Analysis:Consultant collegiality should never again be allowed to endanger patients, writes Eithne Donnellan.
How three well-respected consultant obstetricians, at the pinnacle of their careers, managed to produce reports in 1998 exonerating their colleague, Dr Michael Neary, is outlined in great depth in reports published by the Medical Council yesterday. They make for fascinating reading.
Dr John Murphy was working 70 or 80 hours a week. He got a call from his union, the Irish Hospital Consultants Association, to say Dr Neary was in a spot of bother with the north eastern health board (NEHB) and there were suggestions he was going to be suspended over a high Caesarean hysterectomy rate.
Finbarr Fitzpatrick, secretary general of the IHCA, asked Dr Murphy if he would conduct a review of Dr Neary's work. Initially he was reluctant because there was no precedent for this sort of thing but he was eventually persuaded to do it.
The IHCA asked two other obstetricians - Prof Walter Prendiville and Dr Bernard Stuart - to join him in reviewing Dr Neary's practice and they agreed.
As counsel for Dr Murphy put it to the Medical Council: "At the time they were prepared to act because they felt that there was a consultant colleague in distress at a hospital with notorious bad relations between the NEHB and its consultants."
They agreed to meet Dr Neary, who arrived at Dr Murphy's house with case notes of a number of women whose wombs he had removed. The three questioned Dr Neary for about four hours, looked at the medical records of nine women, and then Dr Neary went home, taking the records with him. But before he left they "extracted" an undertaking from him that he wouldn't again undertake a Caesarean hysterectomy without getting a second opinion.
Within days, Dr Murphy, Prof Prendiville and Dr Stuart sent their peer reviews back to the IHCA and they were forwarded to the NEHB. The reports said Dr Neary had no case to answer. But interestingly they never mentioned that they had "extracted" an undertaking from him.
Dr Neary was allowed to return to work, but not for long because a UK expert the following month said he had major concerns, based on a review of the same nine cases. Years later the Medical Council found that in all nine cases the women's wombs had been removed unnecessarily.
The Lourdes Hospital Inquiry report, published last year, remarked that the obstetricians had been motivated by compassion and collegiality. Now the Medical Council has found the obstetricians guilty of professional misconduct.
It was argued on behalf of the doctors that their reports were just preliminary ones, that they had to be prepared in a hurry for the IHCA, and therefore a finding of misconduct should not be recorded. The council has rightly rejected this argument.
Regardless of who asked the obstetricians to conduct the review, these were intelligent men with minds of their own and they should not have prepared reports to dig out a colleague. The consequences of their actions for women in the northeast could have been unthinkable, were it not for the fact that the UK obstetrician very soon afterwards ensured that Dr Neary was removed. It is only right that they now face the music for what they did so that a message is sent out to others that this sort of collegiality should never again be allowed to endanger patients.
The three obstetricians have received no sanction, even though the Medical Council's Fitness to Practise Committee recommended sanctions be imposed. The Medical Council needs to explain why they have not been disciplined in some tangible way, though to strike them off would probably have been a step too far.