A number of measures should now be put in place to deal with the implications of the alleged over-use of Caesarean hysterectomies in a north-eastern hospital, according to the Irish Patients' Association. It added that it was not presupposing the outcome of the investigation by the North-Eastern Health Board into an alleged incident and accepted that the doctor concerned may have acted appropriately.
The IPA has asked the Minister for Health to ensure that, if the investigation shows that any unnecessary suffering has been caused by this incident, there will be no delays or obstructions on the part of the Department in dealing with victims.
It said that the 1978 Medical Practitioners Act should be updated, in consultation with patients and the medical profession, in order to bring professional regulation up to date. The association also urged the Minister to fund and implement a programme of systematic audit of all clinical activity.
The IPA has urged the Medical Council to consider the issue of fitness to practise in this case, without waiting for someone to make a formal complaint. It said the council should implement a pro-active policy in relation to physician illness, which would actively encourage self-reporting of any ill-health which might affect a doctor's competence.
The Institute of Obstetricians should make public the outcome of its investigation into this incident, and also any guidelines used by practitioners relating to the indications for hysterectomy and the removal of ovaries. It should also make public the differences in technique between the reviews conducted by a group of three visiting consultants from Ireland and that conducted at the health board's request by a colleague from the UK.
The largest number of recommendations from the IPA are aimed at the North-Eastern Health Board, in whose area the incident occurred.
These include a consideration of how procedures apparently made it so difficult for concerned staff to raise the matter; ensuring that its review of the clinical workload of the doctor in question reaches back through his career and is not limited to obstetric cases; reviewing the work of junior doctors working with him and cases of a similar nature under the care of other consultants in the hospital; making public the outcomes of these reviews; and ensuring that all concerned patients receive proper access to responsible individuals within the NEHB.