Speaking in Mulranny, Co Mayo, at the annual conference of rural GPs and doctors from the islands, Dr Hillery warned the system is designed to fail as it acts only when harm is done.

He said, "The profession has asked for change. Proactive self-regulation that intervenes before harm happens will protect patients, recognise the high standards of the majority of doctors and catch those who are falling behind so that they can be remediated."

He claimed that a new regulation bill is flawed as "it seems to take the profession as the problem. Without change it will enact a flawed system that discourages professionalism and does not deliver for patients."

He stressed the need for the system to guarantee the independence of the regulator in the public interest.

He added that the medical profession must and will continue to show leadership for patients' interests including participation in the Medical Council's pilot projects that will shape future competence systems.

He warned, "However if the medical profession has to act alone without support from the health system and without supportive professionalising legislation the changes from the patient point of view will be minimal."