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

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

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.

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.

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

Medical Practitioners Act 2007 Parts 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

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. (i)Continuing CME / CPD (ii)360 o / Multisource feedback (peer review) (iii)Audit – random (iv)Performance Assessment if problem raised.

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

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