All craft groups in the Irish Medical Organisation (IMO) have now formally indicated that they will begin industrial action in support of public health doctors, who today enter the third week of their strike, writes Dr Muiris Houston, Health Correspondent, in Killarney.
Consultants, GPs and non-consultant hospital doctors were responding to the threat made by the Minister for Health, Mr Martin, in his address to the a.g.m. of the IMO on Friday when the Minister said: "The total abandonment of responsibility by senior staff in the health system is a new departure and one that will need some reflection in thinking through the reclassification of functions in the restructuring of the health service".
Dr Darina O'Flanagan, director of the National Disease Surveillance Centre and the most prominent of nine senior public health specialists identifiably threatened by the Minister, told The Irish Times that is was "extremely inaccurate" for Mr Martin to accuse her of negligence.
"In my opinion, it is the Department of Health who have been negligent for the past nine years for not providing a properly resourced and structured out-of-hours public health service.
"It beggars belief that, having experienced the worst epidemic of meningitis in the developed world over the last few years, GP's and consultants have been trying to pick up the pieces at weekends".
Confirming that there are letters on file from other medical groups expressing frustration with this gap in services, she said: "We would be doing the public a disservice if we allowed this industrial action to end without ensuring that safe systems for the management of infectious diseases are put in place."
General-practitioner sources have told The Irish Times that firm proposals for industrial action will be agreed this week. The initial phase will include the withdrawal of administrative co-operation with health boards. This will mean not collecting vaccines for child immunisation schemes from local health board offices; ceasing to file information returns on completed vaccinations; and not notifying health boards of infectious disease outbreaks and statistics.
If necessary, the next phase will include a partial withdrawal of services in a way that increases pressure on already overloaded accident and emergency departments.
A senior IMO consultant has confirmed that consultants will also start industrial action if the public health doctors' dispute is not resolved. "It will be administrative action first, but will increase in graded steps to a level which may impact on elective hospital admissions," the source said.
However, all three craft groups have indicated that they will not implement industrial action plans for one week.
"We want to allow the Minister and his officials time to reflect on the unprecedented tactics which they have so far used in the public health doctors' dispute. But make no mistake; in the absence of an apology from the Minister or a resolution of the dispute, further action will commence," IMO sources said.
Meanwhile, in a statement the IMO confirmed that all emergencies related to SARS and other serious infectious disease would continue to be dealt with by public health doctors in a fully professional manner. It came in response to an earlier statement from the legal adviser to the Medical Council, Mr William Kennedy, clarifying a report in Friday's Irish Independent.
"I did not tell Mr Flynn [industrial relations correspondent of the newspaper] that any person who was unfortunate enough to contract the SARS virus could complain or take action against a striking doctor", Mr Kennedy said.