Last Updated on 12 July 2026 by Watchdog Witness
Introduction: A System Built on Secrecy
Imagine you are about to undergo a medical procedure. You research your doctor, check they are registered, and feel confident in their credentials. What you don’t know—and what the system actively prevents you from knowing—is that this doctor may have been struck off in another country, may have been found guilty of sexual misconduct, or may have been sanctioned for endangering patients.
This is not a hypothetical scenario. It is the reality of medical regulation in Ireland today.
A landmark investigation by The Irish Times, working alongside 50 international media organisations and coordinated by the Organised Crime and Corruption Reporting Project, has exposed a system so opaque that half of all sanctions against Irish doctors are concealed from the public. In some years, as few as 20 per cent of sanctions are made public.
This is the story of how Ireland’s Medical Council has created a system that prioritises doctor confidentiality over patient safety—and why patients are paying the price.
The Shocking Numbers: What the Data Reveals
Freedom of Information figures obtained by The Irish Times paint a damning picture of secrecy:
| Statistic | What It Means |
|---|---|
| 159 doctors sanctioned since 2014 | Professional misconduct, incompetence, or other serious breaches |
| Details of only 81 cases made public | Almost half of all sanctions remain hidden |
| 2016: 24 doctors sanctioned, only 4 cases published | Just 17% transparency in that year |
| 2023: 15 doctors sanctioned, only 3 records published | 80% of sanctions kept secret |
| Even when published, a third don’t include the doctor’s name | Patients cannot identify sanctioned doctors |
| Only 0.2% of registered doctors have publicly visible sanctions | Of 34,383 doctors, only 84 have restrictions visible |
The picture is one of deliberate opacity. Of the 34,383 doctors registered in Ireland, details of restrictions or sanctions are published in only 0.2 per cent of cases. This means a patient checking their doctor’s registration will almost certainly find nothing—even if that doctor has been found guilty of professional misconduct.
The Case Studies: When Secrecy Became Dangerous
The Heart Surgeon and the Bra Strap
Dr Fabrizio de Rita is a renowned heart surgeon who previously worked at Crumlin Children’s Hospital in Dublin. Last year, he was struck off the UK’s medical register for sexual misconduct after a fitness-to-practise tribunal found that while working at Freeman Hospital in Newcastle, he grabbed a colleague’s breast and “pinged” her bra strap.
Despite being struck off in the UK, Dr de Rita remains registered to practise in Ireland. No details of the sexual misconduct findings are listed on his Irish public registry. A patient in Ireland could walk into his practice today and never know about the tribunal’s findings.
In response to queries, Dr de Rita’s lawyer said his client had always denied the “unjust accusations” and that an Italian disciplinary procedure had found the UK proceedings “deeply flawed”. But that defence is irrelevant to patients in Ireland: they are entitled to know about the UK finding and make their own assessment.
The Doctor Under Investigation for 18 Months
Dr Asif Ali was one of 11 practitioners identified in the investigation who faced serious sanctions in the UK yet remained registered in Ireland. He was subject to strict conditions on his practice by the UK’s General Medical Council (GMC)—and had been for 18 months—before Ireland’s Medical Council finally suspended him.
The suspension only came after the investigation was published and the GMC moved to suspend him fully. The reason behind the sanctions remains unclear, but the GMC confirmed he was “under investigation and not permitted to treat patients in the country”.
Dr Ali obtained his medical qualification from Xinjiang Medical University in China in 2018 and registered in Ireland in February 2023. A month later, he also registered in the UK. Shortly after, UK authorities restricted his ability to practise—yet no restrictions appeared on his Irish registration until the investigation exposed the gap.
The Norwegian Problem
Dr Gavriel Simha Furedi was able to obtain a licence in Ireland and retain it for more than two years despite being under investigation in Norway for lacking basic medical knowledge. He was eventually issued with an interim suspension, but remains on the register pending a full fitness-to-practise hearing.
Why the delay? The Irish authorities have been unable to obtain certain documents from their Norwegian counterparts. This is not an isolated problem: it reflects a wider failure of international information sharing that puts patients at risk.
11 Cases, No Public Record
Overall, the investigation identified 11 doctors who faced serious sanctions in the UK, including being struck off, who remain registered in Ireland. In each case, the UK sanction was not recorded on the doctor’s publicly available record published by the Medical Council.
