Whipping out the wombs of women when they were having babies, even though some of them were first-time mothers in their 20s or younger. Sometimes whipping out their ovaries, into the bargain, thus plunging them into early menopause.

In the venue appropriately called the operating theatre, these emergency procedures have to have involved a lot of drama and blood.

Yet none of the other consultants and medical staff around Neary noticed a thing. Down all the days . . . and there were many days . . .

those around him saw no mutilation, heard no mutilation, spoke no mutilation.

When his strange surgical track record was eventually brought to the attention of the then North Eastern Health Board, a middle manager there took action. And Neary took action right back. He roped in eminent medics to examine a few of his cases and vindicate him. Which they duly did, in jig time. He was only grand, they said.

Fine man. Good practitioner.

Nuthin' strange at all in his wombexcision pattern.

This vindication would have freed him to go back to the mutilation of women unlucky enough to be his patients, if a newspaper hadn't got involved and blown the scandal sky high.

Neary's passionate defenders protested against what they saw as appalling "trial by media". Those defenders, at the time, included many of the women he had rendered, in Robert Bolt's brutal phrase, "as barren as a brick". Those women . . . God love them . . . had bought his story that they had lost their wombs and chances of having other babies because he'd been forced to remove the organs in the process of saving their lives.

The mills of God grind slowly, but they grind exceeding small.

The mills of medical self-policing grind even more slowly and, in the Neary case, might not have ground him at all, if the exculpation offered by his team of experts had been accepted. Which is probably what would have happened, were it not for the intervention of non-expert media.

Fast-forward to the present, and the Neary experts have themselves been shamed. Shamed by public revelation of how cursory was their examination of evidence in a case involving the gratuitous and repeated maiming of women.

This shaming has happened at the same time as the British government, for quite different reasons, has announced its intention of ditching the old General Medical Council approach, which allowed doctors to police their own profession.

In Britain, the fact that a drugaddicted, floridly weird doctor named Shipman managed to: a) supply his own habit, and b) murder 250 of his patients without any of his colleagues raising a cheep, has hung a question mark the size of a horse over the willingness and ability of doctors to catch their own in wrongdoing, even when the wrongdoing takes the form of serial killing so energetic as to have decimated the granny population of an entire county.

The proposition that doctors should no longer be in charge of deciding who's fit to practise and who's not, would have been roundly rejected, all over the western world, until very recently. How could anybody other than doctors judge members of their own profession? Yet Mary Harney managed to put a majority of lay people on the medical council here and ensure that all fitness-to-practise cases are held in public, and the British plan is likely to go through, too, without much protest. Which goes to show just how diminished is the reverence with which we view doctors.

Particularly consultants.

One of the key reasons has been the "circle the wagons and protect our own" approach manifest in the Neary case. For decades, healthboard managers were reluctant to take action against even the most flawed medical practitioner, particularly a consultant, lest he or she gather together friends within the profession who would swear a hole in a sock that the consultant was picture-perfect in every way.

The same pressure affected insurers, who skewed their own statistics, not to mention the course of justice, by paying up long before a malpractice or negligence case was argued in court, on the basis that it was cheaper than paying for their bunch of experts to fight the bunch of experts hired by the accused.

What's puzzling is that nobody has proposed the perfect timeand-cost saving approach to examining standards. The one that applies whenever drug tests are going on: double-blind. No doctor involved in a drug test has a clue whether he or she is dosing their patient with Un-named New Wonderdrug or a placebo. If they did know, no matter how hard they tried to be objective, they'd send signals to the patient indicating their expectation of the outcome.

Why don't we have the same system when a doctor is accused of malpractice? Why are the doctor's records, with all identifiers removed, not given to three overseas teams for double-blind examination?

This approach would eliminate the possibility that medics who know, admire and like the accused will protect him or her. It would also have another, less obvious advantage. It would end the caricature of patients as litigious. Most patients bring their bodies to the medical profession the same way they bring their cars to a garage: to get them fixed. They don't start with a cunning plan to get 'compo', and the prevalence of this view of patients does neither side any good.

The double-blind approach worked a treat, not so long ago, in the music business. A violinist, rejected for the lead role in a major orchestra, sued. The eminent musicians who had rejected her genuinely believed she just wasn't as good as the man they picked. A simple double-blind test was arranged. Musicians auditioned from behind a curtain. The woman won.

Collegiality is pivotal to medicine. But it's best applied in teams devoted to the enhancement of surgical and other procedures.

Not . . . as it has been . . . to the protection of the inept and dangerous.

Diarmuid Doyle returns next week