Dr Ronan Boland - Outgoing Presidential Speech AGM 2012
Last year I stood before you and issued a call to arms to you. I quoted Martin Luther King who said “The ultimate measure of a man is not where he stands in moments of comfort, but where he stands at times of challenge and controversy” - I did so on the basis that a new government had just taken office with a strong electoral mandate and a voracious appetite for radical reform - not least reform of the health service. I reasonably anticipated that all hands would be required on deck to ensure that the voice and input of Ireland’s highly trained and experienced doctors would be adequately heard during the engagements with the state that would inevitably be required.
How much has changed during the last year? Surprisingly little. True, there have been changes in governance structures at corporate level. In the main at the coalface however, it’s a case of “as you were”. More patients, more procedures, fewer beds, fewer staff and fewer resources. If radical reform is at hand, it feels little closer than it did that sunny weekend a year ago.
There has been no transformation programme for GPs. There has been no movement on honouring repeatedly made commitments in relation to Competition Law. The only solution to the current impasse is one which guarantees in law the protection of this Organisation in its unencumbered representation of General Practitioners in relation to their work carried out on behalf of the state. Until the government recognises this and takes the appropriate action progress on any reforms involving General Practice will be difficult if not impossible.
Notwithstanding the lack of progress in moving forward with a transformation programme for GPs and the almost complete failure of the HSE to provide for much needed investment in Chronic Disease Management in General Practice in line with the Clinical Care Programmes the IMO has been as busy ever across a wide range of interfaces in representing all craft groups. Some progress has been made on implementation of the Public Service Agreement for Consultants, NCHDs and Public Health Doctors but real challenges remain. Contracts continue to be flouted and recruitment and retention of medical expertise in Ireland becomes ever more difficult.
Given the challenging circumstances in which the IMO currently operates, we are fortunate to have in George McNeice a very experienced and able Chief Executive. The capacity to adopt a strategic and long-term approach has never been of more importance and I want to put on record to George on your behalf my appreciation of his stewardship over the last year.
I also want to personally thank all of the IMO staff for their assistance throughout the last year. Our Research and Policy Unit led by Vanessa has been an invaluable resource in producing position papers such as our new paper on Health Inequalities which I will come back to. The IMO is increasingly called upon to provide written feedback, often at short notice, on positions and policies of other state and non-state organisations and this would simply not be possible without the work of the Unit.
Our International Affairs Unit led by Claire had another busy year maintaining relationships with our sister organisations in other EU states, relationships which are frequently of great value in establishing what is actually happening in other jurisdictions. Timely information is invaluable, particularly when comparisons of dubious validity are aired in the public domain.
Our recently restructured Industrial Relations Unit is headed up by our new Director, Steve Tweed and ably assisted by Assistant Directors Eric Young, Anthony Owens and Shirley Coulter and their hardworking fellow officers. The Unit, including the Personal Cases Unit, continues to get busier and busier.
The IMO website has been completely rebuilt since last year and with the recent addition of e-newsletters it is widely used by members and is complementing and augmenting the work of the IR Unit.
Like all membership organisations, the IMO has faced a challenging 4 years since the financial crisis took hold in 2008. These challenges will not lessen for the foreseeable future. Tight control of the Organisation’s finances and efficient running of the Organisation are of crucial importance, as is a proactive and comprehensive approach to membership recruitment and retention. I want on your behalf to thanks Susan Clyne for her unstinting work in achieving these goals.
As your President I have had the privilege of representing you at a wide range of events over the last year. I have been struck at all times by the esteem in which the Organisation is held. I am also very grateful to the many people who took the trouble to contact me and to wish me luck and success in my role.
The first few months of my Presidency coincided with the first few months of our new Government and I have to confess there were times when I felt I was spending as much time discussing the Dutch health system as I was our own! All the more reason to be grateful for the insights gained from the symposium on the Dutch system which we had held at last year’s AGM as well as from the visit last year of our sister organisation in Holland along with the Dutch College of GPs to IMO House. It is perhaps telling that the number of invitations to discuss Universal Health Insurance lessened as the year went on, presumably as realisation grew that Rome will not be built in a day and that a country on the brink of insolvency is not in the best position to fund dramatically improved access to more and speedier health care, irrespective of who is writing the cheque.
A few weeks after the AGM I had the pleasure of accepting an invitation from my alma mater University College Cork to address the new graduates at the Summer Conferring ceremony. I argued that Ireland was not doing enough to retain our young medical graduates, while at the same time I exhorted our newest doctors where possible to stay in Ireland and help us to build a better health service. If latest reports are to be believed, more than half of the new doctors I addressed are already booking their one way tickets to Australia, New Zealand and Canada. Much in our system still needs fixing.
As always our health policy makers and commentators have one eye on what is happening in the Britain and Northern Ireland. I attended the ARM of the BMA in Wales and saw at first hand how our colleagues (especially in England) are similarly grappling with the concept of further far-reaching reforms in the context of their long awaited Health and Social Care Bill. We also had separate liaison during the year with BMA Scotland, as well as with BMA Northern Ireland with whom we jointly made a presentation in Brussels to the island’s MEPs on subject of Health Inequalities. We are this weekend launching our joint paper on this important subject and later this afternoon the first of the Scientific Sessions of the AGM will be focused on addressing the inequalities that are all too prevalent in our society.
Every mature democracy requires a system of checks and balances and in this year’s Doolin Lecture, Ms. Emily O Reilly our Ombudsman gave an eloquent dissertation on why accountability is important when our system lets down its most vulnerable citizens.
Ms. O Reilly’s lecture was preceded by our second annual IMO Student Debate and an event which is going from strength to strength this year debated a motion that “Ireland gets the health system it deserves.” The student debate is one of a number of initiatives the IMO is undertaking to get undergraduates and recently qualified doctors connected with the organisation.
Perhaps the most onerous role of the President of the IMO is that of acting as the public voice of the organisation and of the country’s doctors. I want to thank in particular Maria Murphy on whom I have relied heavily during the year for guidance and assistance. Many national and international health news stories have required careful handling and Maria’s advice has always been sound.
For the first time this year, the IMO became involved in a national television campaign aimed at the general public through its involvement in RTE Operation Transformation and the National Type 2 Diabetes Screening Day. That the day was a resounding success is due in no small part to the huge amount of planning that Maria and Louise put in to the event over several months, and also to the IMO staff members who were present at each of the nine screening centres around the country – where 54 GPs screened almost 1600 patients.
I was greatly heartened by the positive feedback received from members, colleagues, friends and patients alike. It is the type of positive initiative that the IMO will hope to build on over the next few years.
Overall, it has been another busy year for the Organisation on many fronts and I would like to acknowledge and thank on your behalf all of those members who served over the last year- whether as committee members, trustees, committee chairs or members of Council. I would like most especially to thank my fellow honorary officers who have been hugely supportive during my Presidency.
My final task is a pleasant one indeed. It is probably fitting after last weekend’s contest in Thomond Park that a Munsterman be handing over the mantle to the safe keeping of an Ulsterman, albeit in my case with a greater sense of relief than the men in red had last Sunday.
Paul McKeown is known to all of you firstly as an affable and able leader of his Public Health colleagues and more recently as an honorary officer of the Organisation. I have enjoyed working with Paul over the last couple of years and have witnessed at first hand the many admirable qualities that will stand him in good stead over the coming year.
I would like to thank each and every one of you for your support and assistance during my Presidency and indeed my time as a Committee chair and honorary officer prior to that. It has been a great honour for me and I am indeed grateful.