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Failure to address AMO issue ‘almost an embarrassment’ – IMO public health Chair

By Paul Mulholland - 16th Apr 2023


The continued failure of the health service to address the terms and conditions of area medical officers (AMOs) is “almost an embarrassment”, according to Chair of the IMO public health committee Dr Anne Dee.

Two motions were passed on the issue at the national public health committee meeting at the IMO AGM.

The first was that the meeting supports the case for upgrading remaining AMOs to senior medical officers (SMOs).

The second motion called on the Department of Health, Department of Public Expenditure and Reform (DPER), and the HSE to “proactively engage” with the IMO, under the terms of Building Momentum, to resolve the “inequitable treatment” of AMOs and “resolve this matter in a fair manner”.

New structures were introduced in 2004, which resulted in no further AMO recruitment. AMOs have been seeking improved pay and conditions on a par with SMOs for many years.

Conciliation talks aimed at resolving the dispute began at the Workplace Relations Commission in 2020. It is understood pay increases due to AMOs in February 2022 did not occur following  objections from DPER.

“It is purely because of their small numbers and their increasing age that they are just being ignored,” Dr Dee told the Medical Independent.

“It is really important in this year coming that we sort out the issue of our AMOs. It is really sad that these people, who have worked as public servants their entire career and have served the HSE well, and continue to serve the HSE well, have been treated in this fashion.”


The meeting also heard about the need to ensure that the career structure, training, and terms of conditions of those working in SMO and principal medical officer roles are reviewed
and enhanced.

For instance, Dr Dee said that the roles of SMOs have changed significantly “or are expected to change significantly” under the current public health reform programme.

“Before it was a very simple structure: You had specialists and SMOs, you had a few surveillance people and very little else within the departments. And now you have consultants, specialists, SMOs, a nursing cohort, epidemiologists, and other surveillance people. All these people are working together as a multi-disciplinary team, but the clinical lead in that team is the SMO. It is a complete change
in the way they would have been expected to work.”

Dr Dee said there is currently no career pathway for SMOs. “First of all, there needs to be a career structure for SMOs and it needs to be worked on by the faculty and the training bodies,”
she explained.

“Secondly, their remuneration has also been left behind. They are at the same level of remuneration since about 2008 when they didn’t get a promised 20 per cent pay rise. They then got all the cuts of the recession. They are now back to, just a tiny bit less, what they were before 2008. In real terms the value of their salary has reduced considerably.”

Reform programme

A motion at the meeting stated it was important the public health agreement “is implemented in full and on schedule”.

There are 34 consultants in public health in office following the completion of the first phase of recruitment.

At the IMO AGM, Minister for Health Stephen Donnelly said “considerable progress” was being made on the next two phases, which will result in an additional 50 consultants by the end of this year.

However, Dr Dee said while recruitment was continuing, “it is a little bit slower than we might have expected.”

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