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The anatomy of a regulatory case

18 July 2023

Facing an investigation from the Medical Council (Comhairle na nDochtúirí Leighis) can be one of the most stressful experiences of a doctor’s career. The process is often unfamiliar and intimidating with potentially very significant outcomes. Knowing what to expect and how the Medical Council works can often make the experience somewhat easier and less daunting.

 

The Medical Council is the regulatory body for doctors practising in the Republic of Ireland. It has a number of roles, but its primary and statutory function is to protect the public by promoting and ensuring high standards of professional conduct, education, training and competence among doctors.

The Medical Council is a creation of statute and so is governed by various pieces of legislation including the Medical Practitioners Act 2007 (as amended). The legislation confers upon the Council a number of regulatory powers, including ones of investigation.

An investigation by the Medical Council is triggered once a complaint is made against a doctor on the medical register. Complaints can be made by anyone including patients, relatives, patient representatives, fellow doctors, other healthcare professionals or hospital colleagues and even the Medical Council itself. The vast majority of complaints are made by the public however (approximately 80%)

A complaint to the Medical Council can be made on one or more of the following grounds (set out in Section 57 of the Medical Practitioners Act 2007, as amended):

  • Professional Misconduct- Conduct (unconnected to a doctor's professional role) which would be considered disgraceful or dishonourable, including criminal activity, fraudulent behaviour or sexual misconduct. It may also include conduct which is connected to their role as a doctor which falls seriously short of the standard expected among the profession.
  • Poor Professional Performance- meaning a failure to meet the standards of competence that can reasonably be expected of a doctor.
  • Contraventions of the Medical Practitioners Act 2007 (for example, practising without professional indemnity insurance).
  • Relevant Medical Disability -a physical or mental disability (including addiction to alcohol or drugs) which may impair a doctor’s ability to practise medicine
  • Failure to comply with Conditions-imposed by the Medical Council
  • Failure to comply with an Undertaking imposed by or agreed with the Medical Council/
  • A Conviction for an indictable offence (serious) or conviction of a serious offence in another jurisdiction (which would constitute an indictable offence, had it been committed in Ireland)

The Regulated Professions Health and Social Care (Amendment) Act 2020 proposed a number of changes to the Medical Practitioners Act which includes an additional ground of complaint. The relevant section has not yet been commenced, but when commenced it will be possible to make a complaint regarding a doctor who is working in Ireland but who has been prohibited or restricted from practising in Ireland or in another jurisdiction. (For example, if the doctor has been suspended or erased by the GMC in the UK but is continuing to practise in Ireland)

2021 Statistics

The Preliminary Proceedings Committee ("PPC”) of the Medical Council opened and considered 233 new complaints1 relating to 287 registrants (a complaint can often relate to more than one doctor). This was a 16.5% decrease on the number of complaints received by the Medical Council in 2020.

In 2021, the PPC made a determination on 247 matters. In approximately 80% of those complaints (207 in total), the PPC found that there was no prima facie evidence to warrant any further action. 40 complaints (approximately 20%) were referred to a Fitness to Practise Committee.

As can be seen from the numbers above, the majority of complaints to the Medical Council do not proceed to Fitness to Practise hearing stage.  Nevertheless, being the subject of a complaint, even if it does not progress to a full fitness to practise hearing, can be very distressing as well as stressful especially given that the first time a doctor learns of a complaint is when they receive a letter from the Medical Council informing them that an investigation is being commenced.

If you do receive correspondence from the Medical Council advising that a complaint has been made. Do not respond directly to the Medical Council before contacting Medical Protection Society for advice on how best to proceed.

 

  1Annual Report and Financial Statements 2021 – Medical Council