TRAINING ISSUES 

 

1. This meeting calls on the HSE and Department of Health to immediately address the catastrophic lack  of adequate family-friendly policies and work-life-balance for the 'modern' NCHD, which includes the need to access less-than-full-time working, flexible training pathways, and security of training location which are notified at least 2 years in advance. 

 

Proposer: NCHD Committee

Status: Carried

 

2. The meeting calls on the HSE and Department of Health to significantly increase the number of approved training posts for NCHDs and to ensure that all NCHDs have a structured pathway to specialist practice.

Proposer: NCHD Committee

Status: Carried As Amended

Amendment

The meeting calls on the HSE and Department of Health to significantly increase the number of approved training posts for NCHDs and to ensure that all NCHDs have a structured pathway to specialist practice and the benefits of a training scheme such as security of location and mentorship schemes

 

3. This meeting recognises the need for fair and equitable access to internship and training schemes for those international doctors who trained in Irish medical schools. Furthermore, it calls on the Department of Health,  the HSE and the post-graduate training bodies to allow international doctors who trained outside of Ireland, and who meet the standards and requirements, and who hold stamp 4 status, to apply for higher specialist training .

 

Proposer: NCHD Committee

Carried as Amended

Amendment

This meeting recognises the need for fair and equitable access to internship and training schemes for those international doctors who trained in Irish medical schools. Furthermore, it calls on the Department of Health,  the HSE and the post-graduate training bodies to allow international doctors who trained outside of Ireland, and who meet the standards and requirements, and who hold stamp 4 status, to apply for higher specialist training. Recruitment of trainees should be based on open competition, merit and transparency of process

 

GRADUATE ENTRY MEDICAL STUDENT DEBT

4. This meeting calls on the Government to take measures to relieve the high levels of debt, via tax relief or other mechanisms, for those doctors who were and continue to be compelled to take loans to finance Graduate Entry Medical degrees.

 

Proposer: NCHD Committee

Carried as Amended

Amendment

This meeting calls on the Government to take measures to relieve the high levels of debt, via tax relief for student loans or other mechanisms, for those doctors who were and continue to be compelled to take loans to finance Graduate Entry Medical degrees. Failure to do so fails to address a significant driving force for doctors leaving the country

 

ON CALL STAFFING LEVELS

5. Most NCHDs participate in out-of- hours/ on call work to ensure continuous medical staffing. This work  is often the most intense and stressful due to reduced staffing. In many sites, the level of on-call staffing has not increased to reflect increased patient numbers and complexity. This meeting requests hospitals and CHOs review current on-call arrangements so that appropriate staffing is provided, and that such a review be carried out every three years.

Proposer: NCHD Committee

Carried As Amended

Amendment

Most NCHDs participate in out-of- hours/ on call work to ensure continuous medical staffing. This work  is often the most intense and stressful due to reduced staffing. In many sites, the level of on-call staffing has not increased to reflect increased patient numbers and complexity. This meeting requests hospitals and CHOs review current on-call arrangements so that appropriate staffing is provided, and that such a review be carried out every three years or sooner if required

 

 IMO NCHD AGREEMENT 2022

6. As evidenced by the difficulties for NCHD in receiving agreed public service pay increases in a timely manner  and the ongoing disruption to pay when rotating between hospital sites, this meeting calls for full centralisation of payroll in line with the terms of the IMO NCHD Agreement 2022.

Proposer: NCHD Committee

Carried As Amended

Amendment

As evidenced by the difficulties for NCHD in receiving agreed public service pay increases in a timely manner  and the ongoing disruption to pay when rotating between hospital sites, this meeting calls for full centralisation of payroll in line with the terms of the IMO NCHD Agreement 2022 with transparency of all payments.

7. The meeting recognises that many NCHDs will have a permanent home where their family are based.  NCHDs are regularly forced by the employer to rotate temporarily to a new location which frequently necessitates payment of additional rent for a second accommodation. The meeting calls on the government to introduce tax relief on payments for secondary renting arising from such rotations.  Despite commitments made in reaching the IMO NCHD Agreement 2022 no proposals have been proposed by Government to address this financial burden for trainees.

