The Medical Council has considerably strengthened its ethical guidelines covering whistleblowing in a move seen as a direct consequence of the Dr Michael Neary case.
The present Medical Council is nearing the end of its term of office and, as is customary practice, is carrying out a major revision of its "Guide to Ethical Conduct and Behaviour".
The Irish Times has learnt that the following advice will appear in the next ethical guide: "Where a risk to a patient exists in relation to a colleague's conduct or competence, doctors should express their concern initially to the colleague concerned and advise remedial action. Where local systems of support and remediation are available, they should be availed of as the next step. Should the colleagues response be unsatisfactory, then the doctor should refer the matter to the Medical Council."
The wording represents a notable strengthening of present guidelines. It places an onus on medical colleagues to intervene in a proactive manner where they perceive a risk exists to a patient because of a doctor's competence. By including the word conduct, the guideline suggests that a doctor who appears to be under the influence of drink or drugs or who is behaving in a bizarre way, must be confronted.
Last night a senior medical source said that the reference to local systems of support and remediation will put pressure on existing health service structures to have remedial systems in place. It suggests a defined role for hospital medical boards and GP units in health boards in acting as places of referral for doctors who, in the opinion of medical colleagues, represent a danger to patients.
By placing an onus on individual doctors to refer the problem doctor to the Medical Council, the new guideline has clarified what was a grey area. It also suggests that should a future fitness to practice inquiry find a doctor guilty of professional misconduct and should evidence be given that other doctors were aware of this misconduct, but took no action, then these doctors may themselves become the focus of separate fitness to practice enquires. The updated ethical guide is expected to be published in the New Year.