Battle with striking doctors is set to worsen after Minister's Scud attack

The gloves came off the public health doctors' dispute in Killarney, writes Dr Muiris Houston

The gloves came off the public health doctors' dispute in Killarney, writesDr Muiris Houston

With the battle between the Minister for Health and the public health doctors raging inside, the precarious progress of a windsurfer across a squally Killarney lake on Friday afternoon was an appropriate reflection of events at the a.g.m. of the Irish Medical Organisation.

Although the three-day conference was held against the background of the public health specialists' dispute, it started quietly. There was some banter when a motion proposing that the Taoiseach order the installation of tachometers in Ministers' cars to cut down on recent speeding excesses came up for debate.

But the IMO is a responsible trade union, and when a motion from non-consultant hospital doctors referring to the imminent need for bunk beds in our hospital wards was debated, it was gently lobbed back to the juniors' national committee for some mature reflection and a smidgen of parliamentary rewriting.

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And, continuing the respectful mood, we then had an excellent seminar on "Alcohol, suicide and depression". It mixed hope for the future with the desolation of statistics past and present.

The session finished with Dr Marie Cassidy, the Assistant State Pathologist. She demonstrated a witty style of delivery, which suggests that when she finally takes over from Prof John Harbison as State pathologist, the tradition of educating medical students and doctors on the finer points of forensic medicine in an entertaining manner will continue.

Public health doctors did not arrive in force until Friday. It was clear from their relaxed demeanour that confrontation was not part of the game-plan.

True to the qualities of patience and gentle persuasion which are the hallmarks of a well-trained public health medical specialist, the predominantly female craft group were never going to "gang up" on the Minister.

And despite the differences between them, they applauded Micheál Martin's arrival in the main auditorium.

However, those of us who had witnessed the Minister's arrival outside the Hotel Europe had already picked up some warning signals.

Normally he, the IMO president and the organisation's CEO will chat on the steps of the hotel. He has even been known to enjoy a cordial cup of tea before getting down to business. But no, this was different. In fact, almost unrecognisable.

The Minister looked stern and headed straight through the hotel to the conference area. Eyes looking straight ahead, no smile on his lips, this was a man on a premeditated mission.

His officials formed a secret service-like protective phalanx around him, as if somehow their advance intelligence had indicated the possibility of an IMO-led decapitation exercise.

And despite the welcoming applause, the Minister strode to the podium which had barely been vacated by a proposer of a conference motion. The press corps scrambled into their seats, sensing an upset.

It came towards the end of an otherwise hard-hitting but fair speech. As Mr Martin came to his Scud missile paragraph, he hesitated and then produced the bombshell. The nine most senior public health doctors in the State would effectively have their futures reconstructed for them if they did not get back to work. The message was blunt: you are now senior management and senior managers do not go on strike.

Sitting with line of sight to a prominent public health specialist, I watched the blood drain visibly from her face. There were sharp intakes of breath around the auditorium, and heads could be seen conferring urgently.

The Minister then left the conference centre, pursued by a pack of journalists. He had signalled a press conference, which was hurriedly set up in an area adjacent to the main foyer.

Flanked by the secretary-general of the Department and his two most senior medical officers, the Minister indicated there was further news of the by-now-infamous probable/suspect/probable Chinese SARS victim.

Dr Jim Kiely, the Chief Medical Officer, explained that she was now once again a suspect case and was in fact recovering well in the isolation unit of Cherry Orchard Hospital.

Questions on the Minister's extraordinary attack on public health doctors were deflected.

This was a Minister on a determined mission to reclaim control over a Department of Health in severe danger of going into a SARS-induced orbit. But the conference mood had been irrevocably changed, with all doctor groups now firmly behind their striking colleagues.

Mr Martin's speech means the gloves are now off in the public health doctors' dispute.