THE FOLLOWING IS A TRANSCRIPT OF EXTRACT FROM:

Programme - Morning Ireland
Subject - IMO AGM
Station - RTE Radio 1
Date/Time - 28.04.11 – 8.21AM

Robert Shortt:

Well the Government’s plans for universal healthcare will be among the topics on the agenda at the Annual General Meeting of the Irish Medical Organisation which kicks off in Killarney today. I’m joined by outgoing President of the IMO, Professor Sean Tierney. Professor Tierney, we heard a lot about the Dutch model of healthcare over the course of the election campaign, now you’ll also be hearing about the Dutch experience at your conference today.

Prof. Sean Tierney: (President, IMO)

That’s right Robert, good morning. We are gathering this morning I suppose to debate lots of issues but one of the key issues facing healthcare at the moment is how it’s going to be funded going forward and last year we put forward a set of principles by which we think changes in how healthcare is funded, how it should be assessed. So this year we’re bringing three people from Holland, somebody from the political side, a doctor and a patient, to give us their perspective on what they’ve seen in the Dutch system.

Robert Shortt:

Now every healthcare system has a lot of complicated detail but in general what is the IMO view, or is there an IMO view, of the Dutch model?

Prof. Sean Tierney:

Well I don’t think we’ve a view on a particular model, I think you’re absolutely right to say that the systems are very complicated and we have a particularly complicated system of our own that’s developed here over the last twenty years. I don’t think we can turn around in one day, turn a switch and adopt a model that evolved in Holland over the same time period. So I think there are good things in the Dutch systems, I think there are good things in our own system. We’ve seen good things in the UK in the NHS in the past fifty years, I think we actually need to adopt the best parts of all of the systems and try and get something that will work, will be sustainable and will be affordable.

Robert Shortt:

Now one of the main planks of the Dutch model is universal healthcare insurance. What’s your view on that?

Prof. Sean Tierney:

Well we would support the principal of universality, one system, a one tier system for all which is free at the point of access and where there’s equity of access. People get access to healthcare based on need not on their ability to pay and also where there’s solidarity so young people pay for older people, the rich pay for the poor and the weak pay for the sick. We’d have some concerns with handing control of this over to private insurance companies because we’ve had a lot of concerns, you’ve just heard some of them in relation to the private financial sector making choices for the entire population and we don’t think that necessarily private insurance companies are the best way to go.

Robert Shortt:

But does requiring everybody to have private healthcare insurance, or whether it’s private or given by a State agency, does that necessarily imply that you’re handing over control to insurance companies?

Prof. Sean Tierney:

Well I think if you have private insurers involved, private insurers have shareholders and their primary obligation is not provide healthcare, it’s to provide profit to their shareholders, and I do have concerns about that and I do think that that’s not necessarily the best way to provide healthcare. One of the key concerns is that a system that’s based on profit will drive activity, you’ll get treatments provided to patients rather than the care that provides the best health gain and we’d have great concerns about that.

Robert Shortt:

But if you have to rely on insurance for an element of the funding of the system, and we’ve seen that that is the case in Holland and that is our own case here as well, wouldn’t it be better for the system as a whole if that risk were spread by making it compulsory for everybody to join a health insurance system.

Prof. Sean Tierney:

No, I think everybody should be in a funded system, it’s actually a different question whether that fund is operated by competing private insurance companies or whether it’s operated by the State and look in the UK at the NHS where it’s a single centralised fund operated at arms length by the State and there is a lot of merit in that, there are still problems and indeed there are problems in the Dutch system. We’ve already heard about some of them, I’m sure we’re going to hear about more of them today. It’s the principal that everybody pays into a fund according to their ability to pay is a good principal, the question is whether that fund has a slice taken off the top for profit or whether all the investment is ploughed into healthcare, that’s the crucial question.

Robert Shortt:

What are the implications for GPs in this?

