YOUR paper has recently carried a series of commentaries by Mr Fintan O'Toole on the inquiry carried out by the Medical Council into complaints made against Prof Ivor Browne.
While the possibility existed of further action in the courts, the Medical Council has not been in a position to respond to these and other articles in the media. The Medical Council has now been informed that Prof Browne has decided not to make an application to the High Court in relation to the inquiry or its outcome.
It is not the practice of the Medical Council to comment on the conduct of an inquiry held in private, but in the circumstances created by the media articles, the council is compelled to correct any misunderstandings or misrepresentations which may have occurred.
Four issues arising from the inquiry are particularly noteworthy:
1. The Medical Council is not in a position to publish the transcript of this inquiry, which was held in private.
2. A submission was made by Prof Browne's legal advisers at the commencement of the inquiry that it be held in private. This was not opposed by the Registrar, representing the council, and the Fitness to Practise Committee agreed to Prof Browne's request.
3. At the conclusion of the evidence, Prof Browne's legal advisers commented that they were extremely happy with the fairness which characterised the proceedings.
4. The ethical principles underpinning the practice of medicine in this country are derived from the experience and guidance of the profession and are published in the Medical Council's Guide to Ethical Conduct and Behaviour and to Fitness to Practise. The ethical principles governing confidentiality were not contested during the inquiry, which heard evidence from both sides on how these principles should be applied to the particular aspects of clinical practice which were the subject matter of the inquiry.
It is the responsibility of the Registrar and the legal advisers to the doctor to call witnesses in relation to the allegations of professional misconduct. Witnesses may be experts in a specialist area or witnesses to facts at issue in a inquiry. In this inquiry, expert opinion on the allegations of professional misconduct was called by both sides. Expert witnesses included an academic who has published widely in this area and a consultant psychiatrist.
The findings of professional misconduct against Prof Browne included the failure to minimise the extent of the breach in confidentiality which he committed and the damage to the public's confidence in confidential communications with the medical profession resulting from his actions.
The findings of the Fitness to Practise Committee were accepted by the Medical Council, which admonished and censured Prof Browne.
The Medical Council is conscious of the rights of a doctor who is the subject of an inquiry. This inquiry therefore included a number of safeguards to those rights:
(a) Full legal representation by solicitor and counsel.
(b) The entitlement to call witnesses and conduct a full cross examination.
(c) The presence of senior counsel to act as independent legal assessor to the committee.
(d) Acceptance of the criminal standard of proof (beyond reasonable doubt), for a finding against a doctor.
(e) A High Court review of the proceedings, if required.
At any stage during an inquiry or following a finding of professional misconduct or unfitness to practise for health reasons against a doctor, it is open to that doctor to apply to the High Court for a ruling on the conduct of the inquiry. I understand that Prof Browne has chosen not to seek such a review.
In order to protect the wider interests of the public, the Medical Council's usual procedure is to publish findings of professional misconduct against a doctor in the media.
The Medical Practitioners Act, 1978, established the Medical Council to protect the interests of the public when dealing with the medical profession. It discharges these responsibilities by monitoring undergraduate and postgraduate education, by maintaining a register of qualified doctors, by establishing ethical standards of practice and by inquiry and disciplinary action against doctors who have been the subject of complaints.
The Medical Council is a 25 member representative body, 10 of whose members are elected by the profession, nine are nominated by the universities and postgraduate colleges and six are nominated by the Minister for Health, four of whom represent the interests of the public. All inquiries established by the Fitness to Practise Committee include at least one lay member of the Medical Council. The Medical Council holds office for five years the current council was established in 1994.
The allegation by your correspondent that the Medical Council and its Fitness to Practise Committee are representing the views of the Catholic Church or any other interest group are ludicrous, without foundation and irresponsible.
The Medical Council rejects the premise that its conduct of this disciplinary case was prejudiced or flawed.
The very serious responsibilities carried by the council across a broad spectrum of issues require it to constantly reassess its procedures and performance. It acts on the recommendations and findings of its own committees and those of bodies such as the High Court. Complacency has no place in the pursuit of the councils aims - however, there is no justification for the current allegations of impropriety or bias made by your paper.