Doctors with psychiatric and substance-abuse problems should be dealt with in a different way, according to the new president of the Irish Medical Organisation, Dr Fenton Howell. The profession was not good at looking after sick colleagues, he said in his keynote address.
The mechanisms used by the Medical Council for dealing with such sick doctors were "crude and outdated".
He said the publication of individual clinical details by the council was "a step too far for many" and would not be tolerated for a member of the public.
He said the proposed establishment of a Medical Council health committee, which would deal with
such matters, was a step in the right direction. The separation of health and disciplinary matters could mean that health matters would be dealt with more quickly, said Dr Howell, a specialist in public health with the North Eastern Health Board.
"More doctors might be encouraged to bring their health problems to the attention of the council themselves and it might mean that doctors who are ill are dealt with in a context which respects their patients' need and their needs as patients."
He said there was an urgency to deal with such matters. It required changes in the 1978 Medical Practitioners Act.
Speaking about continuing medical education for doctors, Dr Howell said that, as a self-regulating profession, doctors needed to assure the public and their patients that once training was completed they would continue to maintain their skills so that they could provide a quality service.
On the hours worked by junior doctors, he said their plight was of great concern. "In this day and age it is unacceptable that anyone be asked to work the hours our non-consultant hospital doctors work. It is bad for patients, it is bad for our health care services and it is bad for the doctors concerned and their families."
He said there was a significant degree of understaffing "right across the board" in Irish hospitals and it was estimated that around 800 new consultant posts were needed.
In his address, the Minister for Health, Mr Cowen, said the taxpayer had, in the last 10 years, increased the level of capital expenditure on health by 360 per cent.
"I believe that the taxpayer is entitled to some flexibility in terms of how those facilities are run and in terms of the efficient and effective use of these facilities by healthcare staff."
He said a new post of hospital specialist, below that of hospital consultant, had been proposed at a meeting of the Department of Health's medical manpower forum. This type of doctor was already in place in some countries, and it was inevitable here if we were to meet patient needs and doctors' career expectations.
However, at a meeting of junior doctors, such a proposal was unanimously rejected. Dr John Kiely, of Dublin, described it as an effort to introduce a "type of yellow-pack healthcare system" with a two-tier system of consultant and sub-consultant.
Dr Hugh Bredin, a former IMO president, said he opposed the proposed new grade but added that 800 new consultant posts were needed in the health system. A consultant urologist, he said Ireland was in the worst position regarding urology in Europe. There was one urologist per 200,000 population, when there should be one per 100,000. The situation was similar for dermatologists.
"We need 800 properly paid and trained consultants, not cheap posts which will attract people less well trained, bringing down the standard in this country."