Will the HSE really listen to the concerns of doctors?

As usual, a wide variety of issues were discussed at the IMO AGM, which took place at the end of last month in the Europe Hotel in Killarney. Panel discussions covered topics such as health inequalities and the role of pornography in fuelling gender-based violence. General motions included calls for the extension of the community ophthalmic services medical treatment scheme, clarification on the future of health policy after Sláintecare, and a condemnation of the targeting of healthcare professionals and facilities in conflict zones such as Sudan and Gaza.

Various groups raised concerns specific to their specialties. For consultants, the main issue was the planned increase in weekend rostering. The national public health and community health doctors’ meeting criticised the HSE’s “ongoing failure” to address the terms and conditions of senior medical officers and principal medical officers. At the NCHD meeting, motions were passed concerning safe staffing levels, breaches of the Organisation of Working Time Act, and support for pregnant doctors and those on maternity leave. Meanwhile, GPs called for engagement on  establishing comprehensive programmes for women’s health and obesity, while condemning the “continued increase in unresourced work” in general practice.

A novel feature of this AGM was the opportunity for doctors to voice their concerns directly to someone with the power to address them. As reported by the Medical Independent (MI), Minister for Health Jennifer Carroll MacNeill did not attend the meeting. However, HSE CEO Mr Bernard Gloster delivered an address, which was followed by a lengthy Q&A session. In his address, Mr Gloster pointed to progress in the areas of scheduled and unscheduled care.

“In our unscheduled care position, we saw a deterioration in the first two months of this year, but also a rapid recovery and return to improvement best seen between the St Brigid’s and St Patrick’s holiday weekends,” he said.

According to his presentation, the number of people on trolleys between these two weekends was reduced by 831, while discharges increased by 277.

He also referenced increased investment in the health service and a 25 per cent growth in workforce over five years.

However, in both his speech and his responses to the concerns of doctors, Mr Gloster emphasised that all the problems with the health service would not necessarily be solved by more recruitment.

On NCHDs specifically, he said that simply increasing doctor numbers had not resolved the group’s longstanding issues. 

In the Q&A, Mr Gloster promised engagement with the IMO on areas of concern. But it was also clear there were limits on what he would agree to. For example, the IMO national consultant meeting passed a motion calling on the HSE and Minister for Health to commission a comprehensive review into the “advantages and feasibility” of increased rostering of consultant staffing over weekends. When asked by MI about whether such a review would be undertaken, Mr Gloster said he was “certainly not in favour of any further analysis, or any other long-term debate”, before such rostering arrangements are embedded.

The exchange between doctors and the HSE CEO was civil, with Mr Gloster even receiving praise for his openness in agreeing to take questions. But, in the end, it felt like the real conversations were being deferred until another day.