Prof. Sean Tierney:

Well I mean at the moment less than 40% of the population are entitled to free GP care and everybody else has to pay and in reality that’s not delivering an optimal healthcare system for the population so I think Dr. Reilly has put forward proposals for universal access to GPs and I think we would welcome that and are happy to negotiate the changes to the GP contract that would require.

Robert Shortt:

Now you’re also going to be addressing the issue of the retention of junior doctors in hospitals, how significant an issue is that?

Prof. Sean Tierney:

Well it’s difficult to get precise figures, the most recent figures we have from the HSE is that there are up to four hundred vacancies, that’s out of nearly four thousand doctors, but it’s still an important number because it doesn’t occur evenly throughout the State and it can affect particular hospitals and unfortunately the hospitals at particular risk are smaller hospitals, rural hospitals which aren’t, don’t have the big training infrastructure that our large university teaching and regional hospitals have. So while it’s difficult to know the scale of it it has been a continuing problem now for nearly two years and it’s likely to continue to be a problem into the future and it will make a rational approach to how services are reconfigured more difficult.

Robert Shortt:

Professor Sean Tierney, outgoing President of the Irish Medical Organisation, thanks for joining us.

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http://www.rte.ie/news/av/2011/0428/media-2949546.html

THE FOLLOWING IS A TRANSCRIPT OF EXTRACT FROM:

Programme - Six-One News
Subject - IMO AGM
Station - RTE TV 1
Date/Time - 28.04.11 – 6.01PM

Sharon Ni Bheolain:

The Irish Medical Organisation has questioned whether the country can afford the Government’s plan for a universal health insurance system for everyone. At the start of the Organisation’s Annual Conference in Killarney the new IMO President, Dr. Ronan Boland, said there was no such thing as free GP care.

Fergal Bowers:

As the Health Minister moved today to act on one commitment in the Programme for Government on the HSE another Government promise was coming under the microscope at the Annual Conference of the Irish Medical Organisation in Killarney. While doctors say they support universal healthcare they say it has to provide access to every patient who needs care at an affordable cost.

Dr. Ronan Boland: (Incoming President, IMO)

The first and most obvious question is can we afford it and there has been, what would concern me slightly is there’s been some loose talk about free care and free GP care. There’s no such thing as free care.

Fergal Bowers:

Today three experts from the Netherlands explained the pros and cons of the Dutch system on which Ireland is partly basing its plans. A senior physician there had this warning for Ireland.

Dr. Henk Van Der Velden: (Senior Health Policy Analyst Netherlands)

There is hesitation among politicians, what they’re afraid of, I think they’re right, the competition, market force, does not exactly make healthcare more efficient or even more cost effective, it might even increase costs.

Fergal Bowers:

The Government has promised to have legislation in place for universal health insurance within five years. The message from this meeting is that the Dutch model is very much a work in progress having taken around twenty years to plan. How the Irish system will work in detail has yet to be outlined. Meanwhile, the Health Minister is due to speak at this conference here tomorrow seven years after addressing it as the IMO President.

Bryan Dobson:

Well let’s talk to our correspondent, Fergal Bowers, who joins us now from Killarney. Fergal, first of all this announcement today in relation to the HSE, I suppose in one sense maybe doesn’t come as a surprise because the new Government has said that it intends eventually to scrap the HSE but moving this soon, this quickly, has that perhaps come as a bit of a surprise do you think?

Fergal Bowers:

Well the HSE must have been aware of it because it is in the Programme for Government that the HSE will cease to exist over time but in recent weeks you’ll know that Dr. Reilly, as Health Minister, has indicated he wanted to replace some members of the Board. Now he’s one a lot further today. The Board members wouldn’t have been aware of it but once it emerged this morning they were ready then by the time he arrived with them at noon to tender their resignations, it’s not a reflection on their performance but it’s part of the change agenda. We’ve an interim board now, we don’t know who’s going to be on that precisely, how long it will last and exactly what its role will be. For example, will it oversee the dismantling of the HSE which is promised?

Bryan Dobson:

Of course Dr. Reilly will be there at the doctors conference tomorrow, it’s familiar territory for him, what kind of reception is he likely to get do you think?

