GP accused of professional misconduct over criticism of Covid guidelines during pandemic

Seán McCárthaigh

A Wexford GP has been accused of professional misconduct over social media posts which were critical of measures and restrictions introduced by the health authorities during the Covid-19 pandemic.

Billy Ralph, who runs his own practice at The Ballagh Health Centre, The Ballagh, Enniscorthy, Co Wexford, is facing six separate counts of professional misconduct at a medical inquiry over comments he posted on Twitter (now X) between October 2020 and June 2022. 

They included a claim that various public health initiatives to contain the spread of Covid-19 were “all bulls**t.”

The fitness-to-practise inquiry held by the Medical Council heard the allegations relate to tweets by Ralph, which were critical of the National Public Health Emergency Team (NPHET) and Covid-19 vaccinations, particularly to children.

Other allegations relate to the GP’s promotion of ivermectin as a treatment for Covid-19 and his opposition to facemasks and lockdowns as measures to restrict the spread of the virus.

Counsel for the Medical Council, Neasa Bird BL, claimed Ralph made comments on social media which he knew or ought to have known were inappropriate and undermined public health guidelines.

Bird claims the comments were also not in accordance with the Guide to Professional Conduct and Ethics for Registered Medical Practitioners.

Details of 34 individual tweets by Ralph were outlined to the fitness-to-practise committee, including a post from November 2021 which stated that “some children watching the Toy Show tonight will receive the Covid jab and will not see another Christmas” which he linked to “lies” by scientists, government, doctors and RTÉ.

The inquiry heard that two months later, the GP described any parents who signed their child up for a “pointless and dangerous product” as “a vile individual”, while claiming any doctors administering the vaccine “should be brought before the courts if an adverse event occurs.”

Other tweets included claims that NPHET were a “liability” which caused a “bigger second wave of cases by introducing masks, social distancing and lockdowns”.

In another post from November 2020, Dr Ralph tweeted that NPHET were “responsible for untold destruction of our society.”

He separately claimed the same month that there was no pandemic but “just a lot of misguided fascist professionals who have lost the run of themselves.”

In November 2021, Dr Ralph suggested that ivermectin – a prescription medicine used to treat parasitic infections like head lice – could “end this ‘pandemic’ as well as the careers of many doctors, academics and politicians.”

At the outset of the hearing on Tuesday, the GP welcomed clarification that the allegations against him related solely to social media posts and not to any clinical matter.

He noted that the original complaint made about him to the Medical Council by another doctor in July 2021 had made a reference to alleged advice he had provided in his clinical practice.

He expressed concern about the delay in bringing the case, which he observed was not an isolated one as he was one of eight GPs who challenged public health guidelines.

Dr Ralph, who legally represented himself, was accompanied by Marcus de Brun, a north Dublin GP who was the subject of a similar fitness-to-practise inquiry earlier this year, whose findings are still to be announced.

Dr Ralph argued that disagreeing with NPHET policy did not equate to falling short of the standards expected of medical practitioners and claimed any allegation of harm or risk he had caused “must be clearly pleaded and proven.”

The chairperson of the inquiry, Paul Harkin, acknowledged that there was no statutory definition of the word “undermine” and informed Dr Ralph that the committee would apply its “natural and ordinary meaning” in their deliberations.

The inquiry heard that Dr Ralph had told the Medical Council in correspondence that his social media posts and other longer publications were “no business” of theirs.

He said his Twitter account stated clearly that his comments were not medical advice and that HSE guidelines during the pandemic should be followed.

Dr Ralph said articles he had published on the Cassandra Voices website were critiques of “accepted wisdom” which “any sane society would be valued” and not used as examples of “heresy.”

He stated he would continue to write about what he considered injustices and consensus views “driven by undisclosed conflicts of interest” and anti-science thinking.

The GP said he would not be bullied into “forelock tugging submission” because of a mendacious complaint against him.

The inquiry was also informed that the number of followers of the GP’s Twitter account increased from 4,557 in June 2022 to 5,753 by August 2022.

He told the regulatory body that his practice had grown since April 2021 by 600 patients “fleeing from their previous GPs” – a figure which had subsequently increased to 900.

He stressed that he had given the Covid-19 vaccine to all at-risk patients.

However, the GP said his views were always guided by science and “not dogma and scientism.”

Ralph told the Medical Council that he wanted the “charade” to be over and claimed he would happily expose its “petty censorship and bullying” in the High Court.

Ms Bird acknowledged that Dr Ralph had a constitutional right to freedom of expression, which included questioning strategies adopted during the COVID-19 pandemic.

However, she said it was not an absolute right and was one that is subject to public order and morality.

Ms Bird argued the timeframe of the social media posts by the GP was important and relevant as they were published during a global pandemic when the path of the virus could not be known and when its containment required significant public health interventions.

While she accepted that none of the allegations related to Ralph’s clinical practice, Bird said his tweets were “bound up” in his standing and conduct as a medical practitioner and that he relied on his knowledge as a GP in making such comments.

Bird said the views of a doctor on such matters would also carry weight and influence, while noting that guidelines imposed a responsibility on GPs to use words that were appropriate and which did not undermine public health guidelines.

She also claimed that Twitter was not a forum for “complex discussions on matters of public health.”

Ralph called on the inquiry committee to ensure that all tweets were read in context as some were responses to other posts, while others were “pouring water on flames.”

The inquiry, which is scheduled to last three days, was adjourned and will resume on Thursday.