Why sanctioned doctors still find refuge here (in Ireland)—and what to do about
- Dignity 4Patients
- Oct 2
- 7 min read
By Terence Cosgrave - Irish Medical Times - 03.10.2025 [Prevention] - [IRELAND] Ireland has an unflattering habit of discovering, after the fact, that a doctor disciplined abroad has quietly found sanctuary on our shores. The latest wave of reporting shows this is not a stray summer squall but a weather system – a structural failure in how we flag, share, and publish disciplinary information about clinicians who cross borders.
In plain English, doctors struck off, suspended or shackled elsewhere have been able to keep practising here, often with no public hint of the past embarrassments that recommended them for other pursuits. The Irish Times has catalogued multiple cases in which doctors disciplined in the UK retained Irish licences—and, crucially, their Irish public register entries did not reflect the overseas sanctions. The Medical Council’s response was that it followed ‘correct processes’ (which will surely be a huge, huge relief for Irish patients!) and is constrained by what it may publish. That may be true, but it is also the problem.
This is not a purely Irish dysfunction. A cross‑border investigation led by the Organised Crime and Corruption Reporting Project (OOCRP) – together with Norway’s VG and The Times found more than a hundred physicians who had lost the right to practise in one jurisdiction were licensed in another. Norway’s health minister, confronted with the findings, proposed a joint EU/EEA authorisation register and said out loud what many regulators imply sotto voce – the current European alert mechanism is full of loopholes and used inconsistently. In Norway, authorities even reopened a dozen cases. In other words, the shambles is continental.
So, what is the Medical Council doing about this?
Three things matter: what it can publish, what it must be told, and what it can do in an emergency. First, the Council updated its Sanctions Guidance in May 2024, an attempt (it says) to make decisions more transparent and consistent. That is better than opacity, but guidance is not a siren. It doesn’t tell patients what a doctor did elsewhere or when.
Second, the Council issued a new Publications Policy in 2024 that emphasises the underlying law: sections of the Medical Practitioners Act 2007 and directions of the High Court constrain what, when, and how much can be published about sanctions. That policy also acknowledges discretionary powers to withhold certain information (for instance, sensitive health matters). In practice, ‘caution’ can bleed into silence.
Third, the law does impose duties on doctors: if anything material happens that could affect their registration – say, conditions imposed, or a licence withdrawn in another country – they must notify the Council within 30 days. Failure to do so is not a clerical peccadillo or a small error – it breaches section 55 of the Act. The Council also has an emergency brake – section 60 lets it apply to the High Court for an immediate suspension, where needed, to protect the public. These are potent tools – if used.
The Council also insists on verifying credentials (including prior licensure) through the Electronic Portfolio of International Credentials (EPIC) or Intealth for internationally trained doctors—a good housekeeping measure that checks whether a degree or licence is genuine. Yet verification of a document’s authenticity is not the same as transparency about a practitioner’s disciplinary history. The gap between the two is where risk collects.
Why is this happening here in Ireland?
Follow the bodies – not in the morgue, but in the HR spreadsheets. We run our health service with an exceptionally high share of internationally-trained doctors. The Department of Health reports that 43.4 per cent of physicians licensed in 2023 obtained their first medical qualification abroad – on the General Division, nearly 59 per cent are international medical graduates, and more than 70% of new entrants to the doctor register in 2021–22 were internationally-trained. We are, by choice and necessity, a net importer of clinicians. When you lean this heavily on overseas recruitment, the margin for error in cross‑border regulation shrinks to a hairline.
Add the regulatory plumbing. Within the EU/EEA, the legal backbone for alerting other states to sanctions is Directive 2013/55/EU and its IMI (Internal Market Information) platform. Alerts about bans or restrictions are supposed to be sent promptly – indeed, within three days – through IMI. But as the OCCRP-led reporting shows, some states barely use the system, or use it badly. And after Brexit, the UK lost access to the IMI-based alert mechanism, forcing everyone to rely on slower, bilateral paper-chasing. That matters for Ireland because UK–Ireland medical traffic is a busy corridor – any friction or failure on the UK side is our problem the next morning.
Finally, there is the long memory of a short‑sighted policy. A 2019 High Court matter revealed the Council had, at one point, shifted from pro‑active recording of overseas alerts to what the court tartly called an ‘honour system’ – and was told, in terms rarely used outside a tutorial in moral philosophy, that honour systems don’t work where some people are being dishonest. The Council then reverted to a more sensible approach and even did a back‑check. The lesson should not have needed judicial emphasis.
