People with “little knowledge of the basics of medicine” are being allowed to work in hospitals here due to “defective” recruitment in the HSE, a leading judge warned.
High Court President Mr Justice Peter Kelly warned starkly of the “obvious danger to patients” as doctors lacking basic skills are being employed.
The judge will now contact Health Minister Simon Harris and the head of the HSE over the alarming concerns about recruitment of medical staff.
He made the startling comments in the case of a junior doctor in a maternity unit who was suspended from practising by the High Court.
Other doctors had raised serious concerns, within days of his starting work, that he lacked basic medical competency and was a danger to patients.
Criticism of recruitment in the health service came as the winter trolley crisis kicked in early, with almost 600 patients left languishing yesterday.
A row raged as Taoiseach Leo Varadkar refused to apologise for demanding staff work “full whack” at Christmas.
However, the sharp focus is now also on HSE interview and recruitment procedures, after the case of the junior doctor who was never taught how to examine a pregnant woman.
Mr Justice Kelly concluded the public interest required the doctor, who graduated from medical school in an east European country in 2015, be suspended from practice pending further order.
The judge wondered how the interview panel could have awarded him 55 out of 100 marks for clinical medical and diagnostic skills when his lack of those “was so obvious within days of his coming to work in the hospital”.
He also wondered how the interview panel concluded the doctor was “short on experience” when he had “none at all”.
The suspension order was sought by the Medical Council, and granted by the president of the High Court, to protect the public.
It applies pending a fitness to practise inquiry into complaints by two obstetricians about his methods.
Mr Justice Kelly said it was not an isolated incident and he had encountered other cases where registered medical practitioners “with little knowledge of the basics of medicine” were recruited to work in hospitals here.
He warned that “defective” recruitment and interview procedures have led to employment of persons “wholly unsuitable for appointment and an obvious danger to patients”.
His judgment expressing serious concerns should be sent to the Minister for Health Simon Harris and the acting CEO of the Health Services Executive, he directed.
The judgment noted the doctor never previously worked in any paid capacity in any other hospital anywhere and two consultants said he did not meet the “most basic” standards of competence of doctors practising “at this very junior level”.
Some of his junior colleagues here said they witnessed “wild” clinical assessments by him, made without taking any history or examining a patient.
The application for the order was heard and granted in private last month but yesterday the judge directed his judgment be made public on condition the doctor is not identified.
The doctor had attended an earlier meeting with the Medical Council but did not attend the court hearing or provide sworn evidence.
The judge said while the doctor had described himself as having been a senior house officer in a UK hospital, a letter from the NHS made clear he was merely an observer in a department of medicine and was to have no hands-on contact with patients.
Two consultants here had then raised concerns about his basic competencies, including history-taking, taking blood tests, insertion of IV cannulas, how to prescribe drugs and knowledge of drugs.
The doctor had told the Medical Council he made clear when interviewed here he lacked experience and that it was an observership he held in the UK.
He also said he was nervous and overwhelmed when asked by the consultants here about his medical knowledge.
He added there were “gaps in my training” but he was still studying and going to courses.
Responding to the story, a spokeswoman for the Minister Harris said: “Recruitment of doctors is a matter for the HSE, as acknowledged by the judge in his judgement yesterday. However, Mr Justice Peter Kelly has said he will be sending his judgement to the Minister and the Minister will reflect very carefully on its contents, which highlight a number of concerns in a range of areas.
“The Minister is aware there is a detailed review of the recruitment process underway by the HSE with a view to introducing a revised model in 2019.
“The Minister intends to seek an urgent response from his Department and the HSE on the circumstances of this specific case, the implications of Mr Kelly’s judgement and the implementation of actions arising from it.”