Times Editorial (Sep 6th) Medical Council - Change or die - 12/9/2004

From the TIMES

Medical Council: change or die
One of the most difficult and unpleasant tasks anyone can be faced with is to file a complaint against a doctor who has been administering treatment. Difficult because the patient is likely to have already endured trauma as a result of the condition suffered and unpleasant due to the seemingly contradictory nature of seeking to chastise someone who has been "caring" for that patient.

In Malta, there are two avenues - which can be pursued concurrently - open to a patient who feels aggrieved: one is to lodge a complaint with the Medical Council, whose powers among others are to recommend to the President the withdrawal of licences of any medical practitioner or dental surgeon as well as prescribing and maintaining professional and ethical standards; the other is the more arduous, not to mention costly, process of seeking redress through the courts.

In theory at least, the formal legal process should be the less desirable option for both doctor and complainant. This is not just because of the time and cost involved but also because of the high emotional and professional price that must be paid to see it through.

The presence of a Medical Council, on the other hand, governed by the recently enacted Health Professions Act, is a most welcome comprise measure. Chaired by a senior member of the legal profession, normally a judge, the council has the look of a court. On paper, it has some of the powers but none of the bureaucracy or formality. Moreover, the fact that the majority of its members come from the profession itself endows it with the requisite level of expertise to deal with matters of this nature.

But something somewhere is going woefully wrong with the council. Last month, The Times reported that a pensioner was appealing for more efficiency within the council after his complaint took more than seven months to be determined, as well as more transparency because he was not even told why it had reached the conclusion communicated to him. He was merely told: "...the Medical Council is fully satisfied with the written explanation (of the consultant) and is not proceeding with an inquiry". In spite of his repeated requests, to this day he is still in the dark about his case.

This is clearly an unsatisfactory state of affairs. There is no point having an alternative to court, which, everyone agrees, is in the interest of both patients and doctors, if its procedures are so lengthy and bureaucratic.

But there is an even more critical point to be made than that. Particularly because the council is dominated by representatives of the medical profession, it is clearly unacceptable - and opens the door to accusations of cover-up - for complainants, or the doctors themselves for that matter, not to be granted full disclosure of all the evidence as well as the reasons behind the decision reached by the council.

So where do we go from here? The Medical Council in its current state cannot command public confidence and may as well be disbanded. Alternatively, the government should revisit the law which gives life to the body and impose more rigorous procedures to govern its operation. In short, the council must be turned into a fair and transparent organisation and seen to be one.

If that does not happen, the only true recourse for an aggrieved patient are the already-overburdened courts. And that is not an ideal situation for anybody.

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