Free under-six care set to dominate IMO conferenceWednesday 23 April 2014 15.30 By Fergal Bowers
Doctors gather in conference this week to debate the bitter row with Government over free GP care for children under six, delays filling consultant posts and the impact of successive cuts to the health budget.
The Irish Medical Organisation also marks its 30th anniversary at the annual conference in Carton House in Kildare.
Last week the Government approved the publication of the proposed legislation for free GP care for children under six years, which it wants in place by the summer.
That will not happen if GPs have their way.
Family doctors are angry following several years of cuts to their State income from the medical card and other schemes under the Financial Emergency Measures in the Public Interest Act.
Minister for Health Dr James Reilly and former IMO president will not be at this year’s event.
There was a time when the incumbent Health Minister always made the AGM a key diary item but relations between the IMO and the Department of Health are strained.
With GP issues to the fore, the official view may be that Minister of State for Primary Care Alex White is the man to attend.
When Mr White addresses the national GP meeting on Saturday, 26 April he is likely to get an up-close-and-personal sense of the ire of doctors.
GPs are demanding real negotiations with Government on the plan.
Mr White has invited them to talks about talks and while he says they can discuss the fee structure for GPs participating, in the end the Minister will set the final fee.
That is a big issue.
Doctors claim they may be overwhelmed with the extra 240,000 children which would be entitled to free GP care, while other studies suggest the increased visitation rates may be much less than predicted.
In a succession of ill-tempered press releases over recent months, the IMO has accused the Government of contempt, of behaving like a bull in a china shop, etc – so you get the picture.
Under competition law, GPs are limited in what action they may collectively take but the result is likely to be that, failing a breakthrough, the scheme will not actually operate this year if GPs boycott it.
How might the public react to that?
Meanwhile, Non Consultant Junior Doctors launched a major campaign this year to reduce excessive and dangerous working hours, and some of this has paid off.
But the result has been an increase in the costs to the HSE of hiring agency doctors and nurses, adding to a possible heavy overrun in the HSE’s budget by the end of the year.
In a motion before the annual conference, junior doctors are also accusing the HSE in some instances of engaging in unnecessary criticism and belittlement and are demanding more respect and courtesy in the workplace.
The other big issue for junior hospital doctors is the recruitment and retention of NCHDs here, with many attracted to work abroad for better pay and conditions, as well as specialist training opportunities.
Hospital consultants have been mostly quiet over the last year, stung by their own cuts and the Government decision in 2012 to cut the pay of new consultants by 30 per cent.
With the public spotlight on top-up pay at so many health agencies, they may also have taken the view that out of sight is out of mind.
In the last week there has been some better news for hospital consultants.
A report from the Department of Health has opened the door to some closing of the pay gap between newly appointed consultants and established consultants.
Consultants say the pay gap has had an impact on the recruitment and retention of these specialists.
The big battle however may be the outcome of the demand by the HSE that consultants working at St Vincent’s public hospital cease doing private work at the nearby St Vincent’s Private Hospital.
Over 180 consultants would be affected and this may well end up in the courts, with doctors insisting they are permitted to do this work under the common contract that consultants have with the State.
A motion before the IMO AGM from consultants condemns the recent public attempts by the HSE to undermine the contractual terms and conditions enjoyed by consultants attached to St Vincent’s.
A lot of money is at stake here so this will not be a fight that will end quickly.
There will also be an element of Banquo’s Ghost at this year’s get together.
Last year’s AGM in Killarney was dominated by the retirement package of the union’s former CEO which both sides negotiated to just under €10m.
The IMO had promised an independent review into the matter going back years but it has not happened, despite doctors voting for this at an extraordinary general meeting in March last year.
The cost of a review and the legal issues involved have spooked the organisation.
So at this week’s agm, doctors will be asked if there should be a ballot on whether the review should take place, after they are given a summary of the issues involved.
Does the union want to rake over old coals, or concentrate on the future?
Recently the IMO made a tax settlement with the Revenue Commissioners for €118,400 after an audit covering 2009-2012.
There may be questions at the AGM about that settlement which covered taxes, interest and penalties.
The union says it is stronger now with more members, over 6,000 doctors but the latest annual accounts show that the core day to day business is loss-making, so that’s another problem.
But it is not all work at the conference for the hard-worked medics.
It’s usually a lively social affair, where doctors can share stories from their surgeries and wards but respecting patient confidentiality of course.
There will also be an opportunity to enjoy the Carton House golf course on Thursday afternoon and a kids club and junior camp for the young little doctors of the future.