Medical Council scarred by first public inquiry

ANALYSIS: The tabloid farce of the ‘rumpy pumpy’ case and general media shyness inspire little confidence

ANALYSIS:The tabloid farce of the 'rumpy pumpy' case and general media shyness inspire little confidence

SOME EIGHT months after members of a new Medical Council took office, shortly after the first fitness-to-practise inquiry was held in public, and in the week when a brand new registration system for doctors was introduced, has the 2007 Medical Practitioners Act made any difference? Under the new Act, a general register of medical practitioners will be replaced by a register with three divisions – general, trainee specialist and specialist. The specialist division will list all general practitioners and hospital consultants who have undergone specialist training in one or more specialities. All interns and doctors undergoing specialist training in Ireland will be entered in the trainee specialist division, while the general division will register those doctors who have not completed specialist training and are not employed in specific training posts.

From now on, all doctors in the general and specialist divisions will have to demonstrate their professional competence on an ongoing basis. And they will be required to include their medical council registration number on all prescriptions and medical reports. It is now a statutory offence for doctors to practise medicine while unregistered.

All of which represents tangible progress. But are patients any safer and will underperforming doctors be picked up earlier by the regulatory system? The council’s choice of the first fitness-to-practise case to be heard in public raises some concerns in this regard.

READ MORE

An allegation of professional misconduct against Dublin GP Dr Ross Ardil, involving his alleged use of inappropriate language during a consultation with a woman patient, Alma McQuade, was not upheld. Dr Ardil was advised to be careful about his use of the phrase “willy bits” with patients; his admission that he used the term “rumpy pumpy” in reference to sexual activity was also frowned upon.

The fitness-to-practise committee ruled the allegation of use of inappropriate and insensitive language was proven.

Ultimately, no formal restrictions were placed on Dr Ardil’s future practice, but the media, especially the tabloid press, had a field day with the evidence given during the case.

The suggestive language used painted a picture reminiscent of saucy seaside postcards of old, with their vivid portrayal of red-faced vicars enjoying voyeuristic holidays surrounded by well-endowed bathers in various stages of undress.

Is this really the image the Medical Council wishes to portray at the beginning of a new regime of openness and accountability? If it chose this case as the first to be heard in public, what does that say about its collective judgment?

Journalists and other non-medics at the hearing were left scratching their heads as to why the case had proceeded as far as it did.

While not wishing to minimise the inappropriate language used by Dr Ardil, the case did not involve major harm to a patient. And the fact that Dr Ardil had quickly apologised in writing to Ms McQuade should have been the impetus for the council to take a different approach to her complaint.

Section 61 of the new Act states: “where the preliminary proceedings committee is of the opinion that . . . the complaint is one that could be resolved by mediation or other informal means pursuant to guidelines . . . it shall inform the council of that opinion”.

From the information made available at the inquiry, it would seem that mediation between the two parties, using the original apology as a starting point, may have achieved a satisfactory result at a much lower cost and with less stress for both sides.

Certainly a woman, who in the future wished to complain about serious malpractice involving gynaecological or sexual matters, would not be encouraged by the publicity surrounding the Ardil/McQuade case. The danger is that serious professional misconduct could go unreported to the Medical Council based on its handling of this case.

While the president of the council Prof Kieran Murphy has spoken of his desire to establish greater trust between the council and the public, saying last week “there is no reason why there should not be an openness between the Medical Council, the medical profession and the public that encourages a wider understanding of how the council does its work”, this is at odds with the media’s experience.

Since the new council took office, no press conferences have been held. This contrasts with the approach taken by the three most recent presidents, who ensured appropriate media access to the council’s business.

Reporters have been told that inquiries will be only be dealt with by e-mail, with telephone contact discouraged.

Admittedly, an electronic newsletter was shared with the media last week, and individual members remain approachable, but overall, the impression is of a council that wishes to restrict media access rather than encourage it.

The Medical Council will argue that it is early days in the administration of a new Medical Practitioners Act. That may well be the case, but it has to be said that were the council to be the subject of a quality inspection this week, the question of an honours outcome could not be entertained.

Dr Muiris Houston is Medical Correspondent of The Irish Times