Medical Council

Table of Contents

Background

The Medical Practitioners Act was designed to update provisions relating to the registration of medical practitioners by the Medical Council. The Act is consistent with the commitment in the Health Strategy Quality and Fairness — a Health System for You to strengthen and expand provisions for the statutory registration of health professionals, including doctors.

The existing Medical Practitioners Act 1978 provided for the establishment of the Medical Council and the regulation of the medical profession. The need for doctors to continually keep abreast of new developments, the right of patients to be kept informed, and the expectations of the public have all greatly increased since the 1978 Act was passed. The balance between self-regulation and public accountability needs to be adjusted to reflect these requirements and to provide a legislative framework which supports the Medical Council in the efficient and effective discharge of its functions. The recent Lourdes Hospital Inquiry Report has also informed preparation of the Act.

Purpose of 2007 Act

The main objective of the Act is to provide for a modern, efficient, transparent and accountable system for the regulation of the medical profession which will satisfy the public and the profession that all medical practitioners are appropriately qualified and competent to practise in a safe manner on an ongoing basis.

Principal Elements of the Act

The main elements of the Act are as follows:

A comprehensive updating of legislation regulating medical practitioners.
An explicit definition of the role of the Medical Council as being the competent authority to protect the public interest.
A significantly increased ‘‘lay’’ membership of the Council. A majority of persons on the Council will not be nominated or elected by the medical profession and a majority of persons on
the Fitness to Practise Committee will not be medical practitioners.
A new obligation on the Council to adhere to governance arrangements applicable to other statutory bodies in the Health Service.
Accelerated investigation mechanisms including the setting up of an assessment committee prior to fitness to practise investigations and the appointment of investigators to facilitate such preliminary investigations.
Streamlined registration processes for medical practitioners generally.
Prohibition on unregistered medical practitioners engaging in the practice of medicine.
A new statutory framework for the maintenance of professional standards of registered medical practitioners.
An obligation on the Health Service Executive and other employers to facilitate the maintenance of professional competence of medical practitioners (e.g. clinical audit, continuing medical education, peer review).

Fitness to practise inquiries will generally be held in public. The Fitness to Practise Committee may decide, on application by the medical practitioner or a witness, including the complainant, to hold some or all of an inquiry in private, depending on the circumstances.

Streamlining of the functions of the Postgraduate Medical & Dental Board into the Health Service Executive and the Medical Council, as appropriate, in accordance with the Government decision arising from the report Audit of Structures and Functions in the Health System 2003 (the Prospectus Report).

New medical education and training provisions reflecting Government policy on medical education and training arising from its consideration of the recommendations of the Report of the Working Group on Undergraduate Medical Education and Training (the Fottrell Report) and the Report of the Postgraduate Medical Education and Training Group (the Buttimer Report).

Measures to transpose provisions of Directive 2005/36/EC on the recognition of qualifications as it relates to medical practitioners.

Functions of Council

The 2007 Act provides for the continuance in being of the Medical Council and includes savings provisions for matters which have been commenced by the Medical Council under the 1978 Act but not completed at the time of its repeal.

The Council regulates its own function, subject to the provisions of Schedule 2. The object of the Council, which is:

— to protect the public by promoting and better ensuring high standards of professional conduct and professional education, training and competence among registered medical practitioners.

The act outlines the functions of the Council which relate to the registration of medical practitioners, the regulation of their education and training at all levels and matters relating to the recognition of qualifications of medical practitioners.

The Council’s functions also include the setting of standards of practice (including advertising) and ethical guidance for medical practitioners, the handling of complaints and inquiries relating to the conduct of medical practitioners and proactively advising the public on all matters of general interest relating to the functions of the Council, its area of expertise and the practice of medicine.

Council Matters

The Act includes provisions requiring the Council to have regard to the role of other bodies and authorities, the need to ensure effective and efficient use of resources and policies of the Minister or Government which relate to its functions. It provides for the Minister to require the Council to give information to the Minister relating to the performance of its functions.