Proposer: NCHD Committee

Status: Carried

 

8. This meeting calls on the HSE and Department of Health to ensure that the Verification and Sanctions System for compliance with the Organisation of Working Time Act is designed, with the IMO, so as to ensure employers are obliged to ensure NCHD working hours are reduced and sufficient rest is rostered. 

Proposer: NCHD Committee

Status: Carried

 

NEW NCHD CONTRACT

9. This meeting calls on the HSE and the Department of Health to be proactive in negotiations with the IMO  on a new fit for purpose NCHD Contract that reflects the demographic of the NCHD population and addresses the underlying issues leading to high levels of emigration.

Proposer: NCHD Committee

Status: Carried

EXTENSION OF ELIGIBILITY FOR DOCTOR VISIT CARDS

1. This meeting believes that introducing upwards of 500,000 people into the GMS Scheme will lead to negative consequences for patients and General Practice including:

-              Lack of GP capacity to meet inevitable patient demand for appointments

-              Replacing cost as a barrier with a new barrier of access

-              Worsening waiting times to access GP services

-              Displacement of care for the sickest and most vulnerable

 

Proposer: GP Committee

Status: Carried

 

2. While recognising the aspiration of a GP service that is free at the point of access the IMO calls on Government to ensure that any such expansion of care is done so in a planned manner that recognises the capacity milestones that need to be in place and is supported with a new fit for purpose contract.

Proposer: GP Committee

Status: Carried

 

3. This meeting expresses concern that the valued and equitable model of GP access for patients, where public and private patients do not face discrimination on the basis of income, will be undermined by the unplanned extension of GP care that is free at the point of access and will drive a two tier system of General Practice.

Proposer: GP Committee

Status:Carried

 

4. This meeting calls on the Department of Health and the HSE to recognise the right of an individual GP to determine the patient numbers that their individual practices can safely manage bearing in mind staffing levels, demographics of population , sustainability of service and work/life balance.

Proposer: GP Committee

Status: Carried

 

OUT OF HOURS

5.This meeting calls on the Department of Health and the HSE to recognise that the current model of GP out of hours is not sustainable and a barrier to recruitment and retention of GPs.  The IMO calls for a complete review of the service so as to ensure equity for GPs across the country, with limits on number of rostered hours a GP should undertake in the context of safe practice, fairness and recognition of work/life balance.

Proposer: GP Committee

Status: Carried

 

6. The IMO calls on the Department of Health and the HSE to recognise that the GP Out of Hours service is for emergency and acute presentations and is neither funded or staffed to become an extension of normal GP daytime services.

Proposer: GP Committee

Status: Carried as Amended

Amendement

The IMO calls on the Department of Helth and the HSE to recognise that the GP Out oF Hours service is for urgent presentations which cannot wait until the next day and is neither funded or staffed to become an extension of normal GP daytime services

 

7. The IMO calls on the Department of Health and the HSE to fully fund the GP out of hours service and remove the financial burden from individual GPs.

Proposer: GP Committee

Status: Carried

 

WOMEN’S HEALTH

8. This meeting calls on the Department of Health to immediately extend the Contraceptive Scheme for all women in their reproductive years.

Proposer: Dr Aideen Brides                          Seconder : Dr Sumi Dunne

Status: Carried

 

9. This meeting calls on the HSE and Department of Health to ensure that, as part of a comprehensive Women’s Health Programme, a structured menopause care programme is introduced and supported in General Practice so as to enable GPs to dedicate appropriate time and care to women.  The vast majority of women will have this care safely and expertly delivered within General Practice without the need to access specialist clinics.

Proposer: Dr Aideen Brides                          Seconder : Dr Sumi Dunne

Status: Carried

 

 

MENTAL HEALTH PROGRAMMES IN GENERAL PRACTICE

10. This meeting calls on the Government and HSE for the introduction of a functional, accessible and universal Primary Mental Health Service.  Acknowledging that most mental health conditions present  to, are contained within, and are effectively care for by General Practice, a funded programme by the HSE should be introduced as soon as possible.  Furthermore a model of tiered psychosocial supports around General Practice, which is publicly funded, face to face, evidence based and geographically located in our communities, should be made available, developed by GP experts in conjunction with our secondary care mental health colleagues and primary care psychology colleagues.  This model of care should cater for the management of all presentations pf psychological distress, anxiety, depression and addiction within General Practice.

