discipline a doctor who swore at a nurse.

The Hon. Sir James Astwood said slanging matches between staff would weaken patients' confidence in medical care.

And he ruled the Bermuda Hospitals Board had the power to take action against gynaecologist Dr. Delmont Simmons.

Costs were awarded to the Board, and its Chief of Staff Dr. William R. Cooke.

Sir James' decision has far-reaching implications, and lays down the law on employer-employee relations at Bermuda's hospitals.

Yesterday Mr. Hume Martin, the Board's executive director, said he was pleased by the decision.

"The Board is gratified by the finding of the Chief Justice that the medical staff by-laws are in full force.'' Mr. Martin said it was "unfortunate'' the matter was subjected to legal review. But he said the decision would ultimately benefit all patients at King Edward VII Memorial Hospital.

Dr. Simmons was disciplined after swearing at nurse Joanne Uttley in front of a patient at the hospital last year.

The Hospitals Board medical staff committee suspended his patient-admitting privileges for four weeks.

On appeal, the punishment was reduced to 10 days. But this was challenged by Dr. Simmons.

Sir James' ruling means Dr. Simmons will now be unable to work at the hospital for 10 days.

Mr. Ian Kawaley, representing Dr. Simmons, argued the Board had improperly made regulations on disciplinary matters when only the Health Minister was entitled to do so. He said the Board had passed regulations which were unlawful.

Mr. Kawaley also claimed Dr. Simmons had been provoked into swearing because of dissatisfaction at the nurse's standard of care.

But Mr. John Barritt, for the Board, said hospital chiefs had a legal duty and a power to deal with such behaviour. He said the Minister would only get involved on issues of termination.

Mr. Barritt claimed Dr. Simmons had a history of swearing in front of nurses.

In giving his judgment yesterday in the Supreme Court, Sir John sided with Mr.

Barritt.

He said the Board was responsible for "administering the hospital generally in an efficient manner and in such a way as to promote the welfare of patients''.

"In my view, if a doctor and a nurse gets into a slanging match in front of patients it will undermine the confidence that patients have in obtaining efficient medical care in the hospital.

"This is a matter falling directly under the management of the hospital and to be dealt with by the Board under its powers of management. There arises the question of how will the Board proceed with the problem of discipline.

"In the case of a nurse I would imagine that the Board can deal with the problem directly under an employer-employee relationship and the machinery set up for such matters.

"In the case of a doctor who is a member of staff, if no rules have been properly made by the relevant authority for dealing with discipline, the Board will have to resort to its contractual arrangement with the doctor concerned.'' Sir James said Dr. Simmons had signed his agreement to the hospital's regulations, rules and standing orders, which clearly set out disciplinary procedure.

"In my opinion, if these rules and orders do not have force of law, they would be a sort of `collective agreement' between doctors and the Board designed for the good management of hospitals.'' Sir James said the terms of the rules and orders were "incorporated'' into Dr. Simmons' contract with the board. "These rules and standing orders are, in my opinion, lawful and in full force and effect.

"Moreover, it this is not correct, the application must fail since the rules and standing orders became a condition of the contract between the applicant and the Board.''