Cahill v Beacon Hospital Sandyford Ltd
| Jurisdiction | Ireland |
| Judge | Mr. Justice Robert Eagar |
| Judgment Date | 17 August 2020 |
| Neutral Citation | [2020] IEHC 456 |
| Docket Number | [2020 / 5470 P.] |
| Court | High Court |
| Date | 17 August 2020 |
[2020] IEHC 456
Robert Eagar J.
[2020 / 5470 P.]
THE HIGH COURT
Summary suspension – Injunctive relief – Bye-laws – Plaintiff seeking injunctive relief – Whether the defendant had suspended/restricted the plaintiff’s privileges in circumstances where it was not entitled to do so
Facts: The plaintiff, Mr Cahill, applied to the High Court seeking in effect an order restraining the defendant, Beacon Hospital Sandyford Ltd, its servants and agents from continuing the summary suspension of the plaintiff’s theatre facilities at the hospital which was imposed with immediate effect from the 23rd of June 2020. It was the plaintiff’s case that the defendant had suspended/restricted the plaintiff’s privileges in circumstances where it was not entitled to do so. The plaintiff submitted that the circumstances whereby summary suspension is applicable is found in the Bye-laws, Rules and Regulations of Medical Staff April 2018, in particular section 6.6 which entitles summary suspension in circumstances where there is cause to believe that the Medical Staff’s conduct requires immediate action to be taken to protect the life of any patient or reduce the likelihood of imminent danger to the health or safety of any individual. The plaintiff submitted that the defendant had offered no grounds of entitlement to suspend/restrict the plaintiff’s privileges other than to effectively say it possesses an inherent power to do so.
Held by Eagar J that there were so many disputes within the affidavits that the court would fall short to say that there was a degree of assurance that the plaintiff would succeed at trial; therefore, the plaintiff had not established the higher threshold. Additionally, the court was of the view that granting an injunction would not minimise the risk to injustice.
Eagar J held that the reliefs sought would be refused.
Reliefs refused.
The plaintiff in this case is seeking in effect an order restraining the defendant, its servants and agents from continuing the summary suspension of the plaintiff's theatre facilities at the hospital which was imposed with immediate effect from the 23rd of June 2020.
The notice of motion is dated the 30th July 2020, and the affidavit of the plaintiff is dated the 30th July 2020. The affidavit of Michael Cullen, the Chief Executive Officer of the defendant, was sworn on the 4th August 2020. This matter came before the court on the 5th August 2020.
Clearly, if this matter comes to trial it will be a substantial case and the issues of conflict which appear to exist in the affidavits will have to be the subject matter of cross -examination.
The court in this regard can only deal with the application in the Notice of Motion and has the bare facts of the affidavits of the plaintiff and the Chief Executive Officer of the defendant, in which there are substantial disagreements.
The plaintiff is a Consultant Ophthalmologist and Vitreoretinal Surgeon with a special interest in retinal diseases. He conducts practice from the Royal Victoria Eye and Ear Hospital and the Beacon Hospital. He also conducts a small practice from the Blackrock Clinic.
The plaintiff is also the co - owner of a private clinic which he operates through a limited company. This clinic is a multidisciplinary private eye clinic which specialises in the areas of macular degeneration, medical retina and vitro - retinal surgery and diabetic eye disease. He said that all surgical and general anaesthetic treatments that are required to be carried out are carried out in one of the three hospitals in which he practices.
He says at para. 6 in his affidavit, that he is seeking injunctive relief restraining the defendant from continuing a suspension of his theatre facilities in the Beacon Hospital which was imposed by the defendant's Chief Executive Officer (CEO) on the 23rd June 2020 with immediate effect. He says that he has at present 96 patients who require cataract surgery and/or eye injection treatment under sedation or general anaesthetic. He then refers to the Bye - laws, Rules and Regulations of Medical Staff dated April 2018 (The Bye - laws). The court will revert to those in due course.
It was agreed by both the plaintiff and the defendant that there is no written contract in relation to the employment of the plaintiff with the defendant, and it appeared generally accepted that the Bye - laws governed the regulations in relation to the employment and appointment of the plaintiff with the defendant hospital.