Proposer: Dr Mark Murphy                                          Seconder : Dr Conor O’Kelly

Status: Carried

 

11. This meeting calls on the HSE to urgently address the acute deficits in the Mental Health Service provisions for both Adult Mental Health Service and CAMHs services given the significant problems for GPs encountered by GPs when seeking to refer patients for timely care.

Proposer: Limerick GP Branch

Status: Carried

 

RURAL GENERAL PRACTICE

12. Due to the serious issues with the recruitment and retention of rural general practitioners in the  most isolated rural areas and on the offshore islands, this meeting proposes that these single handed practices be supported by a second GP, and become 2 doctor practices, which will be fully funded by the HSE.

Proposer: Dr Jerry Cowley                                            Seconder: Dr Catherine Donnelly

Satus: Carried

 

13. This meeting proposes that all GPs in active practice should be invited to join and, with their assent, be accepted for inclusion in sustainable out of hours rotas run by our existing co-ops.

Proposer: Dr Jerry Cowley                                            Seconder: Dr Catherine Donnelly

Status: Carried As Amended

Amendment

This meeting proposes that all GPs in active practice should be invited to join and be accepted for inclusion in sustainable out of hours rotas run by our existing co-ops.

14. This meeting proposes that single handed GPs, who are in receipt of a rural practice allowance, be provided with 5 weeks protected annual leave, by locums provided by the HSE.  Such a measure would facilitate the retention of the existing cohort of GPs, and assist in the recruitment of newly qualified GPs to these posts, which are acutely in need of such a provision.

Proposer: Galway GP Branch

Status: Carried

 

15. This meeting calls on the HSE to guarantee GP Locum cover for all statutory leave including annual leave, sick leave, maternity and paternity leave for rural practitioners in the most isolated rural areas and on the offshore island.

Proposer: Dr Jerry Cowley                                            Seconder: Dr Catherine Donnelly

Status: Carried

 

16. The IMO calls on the HSE and the Department of Health to apply increases in li ne with Public Sector Pay Agreements for GPs in receipt of DMO salaries going forward and retrospectively.  These salaries have been static since the benchmarking pay increases in 2008.  All increases should also apply for anyone in receipt of a pension associated with this salary.

Proposer: Dr Aongaus Flavin                                        Seconder : Dr Martin Daly

Status:Carried

 

PCRS

17. This meeting calls on the HSE and PCRS to put in place mechanisms that would facilitate timely and direct payment of annual leave, study leave and sick leave.

Proposer: Limerick GP Branch

Status: Carried

 

HEALTHLINK

18. The IMO calls on the HSE to extend the referral pathways in Healthlink to include referrals to other healthcare professionals in the Primary Care Team.

Proposer: Limerick GP Branch

Status: Carried

 

STAFFING SUPPORTS

19. The IMO calls on the HSE and Department of Health to increase the level of funding available for individual staff supports given that these levels have not increased in over a decade while associated costs have increased.

Proposer: Limerick GP Branch

Status: Carried

 

LOCUMS

20. This meeting calls on the HSE to support and resource GPs  who have retired, or who have just qualified and who may be in a position to provide much needed locum services to daytime General Practice, through the provision of supports for registration, medical indemnity, CPD etc.

Proposer: North Dublin GP Branch

Status: Carried

 

21. This meeting calls on the HSE to appropriately support the costs associated with the provision of GP Locums in practice.

Proposer: IMO GP Committee

Status: Carried

INCREASED FINANCIAL COSTS FOR GP PRACTICES

22. This meeting calls on Government and the HSE to recognise the very significant increased costs in the provision of GP services in the context of inflation and medical inflation and to undertake, with the IMO, a review of all fees and payments.

Proposer: IMO GP Committee

Status: Carried

Medical Council

23. This meeting calls on the Medical Council to amend the nominating categories for election to the Medical Council so that a stand alone category for General Practitioners on the Specialist Register can be created.