The Minister may confer additional functions on the Council by order and that an order made must be laid before the Houses of the Oireachtas. The Minister may give general policy directions to the Council in relation to its functions, excluding matters relating to ethical guidance, complaints, inquiries and sanctions.

There is protection from civil liability of Council members and staff, former members and former staff and people appointed to assist the Preliminary Proceedings Committee.

The Council has power to make rules and details a range of matters for which the Council may make such rules, including registration, the operation of committees, the setting of standards and criteria in relation to medical education and training and professional competence and the giving of evidence before a fitness to practise committee.

Rules will be subject to publication in draft form and to Ministerial approval. The Minister for Finance must give consent for any rules relating to a professional competence scheme. Rules must be laid before the Houses of the Oireachtas.

The Council is to prepare and publish guidelines on the manner in which the Council proposes to perform its functions.

Strategy Planning & Reporting

The Council is to prepare a statement of strategy for its term of office, and to subsequently amend the statement if required and to submit it to the Minister who may return it if it does not comply with specified matters.

It provides for the laying of the statement of strategy before the Oireachtas within 21 days after receipt by the Minister. The Council will be required to submit progress reports to the Minister on the implementation of the strategy.

The Council is to prepare an annual business plan and the matters to be included in that plan. The Council is to publish an annual report on its activities and for the laying of the report before the Oireachtas.

Members

The Council shall consist of 25 members appointed by the Minister as follows:

2 persons jointly nominated by the bodies approved under to deliver programmes of basic medical education and training,
one registered medical practitioner nominated by the Royal College of Physicians of Ireland in relation to medical specialties,
one registered medical practitioner nominated by the Royal College of Surgeons in relation to surgical specialties,
one registered medical practitioner nominated by the Irish College of General Practitioners in relation to general practice,
one registered medical practitioner nominated by the Irish Psychiatric Training Committee in relation to psychiatry,
6 registered medical practitioners practising medicine in the State (but excluding any visiting EEA practitioner) following their election, in accordance with regulations made under section 18, by registered medical practitioners,
one person nominated by the Royal Irish Academy who is not and never has been a medical practitioner in the State or in another jurisdiction,
2 persons nominated by the Health Service Executive who are representative of the management of the public health sector,
one person nominated by the Minister for Education and Science, after consultation with the Higher Education Authority, who is not and never has been a medical practitioner in the State or in another jurisdiction,
one person nominated by An Bord Altranais whose name is entered in the register of nurses and midwives maintained under the Nurses Act 1985,
one person nominated by the Health and Social Care Professionals Council whose name is entered in a register established under the Health and Social Care Professionals Act 2005,
one person nominated by the Health Information and Quality Authority who is not and never has been a medical practitioner in the State or in another jurisdiction,
one person nominated by the Independent Hospitals Association of Ireland who is not and never has been a medical practitioner in the State or in another jurisdiction, and
5 persons who— are not and never have been medical practitioners in the State or in another jurisdiction, and have such qualifications, expertise, interests or experience as, in the opinion of the Minister, would enable them to make a contribution to the performance of the Council’s functions.

The Minister may make regulations governing procedures for electing members of the Council. It provides for the regulations to be laid before the Houses of the Oireachtas.

This Schedule outlines the tenure of office of the Council, proceedings relating to resignations or termination of membership and the filling of casual vacancies, the quorum required for meetings of the Council, meetings, the role of the President and Vice-President and the proceedings at meetings.

Members Committees & Staff

The Council has power to establish committees to perform any of its functions and provides that persons who are not members of the Council may be included in the membership of committees.

Two committees relating to Fitness to Practise matters are required — a Preliminary Proceedings Committee to give initial consideration to complaints and a Fitness to Practise Committee to conduct inquiries. At least one third of the members of these Committees must be members of the Council. In addition, an Education and Training Committee is provided for to perform functions under Part 10. A Health Committee, as a support for medical practitioners, is also provided for.

