William Kennedy Head of Professional Standards & Legal Adviser 30 th June 2008

1. William Kennedy Head of Professional Standards & Legal Adviser 30th June 2008

2. Current System – under MPA 1978 • General Register and Register of Medical Specialists (RMS) • RMS established on voluntary basis on 01/01/97 • Doctors on RMS voluntarily submit evidence of participation in Continuing Medical Education / Continuing Professional Development (CME/CPD) • 50 hours per year over a five year cycle • Agreed by Council with training bodies (2002) when framework for Competence Assurance Structures were agreed • Inconsistent approach to auditing this system

3. Recent cases in Ireland • O’Laoire 1995 “conduct…seriously fallen short, by omission or commission, of the standards of conduct expected among medical practitioners” Moral turpitude:- “conduct which doctors of experience, competence and good repute consider disgraceful or dishonourable.

4. Recent cases (contd.) • Neary 2003 • Lourdes Hospital Inquiry Report by the Honourable Ms. Justice Harding Clarke (January 2006) • Recommendations • Competence Assurance is not met solely by attendance at continuing professional development courses. Skills must be certified or validated. • Oblige all obstetricians practising in State, including those not on the RMS, to engage in continuing professional development and independent competence appraisal at least 1 in 5 years. • Oblige all Obs / Gyn / Anaes / Pathol / to submit practice to annual clinical audit and review. – including private practice in public and private hospitals. • Oblige all docs to attend training on clinical governance, including knowledge, engaging in clinical audit and risk management.

5. Medical Practitioners Act 2007, Part 6 • S43(1) The Register of Medical Practitioners • 3 Divisions • General Division • Specialist Division • Trainee Specialist Division

6. Medical Practitioners Act 2007Parts 7, 8 & 9 • A person, or the Medical Council can make a complaint on the grounds of:- • Professional Misconduct • Poor Professional Performance • Relevant Medical Disability

7. Medical Practitioners Act 2007, Part 11 Maintenance of Professional Competence • Duty of Council to satisfy itself as to the maintenance of professional standards and competence of doctors • Within 1 year of commencement, Council must develop, establish and operate scheme(s) • Recognise a (training) body to make and carry out arrangements for assisting Council performing its duties • Duty of HSE to facilitate the maintenance professional standards and competence of doctors • Duty of doctors to maintain professional standards and competence on an ongoing basis • Confidentiality – limited disclosure by Council in form of summary • FOI does not apply • MC may make a complaint if doctor refuses or fails to cooperate with requirements. • Continuing CME / CPD • 360o / Multisource feedback (peer review) • Audit – random • Performance Assessment if problem raised.

8. Ongoing work • Survey of all RMP’s • Where practising • Area of practice • Affiliation to college • Forum of training bodies • MC to agree standards to be applied to doctors belonging to each college

9. Goals of a Professional Competence Program • To ensure doctors are providing good care in practice Assessment of practice outcomes • To ensure that doctors are aware of recent advances in medicine and have potential to treat broad range of less frequent but medically important problems Evaluation of medical knowledge and judgement • To ensure that doctors exhibit professionalism Review of credentials Judgements of peers and patients