The sanctions included sexual misconduct, patient harm, and restrictions on practice. One male doctor was restricted from examining women patients alone. Another specialist was banned from carrying out common medical procedures.
The Regulatory Failure: How the System Broke
The Medical Council’s Defence
When asked about these cases, the Medical Council’s response was defensive. A spokeswoman said that “in all of the Irish-related cases highlighted the correct processes were followed”. She cited “many nuances” in individual cases and said sanctions were only made public in certain circumstances “outlined in regulations”.
Asked about potential risks to patient safety, she said the council “may investigate” doctors sanctioned abroad. But if a doctor makes a “declaration” they do not intend to return to Ireland, then it may not be “immediately necessary” to suspend them.
This is a remarkable position: a doctor who has been struck off abroad can remain registered in Ireland simply by saying they don’t intend to return.
The Legal Framework That Enables Secrecy
The Medical Council’s publications policy, updated in July 2024, outlines the circumstances under which information can be published. The Council has discretionary powers to withhold information that it considers to be confidential.
Key findings from the policy:
- Each decision is made on a case-by-case basis—there is no presumption of publication
- The High Court approves all serious sanctions—but the court may also direct that details be withheld
- Privacy and proportionality are weighed against “the public interest”
- The doctor can make submissions arguing against publication
In practice, “caution can bleed into silence”. The policy is not designed to maximise transparency; it is designed to balance patient rights against doctor privacy—a balance that has tipped heavily in favour of doctors.
What the Medical Council Doesn’t Publish
Even when sanctions are published, the record is often incomplete:
- Minor sanctions (advice, admonishment, censure) may not be published at all, regardless of the nature of the misconduct
- Published notices are removed after a set period—some after just two years
- Health-related conditions never display details of the health matter, even if the condition affects patient safety
- Transcripts of proceedings are not routinely published unless “in the public interest”
The Medical Council’s defence is that it must “strike a balance between protecting the rights of the public to be informed whilst also taking into account the rights of the medical practitioners”. But as critics have noted, a public register that conceals material foreign sanctions is not neutral—it is misleading.
The International Context: How Ireland Compares
The European Disgrace
The problem is not uniquely Irish. 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 acknowledged that the current European alert mechanism is “full of loopholes and used inconsistently”. Norway even reopened a dozen cases as a result.
Within the EU, authorities are supposed to share information on sanctions through the Internal Market Information (IMI) System. However, some European countries—including Malta, Estonia and Greece—rarely use the system while others such as Switzerland do not have access.
Brexit Made It Worse
After Brexit, the UK lost access to the IMI-based alert mechanism, forcing everyone to rely on slower, bilateral paper-chasing. This matters for Ireland because the UK-Ireland medical traffic is a “busy corridor”—any friction or failure on the UK side becomes Ireland’s problem the next morning.
The GMC says it continues to share data with other countries on a bilateral basis, but that it is the responsibility of doctors to disclose sanctions against them. This reliance on self-reporting is dangerous: doctors who have been sanctioned may have an incentive to conceal their history.
The Transparency Gap
Some countries, such as the UK, release large amounts of information about doctors’ disciplinary records to the public. In the Republic, however, this information is only disclosed in limited circumstances.
The contrast is stark. A patient in the UK can search a doctor’s record and find detailed disciplinary history. A patient in Ireland can search the same doctor and find nothing.
The Human Cost: Why Secrecy Harms Patients
Informed Consent Is Impossible Without Information
Stephen McMahon, director of the Irish Patient Association, summed up the problem:
“Patients have a right to know about sanctions imposed on doctors, including those imposed overseas. When this information is not provided, patients cannot give truly informed consent.”
This is not an abstract concern. Informed consent requires patients to weigh risks and benefits. If a patient cannot know their doctor’s disciplinary history—including findings of sexual misconduct, negligence, or incompetence—they cannot make a proper decision.
Opacity Is Not Kindness
Terence Cosgrave, writing in the Irish Medical Times, put it bluntly:
“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.”
He argued that a doctor who is safe to practise should “practise openly, within the context that allows patients to decide whether to trust them or not”. If a doctor is not trustworthy, regulators should not “make them our problem by mistaking the right to earn a livelihood for the right to earn it in medicine”.
