In 1957, relations between the Irish Medical Association and the Department of Health were at an appallingly low level. Doctors of all grades were "lambasted" as ultraconservative, incompetent, money grabbers. It was said that the IMA was not a trade union or excepted body" and it had no authority to negotiate terms or conditions of service. To add to the disharmony, William Doolin, Editor of the Journal of the Irish Medical Association wrote in July 1960:
"For nearly 2000 years, Divinity, Law and Medicine have been bracketed as the three learned professions and how any man with even a glimmer of history in his mental make-up could advocate a descent from that high position is incomprehensible"
Furthermore, Doolin added that if the Irish Medical Association were convened to a Trade Union and called upon its members to strike, "It would cease to be a profession or worthy of its calling". Other counsels prevailed, leading to a division of opinion and allegiance. The high ideals championed by Doolin seemed unsustainable and outmoded in the present political climate.
A number of members of the IMA were co-opted to a sub-committee for the purpose of discussing the desirability and feasibility of founding a trade union, so that the Minister would be forced to the negotiating table. It was felt that without the protection of the Trade Union Acts, the Association was to a certain extent hamstrung, under present day conditions, in fighting for the rights of its members.
In 1962, the certificate of registration was issued at a cost of œ1000 and the Irish Medical Union was established under the Presidency of Dr John Cox. The Union was initially housed at the offices of the IMA in Fitzwilliam Place, and later in Northumberland Road, not without too many accusations that it was being evicted from Fitzwilliam Place.
Dr Cox held office until the first General Meeting of Athlone on November 18th 1962. At this meeting, Sean Ua Conchubair of Oranmore, Galway was elected President. The then Minister for Health, Mr McEntee, recognised the importance of having a determined Trade Union as an opponent and offered a limited negotiating licence to the IMA. This licence excluded industrial action and it could also be arbitrarily revoked by the Minister and his successors. This licence was unfortunately accepted by the IMA and though peace makers in both organisations tried to promote unity there were hot heads and extremists in both organisations who refused even to consider the possibility of joint action.
With a divided profession, resistance to Ministerial manoeuvring was often ineffective.
However, though divisions caused difficulties, the Union continued to grow steadily in strength and effectiveness as a representative body. Alone or in combination with the IMA, it influenced legislation affecting conditions of service for General Practitioners, temporary Dispensary Medical Officers, Junior Hospital Doctors, Specialists in many disciplines and the community in general.
However, no matter how vigorously points of view were presented, a recalcitrant Minister, his officials or local authorities could always weaken an argument by emphasising that the Union or the Association did not necessarily represent the views of every doctor in the country. Sometimes trivial differences in the opinions expressed by the two medical bodies were misrepresented as evidence of deep division.
Work towards unity went on from 1979 and the pages of the Medical Press were brandished with articles and letters from "pro-unity" and "anti-unity" supporters. Finally, at an EGM of the IMA in September 1983, the decision to amalgamate with the IMU was taken. A massive "pro-unity" ballot was also counted at the IMU AGM in Kilkenny in October 1983.