Dáil debates

Tuesday, 31 January 2006

Adjournment Debate.

Overseas Missions.

8:00 pm

Photo of Billy TimminsBilly Timmins (Wicklow, Fine Gael)
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I thank the Ceann Comhairle for allowing me to raise this very important issue. When members of our Defence Forces are sent on overseas missions, the least they can expect is that their medical needs will be looked after by the State. These men and women serve at the request of Government, the Houses of the Oireachtas and the UN. We must not forget the difficult and often life-threatening situations in which they are placed on our behalf.

The ongoing mission to Liberia, in which the Defence Forces have served with great distinction, is a particular case in point. This mission is difficult and dangerous. However, the recruitment of a doctor who had been removed from the medical register in his country of origin and the assignment to him of the key responsibility to provide medical assistance to our troops was an extremely serious lapse. The circumstances that led to this must be investigated fully and our concerns must be answered.

In these days of instant access to information, a simple web search reveals a considerable amount about Dr. Lieberthal. It is a fact that, at the same time that Dr. Lieberthal was being considered for appointment, information was available which clearly detailed his unsuitability for the post. An official statement from a provincial department of health in South Africa, carried on a website entry from November 2002, states clearly that Dr. Lieberthal had been suspended from Johannesburg Hospital, and that an audit of all the operations that he had carried out there was to be conducted. Another website listed Dr. Lieberthal as fourth on a list of the top 100 newsmakers in South Africa for 2002, having set a new record for the highest number of complaints laid against a doctor at the Health Professions Council.

It is clear that Dr. Lieberthal was removed from the medical register long before he was appointed in Liberia. That this was not uncovered prior to appointment raises very serious questions regarding the manner in which his qualifications were scrutinised. The company responsible for hiring Dr. Lieberthal, Medicare Solutions Limited, is based in the UK. A search of the UK companies office website shows this company is based in Surrey but no telephone number is given and there is no website for the company. I rang international directory enquiries and they were unable to find any telephone number for a company entitled Medicare Solutions, at the Surrey address or any other address. I hope the Minister can help solve the status of the company.

I understand that this company may have been paid €2,000 per day and that Dr. Lieberthal may have been paid out of this sum. I would appreciate if the Minister could confirm this. What payments, if any, were made to the company? I also understand that Dr. Lieberthal applied to the Irish Medical Council to be registered, but that his application failed. As the Minister may be aware, virtually all employment contracts for doctors stipulate that registration in the General Register of Medical Practitioners maintained by the Medical Council is essential.

With these facts in mind, there are a number of serious questions that may be answered by the Minister this evening. If he cannot do this he may do so at a later date. When did the military authorities discover that Dr. Lieberthal's registration had been erased from the South African medical register? How was this information brought to their attention? When was the Minister informed? How was the requirement for medical personnel in Liberia advertised? Was there a tender process, and if so, on what basis was the evaluation made and how was this company accepted? Was this a once-off arrangement, or has this company been contracted in the past to supply medical personnel?

Is the Minister aware of any other Department or agency that has operated a similar process with this company? Is this company currently supplying any medical or other personnel to the Defence Forces? How much money has been spent on the provision of medical personnel in Liberia? Will the Minister ensure that, from now on, all medical personnel contracted to work with the Defence Forces will be registered with the Medical Council and will be a position to show a certificate of good standing to prove such registration?

In light of the fact that Dr. Lieberthal also attended to up to 500 Swedish soldiers sharing Irish resources in Liberia, is the Minister concerned that the State is now legally exposed to an unacceptable degree following the appointment of this doctor? There is a serious shortfall of medical staff employed within the Defence Forces, of which the Minister will be acutely aware. What action will the Minister take to address this problem?

In assuming ever greater responsibilities, the Defence Forces will continue to rely on foreign nationals contracted to work for specific missions overseas. That a disgraced doctor, erased from his own country's medical register, could be employed to provide medical cover for Irish troops on mission overseas must be addressed by the Minister as a matter of urgency. The process that was or is in place put an unsuitable person in charge of the medical needs of Defence Forces personnel, not only from this State but also from one of our EU neighbours. This must not happen again and the Minister should outline how he proposes to change the current procedures.