The Irish Medico-Legal History
The problem has deep roots. A 2019 High Court matter revealed that the Medical Council had, at one point, shifted from proactive recording of overseas alerts to what the court tartly called an ‘honour system’—and was told that “honour systems don’t work where some people are being dishonest”.
The lesson should not have needed judicial emphasis. But the Council’s reliance on self-reporting and bilateral paper-chasing has persisted, despite clear evidence that it doesn’t work.
The Irish Medical Workforce: Why This Matters
Ireland runs its health service with an exceptionally high share of internationally-trained doctors. The Department of Health reports that:
- 43.4% of physicians licensed in 2023 obtained their first medical qualification abroad
- Nearly 59% on the General Division are international medical graduates
- More than 70% of new entrants to the doctor register in 2021–22 were internationally-trained
When you rely this heavily on overseas recruitment, the margin for error in cross-border regulation shrinks to a hairline. The failure to flag overseas sanctions isn’t just a bureaucratic issue—it’s a patient safety crisis waiting to happen.
What Needs to Change
1. Make Foreign Sanctions Visible by Default
The Medical Practitioners Act and the Council’s publications rules should be amended so that any known sanction, restriction, or pending foreign inquiry is flagged on the public register entry. This should include dates, jurisdictions, and links to the original decision.
2. Tighten the Duty to Tell
Section 55 of the Medical Practitioners Act requires doctors to notify the Council within 30 days if anything material happens that could affect their registration. This should carry automatic, public consequences for non-compliance. Failure to disclose a foreign sanction should be treated as presumptively serious misconduct, triggering interim conditions or a section 60 application pending a full inquiry.
3. Use the Emergency Brake
Section 60 of the Act allows the Council to apply to the High Court for an immediate suspension “where needed, to protect the public”. Where credible evidence of an overseas ban or suspension exists, the Council should err on the side of immediate High Court action.
4. Mandate Employer Checks
Hospitals, agencies, and GP partners should be required 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 outsource due diligence to trust.
5. Fix the International Pipes
Ireland should press for a single, public, machine-readable register of sanctions within the EU/EEA that all national regulators must update in real time via the IMI system. Because the UK no longer uses IMI, Ireland should pursue a formal UK-Ireland memorandum that mimics IMI’s three-day alert standard, with public confirmation of receipt.
6. Upgrade Verification
The Electronic Portfolio of International Credentials (EPIC) should include, as a condition of registration, authoritative summaries of disciplinary findings from every prior jurisdiction. A valid licence is not the same as a clean record—and verification of authenticity is not the same as transparency about disciplinary history.
Conclusion: A System That Protects Doctors, Not Patients
The Medical Council’s secret sanctions regime is not a glitch—it is a feature. A system designed to “strike a balance” between patient rights and doctor privacy has become a system that protects doctors from scrutiny and patients from the truth.
Half of all sanctions are hidden. Doctors struck off abroad can continue practising in Ireland, with no public record of their offences. The Council defends this by saying the “correct processes were followed.” But the correct processes are the problem.
Patients cannot give informed consent when they are denied information. A public register that conceals material foreign sanctions is not neutral—it is misleading. Opacity is not kindness; it is a betrayal of the public trust.
Watchdog Witness will continue to expose these failures. Patients deserve to know the truth about their doctors. Anything less is a dereliction of duty.
Sources and Citations
This article is based on:
- Freedom of Information figures obtained by The Irish Times
- A global investigation by The Irish Times, the Organised Crime and Corruption Reporting Project (OOCRP), and 50 international media organisations
- The Medical Council’s Publications Policy (July 2024)
- The Irish Medical Times comment piece on the scandal
- Analysis by the Law Society of Ireland
- The Medical Practitioners Act 2007 and associated regulations
Disclaimer
Disclaimer: This article is based on publicly available information, including Freedom of Information disclosures, court records, and reports from reputable news outlets. The information contained herein does not constitute legal advice and is provided for informational and journalistic purposes only. Watchdog Witness does not guarantee the accuracy or completeness of the information presented and accepts no liability for any errors or omissions. The Medical Council has defended its processes and stated that it follows “correct procedures” in all cases. This article may be updated as further information becomes available.
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