Fergal Bowers:

Well I suppose the IMO will deal with whoever is Health Minister but they do know Dr. Reilly, he was President here seven years ago so he’s familiar with all the issues, he won’t have had to read into his brief very much, he’s very familiar, but the country has very little money, the demands for healthcare are growing and doctors are raising questions about the promise for so-called free GP care for all and universal health insurance. So a warm welcome but there will be tough talking behind closed doors.

Bryan Dobson:

Very good. Fergal Bowers in Killarney, thanks for that.

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http://www.rte.ie/news/av/2011/0428/media-2949968.html

THE FOLLOWING IS A TRANSCRIPT OF EXTRACT FROM:

Programme - Drivetime
Subject - Interview with Dr Ronan Boland
Station - RTE Radio 1
Date/Time - 28.04.11

PHILIP BOUCHER HAYES

I’m joined on the line by newly elected President Dr. Ronan Boland. Congratulations Ronan

DR ROLAND BOLAND: IMO

Thank you very much Philip

PHILIP BOUCHER HAYES

I was joined earlier on, on the programme by the Minister for Health, Dr. James Reilly who also congratulated you on your election but when I suggested to him or put to him that you were contending that there was no such thing as free GP care, this is what he had to say.

DR. JAMES REILLY: MINISTER FOR HEALTH

If we’re to be absolutely pedantic about the meaning or words of course there’s no such thing as free anything but free at the point of delivery is something that everybody understands and paid for through both our taxes and our insurance, that’s clearly what we intend and I believe that general practitioners have a major role to play in this and I know that many of them may be concerned about workload but much of the work that will now be coming their way and more appropriate to them will be work that can be carried out in the practise by practise nurses as well as by General Practitioners.

PHILIP BOUCHER HAYES

Ronan do you have a problem with what he intends there?

RONAN BOLAND: IMO

I suppose what I was simply trying to point out in the earlier interview was that the term free GP care has been used loosely in public discourse and my concern would be that it creates and expectation that something which has never been free to two thirds of the population and an area of care which the state really hasn’t had much regard for in terms of most of the population have been expected to fund that out of their own pocket with no means of recovering that expenditure, that it creates and expectation that without costs and I concur with Dr. Reilly that of course there is no such thing as free care and whether its through general taxation or whether its through an insurance model or a combination of both of those it will have to be funded in some shape or form and I suppose it’s really to flag that one.

PHILIP BOUCHER HAYES

Okay obviously there is a cost but you have no problem with the fact that it should not cost the patient anything.

DR. RONAN BOLAND: IMO

No and in actual fact the IMO launched a policy paper in relation to universal health insurance long before the current government had come to power in fact before the election was in the offing and one of the things that we flagged quite clearly was that we believed that it was in everybody’s interest that care should be free at the point of delivery, that it should be equitable that there should be social solidarity across populations so yeah we would support that absolutely.

PHILIP BOUCHER HAYES

You have three experts from the Netherlands at your conference speaking about the Dutch health care model

DR. RONAN BOLAND: IMO

We have indeed.

PHILIP BOUCHER HAYES

Especially the one outlining the programme for Government, we’ve got thirty seconds left to us here. Do you have any questions now about how it will operate?

DR. RONAN BOLAND: IMO

Well there are lots of questions and in fact so far we really have the broadest outline about what the Government would like to do we don’t really have any detail yet at this point, what’s clear from the Dutch experience was that they started in a different place to us, it took them twenty years to get to the point where they started their free care scheme, sorry their Universal Health Insurance scheme in 2006 and there’s still a lot of tweaking to be done and problems arising that they weren’t expecting so there’s a bit job of work to be done but we’re more than happy to engage with the state in relation to getting there.

PHILIP BOUCHER HAYES: IMO

Ronan Boland thank you very much for joining us this evening, that’s all we have.

