IMO has campaigned for a positive agenda to serve the public better


I write on behalf of hospital consultants in response to points raised in the series of articles on the health services featured in The Irish Times series "An Unhealthy State" (most especially those featured in your October 5th edition). That there were so many unfounded attacks on consultants as a body surprises few of us; however, the litany of false assumptions and cheap point-scoring will disappoint a greater number.

The Irish Medical Organisation is the only representative body serving the entire medical profession; the organisation represents 5,000 consultants, non-consultant hospital doctors, general practitioners and public health doctors.

We emphatically reject the comparison made with groups who are seeking to restrict entry to their own field of work; in fact, since the 1980s the IMO and the various speciality bodies have actually been campaigning for the appointment of an extra 1,000 consultants in order that the unprecedented increase in activity can be adequately coped with in our hospitals. What we are seeking is a near-doubling of the number of public service consultant posts.

In addition, the IMO continues to campaign for a review of medical card eligibility limits so patients in the lower income thresholds can more readily visit their GP without charge. As it stands, a single person under the age of 66 living alone would not be entitled to a medical card although their wage would be nearly half of the minimum wage of £4.40 an hour, or £171 for a 39-hour week.

The obvious consequence of appointing 1,000 extra consultants would be greatly reduced amounts of private sector work for consultants. In passing, it should also be restated that the public/private service mix in Ireland has long been official Government policy and is entirely consistent with the structure of health services across the European Union and beyond.

The need for such extra public sector positions is obvious in view of the rapid increase in admissions, the extra workload expected of consultants whose numbers have not kept pace with rising admissions, pressures to reduce the bed stay for patients and the increasing expectations of patients.

On top of all of this consultants are expected to train non-consultant hospital doctors, meet the increasing demands imposed by so much new legislation and keep up to date with clinical developments.

The analysis contained in the series is based on apocryphal tales of missing consultants; the fact that there has never been any instance of such behaviour cited or any incidence where consultants have been disciplined for such a reason is blithely ignored.

Such caricaturing of the body of consultants is greatly resented by those many consultants who give selflessly of their time and are increasingly paying the price in terms of their own personal health and safety for such commitment.

The series also chose to ignore the fact that there are express provisions in the contract for consultants requiring that time spent in private practice cannot be at the expense of their availability to meet their public service commitments. Consultants are monitored and are asked to account for their time, which can often be shared among a number of public hospitals.

The charge that consultants are blocking change at the Medical Manpower Forum misses one fundamental point. It was never intended that the Forum would serve as a negotiating session where conditions of employment would be negotiated.

In misrepresenting the IMO position at the Forum, the author chooses to ignore the fact that long-established industrial relations procedures dictate that such negotiations take place directly between the Department and the representative bodies.

You may also be interested to know that from the outset the IMO has protested at the absence of reserved places for female consultants and non-consultant hospital doctors at the Forum.

The analysis of consultants' earnings is completely misleading and can only be interpreted as another assault on consultants, which suits the agenda of unnamed sources quoted throughout.

While barely acknowledging that some consultants do work long hours, the author fails to explain that for consultants to earn £17,000 in on-call and emergency calls necessitates their being on call and in the hospital for at least every second night and every second weekend throughout the whole of the year.

Has anybody thought of what this actually means in terms of the working hours and availability expected of such a doctor? The figures quoted in regard to the VHI are entirely without foundation. The author also neglects to mention that the VHI payments are used to pay for indemnity premiums, the wages of nurses, locums and assistants as well as administrative and capital costs.

In the absence of an opportunity to highlight the positive changes which the IMO has been campaigning for over many years, I am left to concentrate on defending the position of consultants from the sustained attack throughout the series.

I would welcome the opportunity to devote even greater time and space to highlighting the positive agenda the IMO has been campaigning upon for over the last decade which aims to serve the public better while also making it safer and easier for all doctors to provide the service they so dearly wish to offer.

George McNeice is chief executive of the Irish Medical Organisation