Industrial relations: In the absence of a more conciliatory approach to industrial relation problems by the Department of Health, the State is likely to see the first all-out strike by hospital consultants since the foundation of the Irish Medical Organisation (IMO), doctors have warned.
As both the IMO and the Irish Hospital Consultants' Association (IHCA) ready themselves for possible industrial action in early March, IMO director of industrial relations Mr Fintan Hourihan has criticised "the new command and control policy" being pursued by the Department of Health in the past year.
Emphasising the "high level of anger and frustration" among consultants, Mr Hourihan predicted a ballot due to be completed this month would result in an overwhelming majority in favour of industrial action. Consultant sources told The Irish Times they expected to see an all-out strike rather than an escalating campaign of action.
"In deciding to sanction a ballot, the IMO consultant committee considered the evidence of a new command and control policy by the Department of Health with the obvious intention of putting new restrictions on the ability of consultants to practise freely and also by diminishing and attacking their contractual protections," Mr Hourihan said last night.
Apart from the unilateral introduction of the Clinical Indemnity Scheme last February - whereby the State took over responsibility for medical practice claims but without an agreement on who would cover doctors' past liabilities - consultant IMO members are upset by attempts to interfere with their pension entitlements as well as changes to disciplinary procedures introduced as part of recent health service reforms.
"The Labour Court has confirmed the indemnity scheme was introduced without agreement and that changes in the consultant common contract need to be discussed and agreed with the IMO," Mr Hourihan said.
He accused the Department of making "a studied decision to introduce radical changes affecting consultants without any prior discussion or consultation". The Department had introduced a new complaints procedure in the new Health Act so consultants now faced a "triple whammy" of a Medical Council action, civil action and a Health Service Executive complaints procedure, he noted.
Reacting to views expressed by the Minister for Health, Ms Harney, in an interview in last week's HealthSupplement, Mr Hourihan welcomed her proposal that some hospital consultants might only work in the public health system. "New consultants certainly should have the option of public-only practice as a matter of principle." Noting we are operating in an international labour market for consultants, he welcomed her view that "the best people [ consultants] have to be paid the best salary".
A Department spokesperson denied it was adopting a "command and control policy" as claimed by the IMO. "There is no hidden agenda. What the Department has been doing and will continue to do is to implement the health reform programme and the health strategy, both of which are Government policy."
Meanwhile, the IHCA has written directly to the Taoiseach warning that industrial action is likely to go ahead within two months as a result of "hostile action and broken promises" by two of his ministers - the current Minister for Health and her predecessor, Mr Martin.
It said it wanted Mr Ahern to be aware a national meeting of consultants would take place within a month and any industrial action decided upon was likely to begin by March 7th. The IHCA said the action stemmed from the failure of the Department of Health to deal with the long-running row over insurance for hospital consultants between the Government and the UK-based indemnity body, the Medical Defence Union (MDU), over who should pay for historic liabilities arising from medical negligence actions against consultants - Department actuaries estimated such liabilities could reach €400 million.
In its letter, the IHCA said its national council believed industrial action would go ahead unless the Government provided doctors with a legally binding undertaking that the State would deal with cases where the MDU has refused to provide cover.