245/2002
Murray J.
McGuinness J.
Fennelly J.
BETWEEN
Appellant/Plaintiff
Respondent/Defendant
JUDGMENT delivered on the 4th day of June, 2003 by FENNELLY J. [Nem Diss]
"The purpose of the disciplinary procedure is to ensure that complaints concerning the competence, capability or conduct of consultants will be dealt with in a matter [sic, recte manner] which has due regard to the rights and obligations of the parties. Where a complaint concerning a consultant is considered under this procedure it shall be dealt with expeditiously while affording the consultant adequate opportunity to reply to any complaint or allegation made against him. The consultant shall be entitled to be represented at all stages of the procedure should he so desire."
"1. Where:(a) The Chief Executive Officer of a Health Board
or
(b) The Chief Executive Officer, Secretary/Manager of a hospital or some other person authorised by him of a hospital not being a Health Board hospital
- hereinafter called "the appropriate person",
is concerned that a consultant may have failed to comply with any of the terms of his appointment or may have otherwise misconducted himself in relation to his appointment, he shall notify the consultant in writing of the reasons for such concerns and inform him that any representations in regard to the matter may be received by the Chief Executive Officer or the appropriate person, as the case may be, from the consultant within two weeks of the issue of the notification and will be considered.
2. A complaint relating to an individual living patient shall not be considered except where:-
(a) It is made by the patient, by a member of his family or by the employer, colleagues, statutory authorities or, by another person with the written consent of, the patient or where the patient is a child, of his parent or guardian and it is in writing and signed by the person making it, and
(b) It is made within six weeks of the alleged event in relation to which the complaint is made or within such longer period as appears reasonable to the Chief Executive Officer or the appropriate person."
Paragraph 4 provides:
"4. The Chief Executive Officer of a Health Board, Chief Executive Officer, Secretary/Manager of a hospital or another health agency or the appropriate person, after consideration of any representations which the consultant may make in regard to the matter, and after carrying out such further examination into the matter as he considers necessary may:-(a) if he is satisfied that the matter was trivial or without foundation, so inform the consultant in writing,
or
(b) if he is satisfied that the consultant had not complied with the terms of his appointment or had otherwise misconducted himself in relation to his appointment, and if he thinks fit, issue a warning or other like communication to the consultant,
or
(c) where he is the Chief Executive Officer of a Health Board, decide to act in accordance with the provisions of sections 22, 23 and 24 of the Health Act, 1970 and the regulations made thereunder,
or
(d) where he is not the Chief Executive Officer of a Health Board, decide to act by way of the following analogous provisions."
Paragraph 5(1) provides:
"5.(1) Where the appropriate person decides to proceed under the provisions of paragraph 4(d), he may request the Minister to appoint a committee under this paragraph to inquire into the matter and the Minister shall thereupon appoint such a committee."
The letter gave the Appellant notice, as required by paragraph 1 of Appendix IV of the Common Contract, of an impending investigation of six matters, described as "complaints." The use of this term is the basis of one of the principal points in the appeal. The letter also notified her that she was to take "administrative leave, with pay, with immediate effect, for such time as [might] be necessary for completion of the investigation … in accordance with the provisions of the Disciplinary Procedure." She was also informed that the investigation would take place with all practicable speed and of her right to make representations. The letter went on:
"It is envisaged that there will be a further examination of the complaints, at which stage the hospital will write to you inviting you to attend a meeting. At this meeting you will have the opportunity to make further representations. You should be aware that you will be furnished with the relevant evidence in relation to the allegations prior to this meeting."
"1. Strike out motion.2. Reserve costs.
3. Dr. Traynor to furnish statement forthwith to Mr Ryan.
4. If Dr. Traynor wishes to furnish further statements, will do so within 48 hours.
5. Dr. Traynor will attend the meeting with Mr. Ryan (solicitor and, if necessary, senior counsel in attendance (to make whatever oral representations she wishes and to answer questions posed by Mr. Ryan.
6. Within seven days of the latest of the above (5) absent force majeure or by agreement Mr. Ryan will issue his direction.
7. If the decision is within (a) or (b) of Appendix IV paragraph 4 administrative leave terminates.
If the decision is to refer to a committee pursuant to the agreed procedure reasons will be given in writing by Mr. Ryan at the time he gives his decision.
8. This is in settlement of the INT. INJ. app only and the parties reserve absolutely all other rights."
1. In four of the five cases, where the Respondent made findings adverse to the Appellant, there was no complaint in the sense of the Common Contract. Firstly, there is nothing to indicate that the writers of the letters of complaint intended their letters to constitute a complaint in the required sense. Secondly, in some, at least, of the cases, the letters are expressed in a neutral and non-critical fashion and do not even contain the material subject-matter of a complaint. Since the Respondent's decision to refer the matter to the Minister was based on the "totality" of the complaint, if even one of the letters does not constitute a complaint, it will invalidate the decision.
2. The Respondent was not entitled to reach substantive conclusions on the alleged complaints. He had no function to do so under the Common Contract. He did not have the professional qualifications to reach any conclusions on clinical matters. The investigation actually carried out constituted a serious breach of the Appellant's right to fair procedures. She was not afforded, in particular, any right to confront or cross-examine witnesses.
Conclusion
"The duty to act fairly is not one-sided. Mr. Robinson had to be fair to the doctors; he had to be fair to the complainants; he had to be fair to the Board, and, indeed, to the public generally. His duty was to make a judgment not on the truth or falsity of the complaint; nor, it need hardly be said, on the guilt or innocence of the doctors; nor even should be have reached a conclusion that there was a prima facie case against them. His sole function, to which he had to apply himself honestly and fairly, was to decide whether he had a complaint of substance, which he could not resolve in any summary fashion, worthy to be referred to the committee."