# Department of Social Welfare Medical Exam



## annet (6 Jun 2009)

Has anybody recently attended an examination in the department of Social and Family Affairs and where you allowed or stopped from having another person stay with you during this physical examination?  Did they mention anything about a policy that existed in this Department where clients are not allowed to have another person present with them during examination other than your GP, the examining Departments doctor and nurse?


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## Smashbox (6 Jun 2009)

I accompanied my mother to a medical exam with SW and they told me to wait outside, that I could not go into the room. The doctor and nurse was in the room. Didn't really bother me, I was only accompanying for support.


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## annet (6 Jun 2009)

Interesting to note that this policy still appears to exist in the Department.

As a Nurse, I was quite surprised to have been faced with such a policy when I was unfortunate enough to have come face to face with the services provided by doctors in this Department.  I have to say, I have never come across a situation in the UK or Ireland, whether in general, acute or specialist practice a doctor or consultant would refuse to allow a patient have a person accompany and support them into the consultation/examination room.

When I asked the doctor to explain the why I was not allowed to have a person present with me during examination, I was told it was the policy of the Department - but unsurprisingly, neither the doctor, nurse or department could produce the policy written or otherwise!  I chose to exercise my right to have a person present - the doctor having sought the advice of the chief medical advisor then said that they were not proceeding with the examination and if I wanted to have a person present that I would have to write and ask THEIR PERMISSION.  

Maybe the real question that needs to be asked is why a doctor and department would develop such a policy that dis-allows people have a person accompany and support them during physical examination.  The nurse who is present is a colleague of the doctor - and this policy places the patient at an immediate disadvantage.


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## Diziet (6 Jun 2009)

I accompanied my OH last year and no policy of any kind was mentioned. It was OK for me to be present.


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## annet (7 Jun 2009)

Diziet said:


> I accompanied my OH last year and no policy of any kind was mentioned. It was OK for me to be present.


 
Was this occupational health - or an exam in the Department of Social and Family Affairs... if the latter it seems the verbal policy (if indeed it still currently exists in practice) is not being applied unilaterally across the board.


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## Diziet (9 Jun 2009)

Social and Family affairs. There was good reason for me to be present and it was not an issue.


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## briancbyrne (9 Jun 2009)

i think in light of the primetime programe last night regarding the failing of the systems in place when the accused Dr. Shine was in place (accused of using his position to abuse patients over a 30 year period), I would def want someone to accompany me if I found myself in such a situation. This is especially true on these such examinations given that the persons being examined are often the more vulnerable members of our society.


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## annet (9 Jun 2009)

My point is that every citizen in Ireland has political, social and civil rights - civil rights includes the freedom of speech, movement and choice etc - and my civil rights does not come within the discretionary power of any doctor or nurse employed in the DSFA.  People who attend examination in the DSFA are often the most vulnerable in our society - so who safeguards the interests of these people when those charged with safeguarding their interests simply violate rights or simply can't be bothered with protecting the interests of vulnerable people.  Numerous judicial findings and those from medical council show that people in highly respected professions whether priests, doctors and nuns can abuse.  Id ask the question why they dis-allow people from having people with them for support during physical examination - what have they got to hide, presuming that everything they do is actually fully above board!  I'd also question the mentality of a doctor who thinks they have the actual authority to dictate a persons civil rights.... is this not a power issue.


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## annet (22 Jun 2009)

Obtained the information leaflet that is generally issued to claimants about the MRA system. This document now states; 

"The attendance of other persons in the assessment, other than your doctor and interpreter if deemed necessary, will be at the discretion of the Medical Assessor".

The DSFA also claim "all assessments are carried out in accordance with accepted medical practice which is governed by the medical council, Ireland.  

To clarify what are the rights of all patients who attend any exam I am attaching relevant sections from The Medical Council.  These are the ethical principles that all doctors must apply in their work - entitled "The Guide to Ethical Conduct and Behaviour" (2004).  Sixth edition.  http://www.medicalcouncil.ie/_fileupload/standards/Ethical_Guide_6th_Edition.pdf 

*3.8  Physical Examination
*[FONT=MGUZLQ+AGaramondPro-Regular,Garamond Pro][FONT=MGUZLQ+AGaramondPro-Regular,Garamond Pro]Physical examinations should be conducted in the context of a thorough assessment of the patient, including relevant history-taking. Doctors should normally ask permission from a patient before making a physical examination. In the case of minors, the child’s parent/guardian should be present or should give permission for the examination.

*3.9 Intimate Examination**
*[FONT=MGUZLQ+AGaramondPro-Regular,Garamond Pro][FONT=MGUZLQ+AGaramondPro-Regular,Garamond Pro]Any intimate examination should be accompanied by an explanation. The patient, irrespective of age or gender, should be offered a chaperone.
[/FONT][/FONT][/FONT][/FONT]


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