Are we alone in this? Does it happen elsewhere?
Ask London. The Times found at least 22 doctors with disciplinary histories abroad whose UK licences did not show those restrictions, prompting the Health Secretary to demand an urgent explanation from the GMC. Norway, for its part, now promises ‘immediate’ reforms after VG’s companion reporting. These are not just rural Irish quirks; they are European seams that have split – and the same physician can walk the fault‑line from Oslo to Offaly.
What can be done—now?
Make foreign sanctions visible by default. Amend the Medical Practitioners Act and the Council’s publications rules so that any known sanction, restriction, or pending foreign inquiry is flagged on the public register entry with dates, jurisdictions and links to the original decision. This is not a lynch mob – it is informed consent for patients. (The 2007 framework already lists the sanction menu; the defect is in publication, not imagination.)
Tighten the duty to tell. Section 55’s 30‑day notification rule should carry automatic, public consequences for non‑compliance – treat failure to disclose a foreign sanction as presumptively serious misconduct, triggering interim conditions or a section 60 application pending a full inquiry. The signal must be unmistakable: concealment is career‑ending.
Use the emergency brake. Where credible evidence of an overseas ban or suspension exists—and particularly where a foreign court has spoken—the Council should err on the side of immediate High Court action. That balance of justice is precisely what section 60 exists to calibrate.
Mandate employer checks. Require hospitals, agencies, and GP partners to run documented, auditable ‘fitness to practise’ checks against foreign regulators before any clinical start date and at renewal. After the 2019 rebuke, no Irish employer should be allowed to outsource due diligence to trust.
Fix the pipes we control; agitate to replace the pipes we don’t. Within the EU/EEA, Ireland should press for a single, public, machine‑readable register of sanctions that all national regulators must update in real time via IMI—with explicit penalties for late or missing alerts. The Commission’s own scorecards admit wide variation in IMI use; an alert system no-one uses is a silent siren. And because the UK no longer sits in IMI’s pews, Ireland should pursue a formal UK–Ireland memorandum that mimics IMI’s three‑day alert standard, with public confirmation of receipt.
Upgrade verification from ‘is this real?’ to ‘what really happened? EPIC checks that a degree or licence is genuine; it can also verify licensure/registration history. The Council should require EPIC (or its equivalent) to include, as a condition of registration, authoritative summaries of disciplinary findings from every prior jurisdiction, not merely letters of good standing. If a regulator overseas has already done the hard work of investigation, we needn’t relearn the alphabet.
What should be done—on principle?
Let’s abandon the sentimental fallacy that opacity is kindness. Patients, unlike regulators, do not enjoy the luxury of uncertainty. They cannot weigh what they are not allowed to know. A public register that conceals material foreign sanctions is not neutral; it is misleading. If a doctor is safe to practise, let him/her practise—openly, within the context that allows patients to decide whether to trust them or not. If he/she is not trustworthy, do not make them our problem by mistaking the right to earn a livelihood for the right to earn it in medicine.
Nor is this an invitation to xenophobia, a word too often press‑ganged into the service of bureaucratic inertia. Ireland’s dependence on internationally-trained clinicians is a fact, not a sin. Many of those doctors keep our hospitals open and our consciences intact. But it is precisely because we recruit globally that we must regulate globally. The convenience of international hiring cannot be allowed to become a cloak for international evasion.
And here, for once, the remedy is reassuringly prosaic. You do not need an inquiry chaired by a retired eminence to stipulate that an overseas ban is relevant to Irish patients today. You need a line of code in a database, a rule about three days, a High Court application when the facts are stark, and an adult conviction that sunlight is not only a disinfectant, but a duty. Anything less, and we are not regulating a profession – we are curating a fig leaf.
If you have been affected by any of the issues raised in this article and were abused in state run medical and health facilities, you can contact Dignity4Patients, whose helpline is open Monday to Thursday, 10am to 4pm.
Dignity4Patients Commentary: This issue raises serious concerns about the integrity, transparency, and interconnectedness of international medical regulatory systems. This lack of coordination creates opportunities for individuals to move between jurisdictions without scrutiny, undermining efforts to protect patients and the public. It is essential that regulatory systems must be transparent, cooperative, and proactive in ensuring that no professional under investigation is allowed to quietly relocate or continue practicing unchecked. #MedicalCouncil #MedicalRegulation #Sanctions #StruckOffDoctors