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THE FOLLOWING IS A TRANSCRIPT OF EXTRACT FROM:

Programme - News At One
Subject - IMO AGM
Station - Newstalk
Date/Time - 28.04.11 – 1PM

Jonathan Healy:

Let’s talk about this idea that James Reilly, the Minister for Health, walked into that Board meeting of the HSE in the past hour and asked for their resignation. Within weeks of his appointment and having received the legal go-ahead James Reilly may be asking the entire Board to stand down…(Interview: James Reilly, Minister for Health, Newstalk Political Analyst, Shane Coleman and John Crown, Consultant Oncologist)…No doubt it’s going to be discussed at length at the Annual General Meeting of the Irish Medical Organisation that’s getting underway in Killarney this lunchtime. The incoming President of the IMO, Dr. Ronan Boland, joins me on the line. Ronan, we’ll come to the agenda at that conference in just a moment but first of all your reaction to this rather bold move by James Reilly.

Dr. Ronan Boland: (Incoming President, IMO)

I suppose, our conference is just convening here in Killarney and we’ve heard the news reports like everybody else, we haven’t really had a chance to discuss it in any great detail given the conference hasn’t started but I suppose my initial response would be that it’s very much a matter for the Minister and the HSE and I wouldn’t see it in reality being an issue that the IMO would have a direct role in commenting on but I’m sure it will come up for discussion at the same time.

Jonathan Healy:

But at the same time it indicates that Minister Reilly is very much intent on changing things, starting at the top, so that’s going to filter down to your members.

Dr. Ronan Boland:

Well obviously the health service is in a time of great flux anyway and there are a number of major initiatives in relation to transformation in relation to hospital services and in relation to primary care which the Government has planned and of course they will have a major bearing and they will certainly come up for major discussion over the course of the next two to three days.

Jonathan Healy:

One of the things that you’re discussing at that meeting is the Dutch model that Fine Gael have said they’re very keen to introduce here, universal healthcare, is there merit in it? I know you’re going to be discussing it. Do you think that we’re going to see that model effectively introduced here within the timeframe set out by the Government?

Dr. Ronan Boland:

Well I think there’s no single that is perfect and obviously we haven’t had that symposium yet but we’ve met with our Dutch colleagues in the past and the, what’s clear in relation to the Dutch system is that it was close on twenty years in creation and that it’s still a work in progress, that there are significant difficulties that they’re ironing out and new difficulties that are arising. So I think certainly in relation to any new system that comes in here it is of course appropriate to look at what’s been done elsewhere, not to reinvent the wheel and to seek to adopt the best of other systems, but I’m sure whatever system, if we do have a new system here, will undoubtedly be a blend of different systems but given the fact that there’s been particular attention focused on the Dutch system and its apparent success and the fact that it’s gone down well with the Dutch population we felt it would be appropriate to have a very close look at it and we have three eminent speakers from within the Dutch system who are speaking at a symposium that we’re hosting this afternoon.

Jonathan Healy:

Ronan, where this is going to get bogged down and where reform is going to slow is when it reaches members of the IMO who say hang on a second I’m not going to change here, why would I do that if this is a system that’s working well for me. Is there a willingness to change amongst doctors because we’ve seen in the past reforms of the health service completely grinding to a halt because of medical unions not willing to move?

Dr. Ronan Boland:

Well that might be your perspective but for a variety of reasons I wouldn’t necessarily share that perspective. What I would say of course is that doctors’ representative bodies have always shown a willingness to engage in relation to positive reform but a caveat in relation to universal health insurance would be that for as long as the health service has been there the State has had no involvement in the provision of primary care services effectively to two thirds of the population who’ve been expected to fund that care as an out of pocket expense that they’ve had no way of recovering, by visiting a GP, with no system for registrations and so on. So obviously any move to a situation where you have whole population cover it is only reasonable that the consent or co-operation of doctors can’t be assumed upon and it does require a discussion and a set of negotiations and probably a new contract, as the Minister himself has pointed out, to allow that to happen. But I can tell you now that the IMO will not be found wanting in sitting down with the Minister and the HSE and the Department if they wish us to do that in relation to this matter.

