Tuesday 18 December 2018

Agency consultant's performance at Cavan hospital was 'substandard in a number of very serious respects', court hears

Stock image: PA Wire
Stock image: PA Wire

Tim Healy

The president of the High Court has voiced serious concern that medical practitioners who are not on the specialist register of the Medical Council are being recruited by agencies to work here as consultants in hospitals.

Mr Justice Peter Kelly said he is very concerned that such appointments are "not at all unusual". It was "difficult to see" how the public is protected by allowing persons lacking the necessary qualification to be held out as consultants, he said.

The situation is "wholly unfair" to patients and it is "hardly surprising" that the courts every week hear the HSE provide apologies about substandard treatment of patients and see millions paid out, he said.

As the Medical Council's objective is to protect the public by promoting and ensuring high standards of professional conduct, he presumed it must have a concern when it saw such non-specialists being appointed and wanted to know, within three weeks, has the Council "done anything about it" or expressed any disquiet to the HSE and the Minister for Health.

A solicitor for the Council said it is not involved in recruitment. While she understood specialist registration is required, that is "sometimes departed from" and she would have to take instructions.

The judge made the comments when granting the Council's application to cancel the registration of Arjan Kumar Bhatia, an experienced radiologist with an address at Drumcliffe, Co Sligo and at Northamptonshire, England, who was recruited by an agency to work as a locum consultant radiologist at Cavan General Hospital and did so between June and September 2014.

During those three months, Dr Bhatia's performance was "substandard in a number of very serious respects", he said.

The Council's Fitness to Practice Committee (FTPC) found a series of allegations cumulatively amounted to poor professional performance, including failures concerning CT scanning, to see liver abscess, to recognise acute stroke, and missed fractures.

Dr Bhatia previously worked over a number of years in other hospitals here despite failing the necessary examinations for the position of consultant radiologist, he said.

The judge said the manager and clinical director of Cavan hospital, having discovered that Dr Bhatia was not on the Council's specialist register, initiated a review of his work which indicated he may have worked below a level that would be expected.

The FTPC later made a number of findings of poor professional performance against him and recommended attachment of conditions to his registration. Dr Bhatia did not participate in that inquiry and was not legally represented.

The Council disagreed with the FTP recommendation and recommended to the High Court his registration be cancelled.

On Monday, having read the reports and relevant evidence, Mr Justice Kelly said he was concerned Dr Bhatia was employed as a locum consultant radiologist in a number of hospitals here when he was not on the Council's specialist register.

He was also concerned the hospital authorities had no part in the doctor's recruitment and had had someone "foisted" on them in those circumstances, with the apparent knowledge of the HSE.

What then occurred was a "litany of failures" on Dr Bhatia's part, some of a most serious nature. The court was "astonished" the FTP had concluded it was enough to censure him with conditions attached and glad the Council took a different view.

While he would make an order affirming cancellation of registration, he wanted to know the Council's views about such cases and whether it was appropriate that an agency who provides the employee, and is paid commission for that, makes the decision on recruitment. These were "very troubling" matters and it seemed to him the Council should be making representations.

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