In general, committees shall have a majority of people who are medical practitioners in their membership, except the Fitness to Practise Committee, which must have a majority of persons who are not medical practitioners.

The Council may, with consent of the Minister and the Minister for Finance, pay an approved allowance to the President of the Council, the members of the Council or the members of committees out of funds at the disposal of the Council.

There are circumstances in which one or all of the members of Council may be removed or may cease to hold office. The Minister may remove a member of the Council from office in specified circumstances or for membership to automatically cease in circumstances relating to indictable offences, bankruptcy or removal from registration by a competent authority. It also provides for membership to cease where a person does not attend the required number of meetings.

The section also provides for the circumstances in which the Minister may remove all of the members of Council from office, including where the Minister considers that the Council is not performing its functions in an effective manner. In these circumstances, the Minister may appoint a person to conduct an independent review of the matter and to submit a report to the Minister on the results of the review.

There is to be a chief executive officer to carry on and manage the administration and business of the Council. The terms and conditions of office are to be determined by the Council with the prior approval of the Minister given with the consent of the Minister for Finance. The section provides for the Registrar of the Council under the 1978 Act to be the first CEO of the Council under this Act.

There is provision for the staff of the Council. Ministerial approval and consent, terms and conditions apply and preservation of the employment rights of the persons employed by the Council under the 1978 Act are included.

The age of retirement of staff of the Council shall be 65 years, unless the person is a new entrant within the meaning of the Public Service Superannuation (Miscellaneous Provisions) Act 2004. It provides that the Minister may, by order, increase the age limit from 65 years. Thre is provision for superannuation arrangements for staff members of the Council under the Local Government (Superannuation) Act 1980.

Accounts & Finances

The Council is to keep proper account of its expenditure and income, property, assets and liabilities. The accounts of the Council are to be audited by the Comptroller and Auditor General, subject to the C&AG not questioning the policy objectives of the Council or the need for or the conduct of an inquiry. The Council must present the audited accounts to the Minister, arrange for them to be laid before the Houses of the Oireachtas and arrange for them to be printed and published.

The expenses incurred by the Council shall be defrayed out of funds at its disposal and that the expenses of the Minister in the administration of the Act shall be paid out of moneys provided by the Oireachtas, with the approval of the Minister for Finance.

The Minister may, with the consent of the Minister for Finance, arrange for the provision of financial assistance to the Council in relation to its functions under Part 11 (Maintenance of Professional Competence), or for other specified functions, out of moneys provided by the Oireachtas for that purpose.

Any surplus of funds at the Council’s disposal may be allocated to education, research or public purposes connected with the medical profession.

The Council may charge fees. Registration fees may be charged for initial registration, retention of registration, restoration of registration following removal or cancellation, registration of additional qualifications and registration certificates. The Council may charge fees to bodies approved for the purposes of medical education and training, subject to Ministerial consent, for licences to practise anatomy and for any other service which the Council may provide from time to time. Registration fees are not payable by visiting EEA medical practitioners.

Dissolution of Board

The Postgraduate Medical and Dental Board shall be dissolved and for any references to the Board to be construed as a reference to the Health Service Executive. The Minister may require the Board to provide any information relating to the performance of its functions on or before the transfer day.

The Act provides for the transfer of the staff of the Board to the Health Service Executive’s staff. Preservation of the terms and conditions of employment of such staff is included. The Act provides for the transfer of the property and liabilities of the Board to the Executive on the transfer day.

There is preservation of contracts between the Board and any other person, with the substitution of the Executive’s name for that of the Board.

There are matters which are absolutely privileged in any action for defamation, in particular matters relating to Parts 7, 8 and 9 (Fitness to Practise) and documents relating to a medical practitioners participation in a Professional Competence Scheme, unless made in bad faith.

Certificates

The Council or a Committee may specify the form of documents required for the purposes of this Act, including statutory declarations, accompanying documents, details of relevant medical disabilities, etc.

Medical certificates must be signed by registered medical practitioners, unless the person is authorised to sign such a certificate by another enactment.