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Dented union

They both attend helpful but somewhat unsettling lectures by clinical risk advisors; they both may feel a flutter of nerves when an unexpected letter from their regulator or employer pops through the letter box; and they read in the newspapers about colleagues who made mistakes, hoping it will never be them.

They both have days when they know they have made a difference; days that reinforce their decision to have entered into their respective professions.

They also share many of the same adversaries, mostly the lack of political will to properly reform the health service, as evidenced by successive governments.

Relationships between doctors and nurses change over time, depending on stages of career and personal development. They might not always get along and sometimes believe the worst of each other’s stereotypes. They may even proffer the odd remark within their own professional circle.

But most pivotally, doctors and nurses depend on each another and they both get on with the job of providing patient care in often difficult circumstances.

That is why many have been left very disappointed by the evident recent tensions between the IMO and INMO.

The INMO’s General Secretary Mr Liam Doran has been questioning consultant work practices for some time now in the context of hospital overcrowding. When escalation is required, what have consultants done to step up, is Mr Doran’s query.  He says that in some hospitals, there is little to suggest that consultants have made any changes to working practice.

Some within and outside the medical profession say questions on the practices of ‘senior decision-makers’ are valid ones. Are consultants honouring the fine print governing their public/private practice, they also ask. However, for the very many consultants who work long hours and routinely miss out on personal, family and leisure activities, these suggestions are understandably difficult to stomach.

Despite the INMO’s recognition that bed capacity, staffing and infrastructure at acute and community levels have driven the overcrowding crisis, comments on ‘senior decision-makers’ in the specific context of consultants seem to have developed a particular prominence. The media and politicians have run with it.

Relations between the medical and nursing unions have also not been helped by an image the INMO published via its Twitter account on 13 January that depicted doctors — junior doctors and specialists — as lazy. This caused outrage among both doctors and nurses on social media, and the INMO apologised.

This all perhaps provides context to the trenchant nature of remarks made by Dr Peadar Gilligan, Chair of the IMO Consultant Committee, in reaction to Mr Doran’s statements, in this edition of the Medical Independent.

The INMO and IMO will always have turf wars and this will likely increasingly be the case, especially in light of the fact that a great many nurses are advancing onto Master’s and PhD programmes. There is also an imminent Department plan, reported in this edition, to increase numbers of advanced nurse and midwife practitioners. Mr Doran has said that non-training NCHD posts can be sacrificed to pave the way for such developments, a position the IMO reacted very strongly against in these pages last year.

But the consensus among doctors and nurses — as evidenced on social media — is that they have no interest in any fall-out between their unions.

As one union representative remarked: “We have more that unites us in the front line than divides us, but sometimes it doesn’t look like that.”

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