IMO AGM 2024 to reflect on progress and challenges

With the IMO Annual General Meeting (AGM) almost upon us, it is worth reflecting on doctors’ concerns compared to this time last year.

Before the 2023 IMO AGM last April, there was tremendous uncertainty and disappointment across the various craft groups.

GPs were apprehensive about the imminent significant extension of free GP care, which would include all children aged six and seven. Although the public-only contract had been agreed, consultants were not overly optimistic about the document and still had concerns in relation to rostering, location, and locum provision. At the time, the outgoing President of the IMO Dr Clive Kilgallen told the Medical Independent (MI) it would take at least a year to judge whether the contract was having a positive impact.

In terms of NCHDs, last year’s national meeting of the group heard implementation of the recent agreement with healthcare management had been “highly fragmented”.

Public health doctors were happy about their agreement, which facilitated the creation of consultants in public health posts, even though roll-out was slower than hoped.

However, the Chair of the IMO public health committee Dr Anne Dee described the continued failure of health management to address the terms and conditions of area medical officers (AMOs) as “almost an embarrassment” to MI.

So where are we now on these issues? On free GP care, shortly after the 2023 AGM, a deal between the IMO and the Government was announced. The agreement put in place a series of capacity supports to allow GPs to recruit additional staff, as well as increases in fees to take account of the likely rise in demand for services. The total financial package amounted to approximately €130 million for a full year. The extensions in eligibility subsequently rolled out on a phased basis over the following months. It is a testament to the strength of Irish general practice that the process has proceeded as smoothly as it has, despite the challenges.

Meanwhile, in March, data from the Department of Health revealed 1,923 consultants had signed the new contract over the last year. The figure comprises 380 new-entrants and 1,543 consultants who have switched from their existing contracts.

It means more than 45 per cent of the total number of consultants working across the public health service are now on the new contract. The sign-up has perhaps shown that it is not as unattractive as originally feared.

However, in our preview of the 2024 IMO AGM in this edition, Chair of the IMO consultant committee Prof Matthew Sadlier warns that there are still a number of questions to answer in relation to implementation.

Regarding their agreement, NCHDs were rocked at the end of last year by the announcement that the group was to be included under the HSE recruitment embargo. The move undermined the very basis of the agreement, according to the IMO, and raised the spectre of industrial action. However, the publication of the NCHD taskforce report in February calmed the waters somewhat. Cautiously welcoming the document, the IMO stressed it is critical that there is an implementation plan with sufficient funding to allow the recommendations to become a reality.

Public health doctors continue to praise the reform programme, even if implementation remains slightly behind schedule. And there is good news on the AMO front, with the long-running dispute finally resolved following the Labour Court decision in October in favour of the IMO.

Of course, the lack of capacity within the health service, both from a staffing and infrastructural perspective, continues to be a major concern across the craft groups. With both the Minister for Health and HSE CEO due to attend, the upcoming meeting will be an opportunity for doctors to highlight these issues to those who have the power to address them.