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Background and Context

The Council’s first statement of strategy was published in 2010, at a time when a new piece of governing legislation (the 2007 Medical Practitioners Act) significantly changed the role and remit of the Council in areas such as education and training, registration and complaints handling.

The Council’s role has evolved, grown and changed in recent years. In developing a new statement of strategy, it was important that the Council reflected on its current position and purpose and developments in the health and regulatory sectors within which it operates.
It was also imperative to listen to the views of doctors, members of the public, leaders in the health sector and a range of other partner organisations. Extensive research with
1,000 members of the public and 700 doctors, as well as consultation with over 40 partner organisations was conducted to ensure that the Council considered a wide range of views in developing its strategic direction. A summary of key themes emerging from this research and consultation process is provided below.

The need for leadership

The need for leadership within the health system was a theme that emerged throughout the Council’s consultation process. The Council cannot impose itself as a leader, but through its work it can inspire others to look to it for leadership. To be effective, the Council must create a vision for patient safety in Ireland that resonates with the public, doctors and partner organisations, and set goals which will be jointly achieved. The Council must look particularly at how it is viewed by the public and profession so that it can emerge as a leader who will be looked to for guidance.

Patients trust their doctor

Research conducted by the Council since 2011 has consistently shown that the vast majority of patients in Ireland are very satisfied with the care they receive from their doctor. Doctors are viewed as trustworthy and ethical by the general public. The Council is conscious of the need to support and enhance this view through its work in setting and monitoring standards of medical professionalism.

Council must balance the needs of the public with those of the medical profession

Through its work, the Council promotes good professional practice among doctors in the interest of patient safety. It is clear in talking to patients and doctors, that there may be
very different views as to how the Council can be most effective in its role. The Council must try to balance the needs and opinions of the public and those of the medical profession in determining the course of action it believes will best deliver improvements to patient safety in Ireland.

Retention of doctors on the medical register

Between January 2010 and December 2013, approximately 5,800 doctors were newly registered with the Council, entitling them to practise medicine in Ireland. Meanwhile, over the same period, approximately 6,300 doctors withdrew their names from the medical register. Research conducted by the Council found that after those of retirement age, doctors aged 25-34 were most likely to leave the register. There were also higher-than-average exit rates from doctors who qualified outside of Ireland.

Ensuring that all new applicants meet the high standards necessary to safeguard Irish patients presents significant resource implications for the Council. Retention of highly skilled doctors within the Irish health system has emerged as a critical issue requiring attention. The Council must take steps to ensure that younger doctors are provided with the necessary support to develop a career in Ireland, while doctors who qualified abroad are supported to stay and build a career here.

Enabling good practice

The Council’s work to promote high-quality education, training and lifelong learning, through postgraduate accreditation and professional competence, for example, is in an early stage when compared to other aspects of its work. An important area of focus for the Council will be to oversee the way its work develops so that it best supports doctors’ practice in a changing health system. A doctor’s practice of medicine is influenced not only by his or her knowledge and skills, but also by the environment in which he or she operates. The Council will focus on working with others, particularly in the area of clinical governance, to best support and enable good professional practice.

Doctors’ health

The health and wellbeing of doctors is an important consideration in the delivery of healthcare services. Like their patients, doctors may experience difficulties with their physical and mental health that can impact on their ability to practise. The Council’s duty to support doctors
whose ability to practise may be impaired is an important one, and the Council will focus on doctors’ health and preventative measures to support doctors during the course of its term.

The need for effective collaboration

For the Council’s work to have a real impact, it must be part of and positively contribute to the development of a wider environment that is focused on ensuring the safety of patients. It is important that the Council helps to shape health policy by collaborating with others in the health service and informing their work. The Council must lead by example and remain an independent and objective voice while also ensuring engagement and inclusivity.

The importance of the governing legislation

The Medical Practitioners Act 2007 is the legislation governing the Council’s work and sets out
its role and functions. At European level, EU legislation provides for freedom of movement of professions, including doctors, among member states. A range of other legal frameworks impact on the Council’s role and in some instances can enable or constrain its decision- making. Issues such as assessment of English language proficiency, the proposed European Professional Card and minimum training requirements are legislative proposals that impact on the Council’s ability to set and implement standards. There have been on-going discussions with the Department of Health regarding potential amendments to the Medical Practitioners Act to help the Council to work more effectively. It is vital that the Council is active in recommending changes where they are needed to support its work.

Maintaining a sustainable business model

The financial position of the Council has been influenced significantly in recent years by its greatly expanded operations. Over the course of the last statement of strategy, the Council’s role expanded to include greater oversight of education and training as well as lifelong learning requirements for doctors, and the handling of an increased number of complaints. Against this backdrop, a programme of operational cost-cutting was successful in reducing, rather than eliminating, annual losses. Conscious of the financial constraints on doctors
in a time of recession, registration fees were increased modestly in 2013 for the first time in five years. Fees will be kept under continuous review, and the Council must direct its limited resources to the areas that will have the greatest impact in enhancing patient safety. Engagement with the Department of Health is imperative in developing an effective financial strategy over the course of the Council’s term.

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