Despite the welcome attendance of both the Irish Medical Organisation and the South Eastern Health Board at the Labour Relations Commission yesterday, the early breakdown in negotiations indicates that the dispute concerning the rostering of junior hospital doctors will take time to resolve.
The kernel of the dispute is the need, accepted by both sides, to reduce non-consultant doctors' working hours, which average 77 a week at present. An EU working time directive has said their weekly hours must be reduced to 58 by the end of 2004, with a final reduction to a 48-hour week by 2010. However, the IMO and the Health Services Employers Agency differ fundamentally over which hours must be reduced.
According to the IMO, doctors must be in hospitals during the prime training period of 9 am to 5 pm and cuts in hours must be aimed at night and weekend work.The HSEA does not accept that hours outside 9-5 have no training value and has introduced new rosters which cut overall hours worked. Because the rosters in Waterford and Tullamore affect the core training hours of non-consultant doctors, the IMO initiated industrial action.
How has the dispute affected patients? So far almost 300 people have had either surgery or outpatient appointments cancelled. With no representative of the Midland Health Board at yesterday's talks, it was inevitable that a three- day stoppage at Tullamore Hospital would go ahead today. And with the breakdown of talks at the LRC, the Waterford strike is set to resume also, putting thousands of patients through unnecessary inconvenience and worry. A prolonged dispute - ballot papers on a national junior doctors strike have already been issued - will have a significant effect on hospital waiting lists. It will certainly impact negatively on the Minister for Health's aspiration to eliminate long waiting times for treatment.
Adopting a moderate tone which both sides in the dispute could learn from, the Irish Patients' Association has called on Mr Martin to intervene, pointing out that he can create an atmosphere in which agreement is possible. Specifically the minister must ask why the HSEA was not in attendance at yesterday's talks. Given the national implications of this dispute it was always going to be difficult for the SEHB to agree a resolution without the HSEA's imprimatur. The IMO and the MHB must also be questioned on their failure to engage in talks at the LRC yesterday. All sides must seriously ask themselves is this an issue worthy of prolonged disruption to patient care.
The short-term solution to this dispute lies in the withdrawal of the controversial rosters by the HSEA as an acknowledgment of the IMO's goodwill in suspending industrial action for the weekend. In the longer term a reduction in non-consultative doctors' working hours will only be achieved in the context of a significant increase in the number of consultants working in the public health service. Only then, will junior doctors be assured of adequate training and patients of receiving the treatment they deserve.