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Achieving tangible change in community medicine

One of the main achievements by the IMO with regard to community medicine over the last year has been the pay increase agreed under the Public Sector Stability Agreement. By October 2020, Senior Medical Officers (SMOs) and Principal Medical Officers (PMOs), as well as remaining Area Medical Officers (AMOs), will be paid a salary which reflects an increase of close to 9 per cent on current levels. This is not including incremental progression.

The IMO also reached a collective agreement with the HSE in Cork/Kerry to address local issues with regard to sessional employment, AMOs and temporary contracts of community medicine doctors in the area. The agreement benefits a large number of community medicine doctors in the area providing for the regrading of five AMOs, with a further three to be eligible for a closed competition for SMO positions once they receive the relevant qualifications. Some 16 doctors have been given permanent contracts in place of temporary or specified-purpose contracts and a further four sessional doctors have also been given permanent contracts.

The agreement shows the importance of members on the ground engaging with the IMO secretariat to bring issues to their attention and of working together to achieve successful outcomes. In this case, a number of cases were lodged with the Workplace Relations Commission (WRC) to seek permanent status, which were then settled as the desired outcome was achieved through engagement and negotiation with management.

The IMO continues to represent community medicine doctors at individual as well as collective level and this representation includes grievance procedures, contract advice and hearings with the WRC. Members who have an individual issue should contact the IMO Member Advisory Service for assistance in such matters.

In addition, the IMO has met the HSE with regard to revisiting the list of relevant qualifications required for SMO and PMO roles. This list has not been revisited since the 2003 Agreement and needs to be updated to reflect the current qualifications available.  It is hoped that agreement can be reached on a suitable list of qualifications in the near future.

The IMO also continues to fight on the long-standing issue of the remaining AMOs. While agreement was reached with Cork/Kerry, this mainly involved AMOs who had been recruited post the 2003 Labour Relations Commission (LRC) agreement and who had the necessary qualifications.

The IMO also took a case before the Equality Tribunal in 2016, which was lost on a preliminary issue with regard to the time of the latest discrimination. The IMO subsequently appealed this to the Labour Court, where we were successful in having the preliminary matter overturned. The Labour Court ruled the matter should be remitted to an adjudication officer for full hearing but the HSE in fact appealed the matter to the High Court on a point of law. The IMO agreed to support the community medicine member in question in the case before the High Court. Unfortunately, the HSE was successful in their appeal and costs were awarded against the IMO. This case was heard on 21 November. The IMO are now looking at one separate individual case, as well as considering referring the matter on a collective basis to the WRC.

The Public Health and Community Health Doctors Committee and in particular the IMO President Dr Ann Hogan have been to the forefront in trying to combat the anti-vaccine message which has been circulating in recent times, particularly with regard to the HPV vaccine. The committee is currently preparing a paper on this issue and Dr Hogan has campaigned on this vigorously during her presidency. It is vital for the health of our young women that anti-vaccination campaigns are not allowed to gain ground. In this regard, it is pleasing to see that uptake has increased from 50 per cent to 62 per cent in the last year, though this is still down from the 87 per cent uptake rate in 2014/2015.

The IMO Public Health and Community Health Doctors Committee continues to work hard to achieve real and tangible change for our community medicine colleagues on the ground and I encourage all members to fully utilise their membership by engaging with both the Member Advisory Services, as well as your IMO committee member.

I hope to see many of you at the AGM, for which there are a number of CME points available and which should prove to be both an enjoyable and educational experience. For those of you who are not members, I would encourage you to join your colleagues in the IMO as we seek to improve matters for all doctors across the profession. 

Dr Johanna Joyce Cooney is Chairperson of the IMO Public Health and Community Health Doctors Committee.

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