Jonathan Healy:

Well he set down a marker with the HSE Board today. Dr. Ronan Boland of the Irish Medical Organisation, incoming President, thanks for talking to us.

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THE FOLLOWING IS A TRANSCRIPT OF EXTRACT FROM:

Programme - Six-One News
Subject - IMO AGM
Station - RTE TV 1
Date/Time - 29.04.11 – 6.01PM

PRESENTER

New figures from the HSE show that waiting lists for treatment are increasing and over 26,000 adults and children are waiting for care. Health Minister Dr. James Reilly told the annual conference of the Irish Medical Organisation that hospitals have to be more efficient.

FERGAL BOWERS

It was something of a home coming today for Health Minister Dr. James Reilly as he arrived to address the annual conference of the Irish Medical Organisation, a union he headed as president seven years ago. While the welcome was warm there was bad news from the HSE with new figures showing over 26,000 adults and children are now waiting over three months for in patient or day case treatment. The Minister described the figures as disconcerting.

JAMES REILLY: MINISTER FOR HEALTH

Why are sending people with reasonably ordinary conditions to major (inaudible) hospitals, when they can be looked at (inaudible)

FERGAL BOWERS

The Chief Executive of the IMO said there may be a shortage of around four hundred junior doctors by June.

CHIEF EXECUTIVE OF THE IMO

Morale is now at a rock bottom, rock bottom across the entire profession, training officers are being reduced or eliminated altogether and other countries are offering very (inaudible) oppurtunities to people who have been trained to high standards here in Ireland.

FERGAL BOWERS

The increase in wage (inaudible) is a set back for the Minister and HSE has blamed the rise on a surge in emergency department omissions to be cancelled.

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http://www.rte.ie/news/2011/0429/health.html

THE FOLLOWING IS A TRANSCRIPT OF EXTRACT FROM:

Programme - Six-One News
Subject - IMO AGM
Station - RTE TV 1
Date/Time - 30.04.11 – 6.01PM

PRESENTER

Doctors are concerned that some patients are going for high-tech medical checks that may be unnecessary or costly and carry health risks. Consultant surgeon Sean Tierney told the IMO’s Annual Conference that some patients are seduced by CT and MR Scans.

REPORT:FERGAL BOWRS

There was some time for mediation today where doctors attending the final session of the Irish Medical Organisation’s Annual Conference in Killarney. Health promotion and well being where the themes as they IMO issued a warning about the dangers of the worried well seeking unnecessary high-tech and expensive medical checks. The IMO said some patients are seduced by sophisticated tests such as CT and MRI scans just to discover that they have no illness to be concerned about.

SEAN TIERNEY: CONSULTANT SURGEON TALLAGHT HOSPITAL

In fact there those texts incur considerable expense, there’s radiation involved. There’s often injections of contrast materials involved which can be quite toxic and I think it’s a much more prudent approach to take the advice initially of your GP.

REPORT: FERGAL BOWERS

With the temperature here in Killarney hitting nearly 20 degrees, today also saw the launch of a new public health website. It allows people to check how strong the dangerous ultra violet rays are from hour to hour in any part of the country. UV rays can cause skin cancer and doctors say Irish people can underestimate the danger here when the sun shines.

DR. TONY HEALY: CONSULTANT & CO FOUNDER OF UV AWARENESS

If the reading is less than three, it means that it’s safe to go out in the sun without any sun protection, if it’s between three and seven it means that you’re moderate risk of damage to your skin that you should be wearing at least factor 15 and if its up a factor, if the index is up at 11 it means that it’s highly dangerous so maybe you shouldn’t go out.

SEAN TIERNEY – CONSULTANT SURGEON: TALLAGHT HOSPITAL

Well I think it’s easy (inaudible) MRI scan might offer you reassurance if you have in fact there’s radiation involved and I think it’s a much more approach see a GP who sends you on to see a specialist if that’s required and to have those kind of texts done only in their medical.

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http://www.rte.ie/news/2011/0430/health.html