the State represents a major red flag for the safety of patients.

Mr Justice Peter Kelly suspended a junior doctor in a hospital maternity unit from practising here after other doctors raised serious concerns about him lacking basic medical competency and being a danger to patients. It follows action by the Medical Council under section 60 of the 2007 Medical Practitioners Act, which is activated when the regulatory body believes the immediate suspension of a doctor's registration is necessary to protect the public. The suspended doctor is subsequently the subject of a full fitness to practice hearing. Latest figures show that, in 2016, there were 411 complaints made to the Medical Council, leading to 47 fitness to practice inquiries.

The detail provided by the judge suggests we have a major problem in recruitment procedures for junior hospital doctors. The doctor concerned graduated from medical school in an eastern European country in 2015. The country was not named, but a doctor from any EU state is entitled to be registered to practice in Ireland without further examination of his competence. However, in some parts of eastern Europe it is possible to graduate with a medical degree with minimal hands-on experience.

The suspended doctor has said he was never taught how to examine a pregnant woman. Within days of starting his job, two consultants raised concerns about his basic competencies – including history-taking, taking blood tests, insertion of intravenous cannulas, and drug-prescription. In addition junior colleagues said they witnessed “wild” clinical assessments by him, made without taking any history or examining a patient.

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Such a poor level of competence is a clear and present danger to patients. In this case pregnant women and their babies could have been seriously harmed. An integral part of junior hospital doctor employment is participation in an “on call” rota. This means being called first to deal with medical emergencies at night. At a minimum it requires competence to stabilise a patient by prescribing appropriate drugs and establishing intravenous access. The judgment suggests the doctor was incapable of these tasks.

Mr Justice Kelly asked that his judgment be sent to the Minister for Health and the HSE. There is a need for an urgent response from both.

We need to be told how interviews for medical posts are conducted. Are they formal in-person encounters or are they carried out remotely? We must be told the truth about how difficult it has become to fill posts with competent practitioners. And whatever legislation is needed for the Medical Council to better protect the public from incompetent doctors must be urgently enacted.