Medical Council sees complaints against doctors rise 20%

The number of complaints made about doctors to the medical regulator last year rose by 20 per cent, with complaints about poor communication up by some 40 per cent.

In its annual report for 2015, the Medical Council revealed it received 369 complaints, compared to 308 the previous year.

Medical Council president Prof Freddie Wood said that, in terms of fitness-to-practise, the council was complaint driven.

But it needed to look at other avenues of intervention, such as examining the accreditation of medical schools and putting a framework on the intern year and training.

“We are actively looking now at the quality of professional competence schemes,” he said. “We are going to have to look at the quality of the schemes and if they are imparting on the doctors of today the knowledge that they need to have.”

He noted that the council had only received one complaint from the Health Service Executive last year about a doctor, which was "a very low" reporting rate compared to the UK and other countries.

Prof Wood said the number of complaints about doctors from the major public employers in other countries would probably be about 25 per cent of the total.

“This raises a concern; does the HSE, for instance, have systems in place in particular institutions to recognise doctors in difficulty, and if they are, are they providing them with remediation?”

“We can only draw attention to it for other branches of our society that provides healthcare to address.”

He said dealing with complaints was a “very important part” of what the council did. “But it’s not all that we do.”

Shortages

More than 20,000 doctors were registered with the council last year, bringing the total to its highest ever. Some 2,600 doctors registered for the first time – an increase of 50 per cent in the number of registrations. A total of 1,200 exited the register.

Prof Wood said it was great to see that the number of specialists on the register has increased significantly this year in light of the doctor shortages experienced in recent months and years.

The council also published its fourth Medical Workforce Intelligence Report, which gives an overview of the medical workforce in Ireland to enhance patient safety and to support good professional practice among doctors.

Exit rates of doctors increased slightly from 5.6 per cent in 2014 to 6.4 per cent last year. The number of specialists on the register in 2015 increased by almost 7 per cent.

Reliance on international medical graduates is among the highest in the OECD with almost 38 per cent of the workforce an international medical graduate, the council found.

Some 73 per cent of Irish graduates under 35 who retained registration in the Specialist Division last year were female.

A total of 62 per cent of graduates from Irish medical schools in the 25-34 age group were female.

In terms of the geographical distribution of GPs, Galway, Westmeath and Waterford had the highest density of general practitioners while Meath, Kilkenny and Leitrim had the lowest.

More females

Some 51 doctors were supported by the Medical Council’s Health Committee throughout 2015 to continue in practice during illness.

Chief executive Bill Prasifka said he found it particularly interesting that although males continued to dominate the medical profession as a whole, there had been more Irish female graduates entering the medical profession than males since the council started compiling the data.

“The majority of those on the register between the ages of 30 and 44 are female; however from 44 years and on the number of females on the register begins to decrease.”

Simon O’Hare, research, monitoring and evaluation manager at the Medical Council, said there were some concerns about replacing the numbers of doctors working in certain areas as older doctors retired, for example.

He said that 11 per cent of trainee doctors wanted to work in anaesthesia, while the number of all specialists working in anaesthesia at present was 7 per cent.

This seemed “healthy” in terms of the replacement of anaesthetists. However, just 23 per cent of trainees had indicated they wanted to be GPs, compared to 35 per cent of doctors on the register who were currently in general practice.

“There may be some challenges in terms of replacing GPs in the future as well. If people’s intent are a good predictor of future intent, ophthalmology and occupational medicine may have some challenges as well,” Mr O’Hare said.

The report also reveals that medical schools in Ireland received nearly 100 anatomy donations last year.

Serious concern

The Irish Medical Organisation (IMO) expressed serious concern at some of the findings in the Medical Council annual report. It said these vindicated many of the concerns raised by doctors over the past number of years.

IMO president Dr John Duddy said: “Much of the data contained in the Medical Council annual report supports the position of the IMO in relation to the current shortage and predicted future shortage of doctors and the urgent need to create more supportive working environments that will benefit patients and doctors. We hope the Department of Health and the HSE will see this as an opportunity to work with the IMO to improve our structures so as to ensure a better patient experience and a better working environment for doctors.”

The IMO said the Medical Council report had expressed concern around systems in the HSE in relation to supporting doctors.

“A detailed analysis of the complaints and the underlying causes is needed so as to ensure we learn from patient complaints and put in place systems to address the core issues. Doctors are working in an increasingly stressful and under resourced environment and we need to see to what extent this is a contributing factor and what changes we can make to ensure communication issues are not a cause of complaint in the future.”

The IMO maintained the Medical Council had noted the rapidly changing face of the medical workforce with more and more women taking up medicine.

“However the Government and HSE continue to fail to acknowledge and work on the changes required in terms of flexible training opportunities and an environment that supports career development so as to ensure we have doctors for the future.”

“ The report confirms that Ireland has one of the highest reliance on international medical graduates. While our overseas colleagues make an invaluable contribution to the running of our service the statistics support the fact that we are unable to retain or recruit Irish medics who are choosing to work in systems that respect and value their skills. According to OECD statistics, Ireland has the highest reliance on foreign trained doctors in the EU yet produces more medical graduates from its universities than any other EU state, two facts that demonstrate the extent of Ireland’s problem with graduate and doctor retention. Ireland possesses one of the lowest numbers of practising doctors, per population, in the EU.”