Medical Council told Wexford GP’s tweets on Covid-19 ‘inappropriate’ and risked public trust

Séan McCárthaigh

A series of social media posts by a Wexford GP, which criticised measures to tackle the Covid-19 pandemic, introduced doubt in the public about the safety and effectiveness of public health guidelines, a medical inquiry has heard.

An expert witness for the Medical Council, Rukshan Goonewardena, told a fitness-to-practise committee of the regulatory body that he believed that comments on Twitter (now X) by Billy Ralph were “inappropriate” for a doctor to make.

He warned that such comments could have made the public distrustful of medical guidelines.

Dr Ralph, who runs his own practice at The Ballagh Health Centre, The Ballagh, Enniscorthy, Co Wexford, is facing six separate allegations of professional misconduct over the content of posts he published on the social media platform between October 2020 and June 2022.

They relate to a total of 34 individual tweets which variously criticised the National Public Health Emergency Team (NPHET) and Covid-19 vaccinations, particularly to children, as well as the use of facemasks and lockdowns to restrict the spread of the virus.

Another allegation relates to the promotion by Dr Ralph of the use of ivermectin – a prescription medicine used to treat parasitic infections like head lice –- as a treatment for Covid-19 infection.

Counsel for the Medical Council, Neasa Bird, said the GP’s tweets were also not in accordance with the Guide to Professional Conduct and Ethics for Registered Medical Practitioners.

On the second day of the inquiry on Thursday, Dr Goonewardena said there was no evidence to support Dr Ralph’s claims that NPHET had caused “a bigger second wave” of cases by introducing facemasks, lockdowns and social distancing.

The expert witness also disputed the GP’s assertion that there was no pandemic as he told the inquiry it was “very clear” there was one and Dr Ralph’s comments were inappropriate given the large number of deaths.

On Dr Ralph’s promotion of ivermectin, Dr Goonewardena said there was no guidance from “reputable sources” for the drug’s use to treat Covid-19 or to replace vaccination.

He said it was unfortunate that information shared by Dr Ralph on Twitter “was not accurate or valid.”

Dr Goonewardena expressed concern that vulnerable people who lacked medical knowledge might be influenced by information shared online that was not factual or evidence-based.

“Doctors should not be giving medical advice on social media,” he observed.

Questioned about giving vaccines to children for Covid-19, the expert witness said that while the initial focus was on vaccinating the vulnerable and elderly, there was a recognition that children could transmit the disease to others.

Dr Goonewardena noted that children with special needs were also considered to be at high risk.

He stressed that the benefits of vaccination for Covid-19 outweighed the risks of any side-effects.

Dr Goonewardena said he believed the cumulative effects of various social media posts of Dr Ralph constituted dishonourable behaviour in terms of a finding of professional misconduct.

He believed the GP’s views about vaccinating children were reflective of what Dr Ralph was doing in his own practice.

However, Dr Goonewardena said he was not “100 per cent sure” if the GP’s tweets in relation to lockdowns were serious enough to merit a finding of professional misconduct.

Under cross-examination by Dr Ralph, he said he was not aware of any connections between NPHET, the Irish College of General Practitioners and pharmaceutical companies in relation to the specific issues before the inquiry.

Asked if guidelines were legally binding, Dr Goonewardena replied that they represented “best practice” which doctors were “expected to adhere to.”

He accepted that doctors were entitled to their personal opinion about such guidelines but said they should not publicly question them as public statements by doctors could cause harm.

However, he acknowledged that there were no allegations to suggest that Dr Ralph had caused any harm.

The witness also noted that the GP had provided 700 pages of testimonials to the fitness-to-practise committee.

Dr Ralph claimed Dr Goonewardena’s assertion that the SARS CoV-2 virus was spread by droplets was “incorrect” and said it was a “long distance aerosol spread virus.”

The two doctors disagreed about whether masks and social distancing would help to prevent the transmission of such a virus.

The chairman of the inquiry, Paul Harkin, had to make a number of interjections during the hearing to remind members of the public in attendance not to disrupt proceedings, including not to approach witnesses.

Dr Ralph is due to give evidence on Friday on what is expected to be the final day of the inquiry.

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