Proposer: Dr Henry Finnegan

Seconder: Dr Michael Kelleher

Status: Carried

NEW CONSULTANT CONTRACT

1. This meeting calls on the Department of Health and the HSE to engage further with the IMO to address the significant concerns of consultants and trainees in relation to Rostering, Location and Locum provisions in the new consultant contract.

Proposer: IMO Consultant Committee

Status: Carried

 

2. The IMO calls on the HSE to put in place clear policies across all sites that ensures no new rosters are introduced until there are sufficient consultants and appropriate levels of support staff in place so as to ensure patient safety and enable best practice.

Proposer: IMO Consultant Committee

Status: Carried

 

3. The IMO calls on the HSE to put in place clear policies across all sites that ensures no consultant is forced to take on unsafe levels of workload particularly in circumstances where there are gaps in the workforce due to vacant posts, illness or any other issues.

Proposer: IMO Consultant Committee

Status: Carried

4. This meeting calls on the Department of Health and the HSE to ensure that no consultant is pressurised to transfer to the new contract and further that contractual rights under current and existing contracts are fully honoured.

Proposer: IMO Consultant Committee

Status: Carried

 

STRESS AND BURNOUT

5. This meeting calls on the HSE and the Department of Health to engage proactively with the IMO to address the significant issues of stress and burnout within the consultant workforce which can be directly attributed to the working environment.

Proposer: IMO Consultant Committee

Status: Carried As Amended

Amendment

 

This meeting calls on the HSE and the Department of Health to engage proactively with the IMO to DEVELOP AN AGREED POLICY WHICH Addresses the significant issues of stress FATIGUE and burnout within the consultant workforce, which can be directly attributed to the working environment AND LEADS TO IMPACTS ON PATIENT SAFETY.

MENTAL HEALTH SERVICES

6. This meeting calls on the Department of Health and the HSE to undertake an assessment of the impact on patients and staff with the policy of moving mental health services to the community in the context of inadequate medical staffing levels and significant difficulties in recruiting consultants to these posts.

Proposer: Prof Matthew Sadlier                                 Seconder: Dr Clive Kilgallen

Status: Carried

Area Medical Officers

1. That this meeting supports the case for upgrading of remaining Area Medical Officers (AMOs) to Senior Medical Officers (SMOs), as AMOs carry out the same range of duties as SMOs and SMO is the entry grade in the Community Medical Service.

Proposer: Public Health and Community Health Committee

Status: Carried

 

2. This meeting calls on the Department of Health, Department of Public Expenditure and Reform and the HSE to proactively engage with the IMO, under the terms of Building Momentum, to resolve the inequitable treatment of Area Medical Officers and resolve this matter in a fair manner.

Proposer: Public Health and Community Health Committee

Status: Carried

 

Recruitment

3. This IMO calls on the HSE and Department of Health to ensure that the career structure, training and terms and conditions of those working in SMO and PMO roles in Community and Public Health are reviewed and enhanced to ensure that there is an adequate number of doctors to fill current and future vacancies at this grade and in order to maintain essential public and community health medical services.

 

Proposer: Public Health and Community Health Committee

Status: Carried

 

4. While commending the work done to date, the IMO calls on the HSE and Department of Health to ensure that the agreement reached between the IMO, Department of Health and HSE on the introduction of the role of Consultant in Public Health Medicine in Ireland is implemented in full and on schedule.

 

Proposer: Public Health and Community Health Committee

Status: Carried

 

5. This meeting calls on the HSE to immediately recruit Community Paediatric Psychology posts in every CHO area to deal with the number of unfilled posts and to enhance the service ao as to meet the urgent clinical needs of children who require services inculding those children who require Autistic Spectrum Disorder assessments.

 

Proposer: Public Health and Community Health Committee

Status: Carried

 

Continuing Medical Education

6. The IMO calls on the HSE to increase CME funding for non consultant Public Health and Community Health doctors to the same level as that provided for consultants, as all doctors are required by the Medical Practitioners Act 2007, to maintain professional competence and to be enrolled in a professional competence scheme since May 2011 and the costs are essentially the same.

Proposer: Public Health and Community Health Committee

Status:Carried