The preamble to the Bye - laws, Rules and Regulations of Medical Staff sets out as follows: -
• Beacon Hospital Sandyford Limited is an independent hospital located in Sandyford Dublin 18 organised under the laws of the Republic of Ireland.
• Its purpose is to provide patient care in an acute setting (this Court's emphasis).
• Its vision is to be a beacon of excellence in Irish healthcare and to be the preferred healthcare provider to the community it serves.
• The mission is to provide exceptional patient care in an environment where quality, respect, caring and compassion are at the centre of all we do.
• It is recognised that the medical staff are responsible to their patients, the Medical Board, the hospital Board of Directors and the Hospital Chief Governance Committee for the quality of medical care performed in the Beacon Hospital (this Court's emphasis).
• Therefore, the consultants who practice in the Beacon Hospital hereby organise themselves in compliance with these Bye - laws (this Court's emphasis).
Section 3 of the Bye laws provides, inter alia, as follows: -
“Continued membership of Beacon Hospital medical staff is contingent on continuously meeting the requirements, qualifications and responsibilities set out in these Bye laws and at the sole discretion of the CEO (this Court's emphasis).
All consultants who join Beacon Hospital medical staff will agree to abide by these Bye laws in order to enjoy Beacon Hospital privileges”.
Section 4 deals with Appointment, Reappointment, Credentialing and Re - Credentialing to the Medical Staff.
“Appointment to the Medical Staff is a privilege which shall be extended only professionally competent individuals who continuously meet the qualifications, standards and requirements set for and approved by the Beacon Hospital Medical Board.
The granting of privileges does not constitute an offer of employment and the Consultant does not become an employee of the hospital.
In most cases, members of the Beacon Hospital Medical Staff act as independent, self - employed practitioners and the granting of privileges will be decided at the discretion of the CEO.”
Section 4.5 entitled “Responsibilities of Initial and Continued Membership of Beacon Hospital Medical Staff” provides: -
“As a condition of consideration for initial appointment or reappointment and as a condition of the continued appointment, if granted, every applicant and appointee shall specifically agree to the following: -
(a) Pledge to provide appropriate continuous care, treatment and services and supervision of all patients in the hospital for whom the individual has responsibility.”
Section 5 deals with clinical privileges. The court is of the view that it is quite clear that the plaintiff held clinical privileges up to the decision of the Government to take over the private hospitals in the National interest due to the COVID - 19 pandemic.
Section 6 deals with review of medical staff member conduct. It provides the following: -
“6.1 Basis for review:-
The procedures provided in this section will be invoked whenever, it appears that the activities or professional conduct of any member of the medical staff: -
(a) Compromises or may compromise the safety, best interests, quality of care, treatment or services of a patient or the safety or best interests of an employee or visitor.
(b) Presents a question regarding the competence, character, judgment, ethics, stability of personality, including the ability to work cooperatively with others in the provision of safe patient care, treatment and services, adequate physical and mental health.
(c) Violates these medical staff Bye laws, rules and regulations, the requirement of clinical services, Beacon Hospital policies, including the Dignity at Work Policy and the Code of Conduct or constitutes conduct that is reasonably probable of being disruptive to hospital operations.
6.2.A When the CEO, Medical Director, or Department Chair is concerned that the conduct of medical staff raises questions under Section 6.1 above, or that a medical staff member may have failed to comply with any of the terms of his or her obligations as outlined in these Bye laws, the CEO will consult with the Department Chair or Medical Director at the earliest opportunity with a view to determining the most appropriate action. The Department Chair and/or CEO will notify the member in writing of the reasons for such concerns and inform him or her that any response that the Consultant may wish to make in relation to the matter must be submitted within 14 days.
6.3 Investigation:
The Department Chair and/or Medical Director may conduct any investigation deemed necessary or may assign this task to an appropriately qualified individual(s) or to an ad hoc committee of the Medical Board.
(e) If, having investigated the matter, and considered the response the Medical Staff Member has made, the Department Chair and Medical Director determine that the concern is unfounded, this will be communicated to the Medical Staff Member, and the CEO in writing.
(f) If the determination is made that the concern was justified, this will be communicated to the Medical Staff...
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