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Successful outcome in AMO dispute

By Dr Joe Quinn - 30th Mar 2024

AMO dispute

Dr Joe Quinn, IMO public and community health committee, describes the long journey area medical officers had to take to receive fair terms and conditions from healthcare management

Following a long and challenging journey, I am happy to say we have brought the long-standing fight for area medical officers (AMOs) to a successful conclusion. With the support of the current committee and previous committees and having battled through many different avenues we have finally secured a fair outcome.

Before focusing on the outcome, I want to discuss how we got here.

2003 agreement

In 2003, following a prolonged industrial action by doctors in public and community health, there was a new agreement dealing with issues across both public health and community health.

Within community health the previous structure was amended, with the introduction of principal medical officers. There would be no further recruitment at the area medical officer grade. This left the senior (area) medical officer (SMO) role as the entry-level role into community health departments.

From the IMO’s perspective, it was clearly envisaged that AMOs would be moved to the senior grade. There was ongoing engagement with the HSE around this and various disputes about qualification requirements for the role. However, despite significant attempts by the Organisation, the HSE, and the Department of Health were not willing to address this issue.

Subsequent actions

The HSE had argued that the roles of AMOs and SMOs were distinct roles, with different requirements and obligations; however, whatever reality there was to this statement was increasingly diminishing. With smaller teams and the fact that when AMOs retired they were replaced with SMOs, the roles became identical. Teams were under pressure and faced increasing workloads, and AMOs and SMOs were treated interchangeably. Indeed, AMOs were often key in training new team members and bringing them up to speed.

A number of AMOs brought individual claims to the Workplace Relations Commission (WRC) over the years, and the IMO was involved with and supported a number of these cases. Unfortunately, while the adjudicators were invariably sympathetic to the situation, they decided in favour of the HSE.

There were also numerous attempts to engage with successive HSE human resources directors to seek a resolution.

Ultimately, the IMO submitted this matter for conciliation with the HSE and Department of Health in 2020 through the WRC. Following a number of sessions, initially in-person and subsequently online due to Covid, this process adjourned in anticipation of the bargaining unit process, which was to be included in the then yet to be agreed Building Momentum agreement.

Building Momentum and bargaining units

This agreement commenced in 2021. In addition to pay increases, it allowed for a fund to address longstanding grievances. This fund was the basis that the HSE sought to adjourn the conciliation.

My colleagues in various committees in the IMO readily agreed that the issue of the status of the AMOs was one that should be addressed, along with a number of other important claims.

The IMO secretariat engaged with the HSE and Department of Health in line with the process, as the proposals were due to be agreed by the end of 2021 for implementation in 2022. But, as ever with this issue, there were further delays and lack of engagement.

Ultimately, proposals were finally received in September 2022, which were completely unacceptable and unfair. The IMO contested these and ultimately brought the matter through the WRC and the Labour Court. The Court heard the matter in October and decided in favour of the IMO.

Based on this decision and subsequent engagement, we now have a resolution to this matter.


The agreement and circular provide that the AMO scale is now aligned to the SMO scale, and this is done with effect from 1 February 2022.

This means that this fundamental unfairness of being paid less for doing the same work is now addressed. It also means that our colleagues who have retired, thinking that this injustice would never be resolved, will get some benefit in relation to their pensions.

As you can see, this has been a long and difficult fight and I would like to pay tribute to my colleagues on the different IMO committees, the work of the Organisation’s secretariat, and particularly to the previous Chairs of the public and community health committees who have kept this issue front and centre down the years. I am delighted to be able to say that this is now resolved. But I know that this outcome is based on the work done through the years, back as far as the original agreement. 

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