Photo of Willie O'DeaWillie O'Dea (Limerick East, Fianna Fail)
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The Deputy has raised a number of questions, and although my response will not answer some of them, I will get him the appropriate replies. I was informed of this case on Friday, 27 January 2006. I share the Deputy's concern that this case should have arisen. My first priority in dealing with this is the welfare of the troops who were attended to by this man. To that end the director of the Medical Corps contacted each person who served in Liberia during the period in question alerting them to the case and advising them of the measures the Medical Corps were putting in place to deal with any concerns they may have.

As a result any Defence Forces member treated by the person concerned and who wished to discuss any aspect of his or her treatment with a medical officer was invited to consult their local military medical officer or alternatively to contact the special medical hotline established by the Army Medical Corps. I understand that, to date, there has been one call to this line.

The background to this case arises from the Defence Forces policy of providing medical care for personnel serving with large contingents overseas. In the case of missions such as Lebanon and Liberia it is the practice to send medical officers as part of the contingent. Given the arduous nature of the Liberia mission, with troops undertaking frequent long-term patrols away from base, it was deemed necessary to have two doctors with the battalion. The mission in Liberia is, of it nature, a peace enforcement one. This resulted in a situation whereby medical officers who had been recruited prior to 1993 could not be detailed to serve there and could only be selected to serve there as volunteers.

These requirements, coupled with a general difficulty in recruiting and retaining doctors in the Defence Forces, created a situation whereby the medical officer requirements for the mission could not be fully met among the doctors serving at that time. Following a tender competition involving a number of agencies, a contract was placed with Medicare Solutions Limited, Unit 15D, Oakcroft Road, Chessington, Surrey, England. I do not have a telephone number but I will try to get it tomorrow.

Photo of Billy TimminsBilly Timmins (Wicklow, Fine Gael)
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I do not think there is one.

Photo of Willie O'DeaWillie O'Dea (Limerick East, Fianna Fail)
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The contract was initially for a period of three months commencing on 1 June 2004 and was subsequently extended to February 2005. Following a further tender competition a fresh contract, at €2,630 per doctor per week, was placed commencing 1 March 2005. During this time Medicare Solutions had supplied a number of other doctors for periods lasting from a few weeks to three months. This contract expired on 31 December 2005. As and from 1 January 2006 the Defence Forces have been in a position to provide doctors from within the Medical Corps. We will not in the foreseeable future enter into any similar type of arrangement to that I am now describing.

The procedure for selecting suitable individual doctors was that candidates were identified and selected by the Medical Corps from the curricula vitae supplied to the Department by Medicare Solutions, which had expressed an interest in working with the Irish military contingent in Liberia. This selection was done on the basis of the professional qualifications, and particular clinical experience, of the various applicants as per their individual CVs. Dr. Lieberthal was selected to replace another previously selected candidate who had decided at very late notice not to proceed to Liberia. There appeared to be nothing whatsoever untoward in the CV supplied in respect of Dr. Lieberthal.

Dr. Lieberthal was first appointed for a three-month period from 8 December 2004. He was retained in Liberia until 31 December 2005, when the overall contract with Medicare Solutions expired. He worked in a civilian capacity and provided primary military medical care services to troops, that is, largely care of the routine general practitioner type. He also provided a similar level of medical service to a small contingent of Swedish military personnel. It was only after the contract had expired that it came to the attention of my Department that Dr. Wynne Lieberthal had been struck off the South African medical register by the Health Professions Council of South Africa in July 2004 after their investigation of various charges brought against him under the relevant South African legislation.

I am extremely concerned as to how this case arose and I will ensure that all necessary steps are taken to avoid any possible repetition. I am awaiting an urgent report from the chief of staff. Legal advice is being sought as to the performance of the specialist medical recruitment agency engaged to provide suitably qualified doctors who either had or would be expected to fulfil the requirements of the Irish Medical Council. It would not be appropriate to anticipate the outcome of legal advice and possible follow-up action at this early stage.

The requirement to pursue Irish Medical Council registration was included in the contract with the agency. However, I understand that the person in question applied for but never obtained Irish Medical Council registration. The delay in identifying this failure to obtain such registration will form part of the report on the case. While the safeguards in place will be reviewed along with the performance of the agency, it should be pointed out that in the first instance the person himself should not have commenced or sought work based on falsehoods.