A review of the council

The Medical Council, which was established in 1978 under the Medical Practitioners Act, is charged with maintaining a general register of medical practitioners.

Its role is to satisfy itself as to the standards of undergraduate and postgraduate medical education and training, and to investigate allegations of professional misconduct. It also assesses fitness to practise medicine by doctors with a physical or mental disability.

The council consists of 25 members made up of 21 professional and four lay members. Five are appointed as representatives of the State's university medical schools. Four representatives are elected from the Royal College of Physicians in Ireland and the Royal College of Surgeons in Ireland (two each). Ten members are elected by the medical profession, with the remaining six appointed directly by the Minister for Health, three of whom are lay members, with the fourth lay member traditionally a doctor.

Each council holds office for a five-year period. The present council took office in 1999 and will remain in place until 2004. The council has several subgroups with specific responsibilities. These include the fitness to practise, education and training, registration, house and finance and ethics committees.

As a statutory body, the council is independent of the Department of Health. It is funded by an annual registration fee of £200, paid by fully-registered medical doctors.

The Medical Council maintains a register of doctors in good professional standing. A doctor can be struck off for professional misconduct following a hearing by the fitness-to-practise committee. Decisions to censure a doctor must be ratified by the High Court before they can be implemented.

While the council attracts most attention for its fitness to practise and ethics functions, the protection of the public is achieved by less obvious work, maintaining the standards of both postgraduate and undergraduate medical education. It has the power to make recommendations to individual hospitals on matters which affect doctor training and ongoing education.

The present council has done much work in the area of competence assurance. It has put forward proposals to tighten the mechanisms through which provisionally registered doctors (hospital interns) become fully registered. In its submission to Government on a revamped Medical Practitioners Act it has sought to place competence assurance at the centre of the new legislation. The council wants to see a five-year review of doctor competence by continuous assessment of individual performance.

The last two medical councils have sought to switch the emphasis from catching wayward doctors, when damage to patients has already occurred, to a system of prevention. Members see a greater benefit to the public from a strict educational and training regime. They believe the ultimate goal of public confidence will be achieved by means of accountability through the external validation of doctor performance.