GAZA

1. The IMO recognises the dire circumstances of the healthcare system, medical teams and civilian population in Gaza and calls on the Irish Government, the European Commission and the European Parliament to use all diplomatic and financial avenues available to support all relevant agencies on the ground in the provision of healthcare, including the reinstatement and augmentation of funding to UNWRA

Carried as amended

Amendment

The IMO recognises the dire circumstances of the healthcare system, medical teams and civilian population in Gaza and calls on the Irish Government, the European Commission and the European Parliament to use all diplomatic and financial avenues available to support all relevant agencies on the ground in the provision of healthcare, including the reinstatement and augmentation of funding to UNWRA.The IMO recognises and supports the position of the United Nations and the International Court of Justice on the war in Gaza and calls for an immediate ceasefire and the release of hostages.  We condemn in the strongest possible terms the ongoing attacks by the Israeli Government on civilians, healthcare settings and on those seeking to provide care and aid to the people of Gaza.  We further call on the Irish Government, all medical institutions and bodies to review their procurement chains and associations so as to ensure they are in line with the UN and ICJ Rulings and Directives and that any procurement does not support military action.

 

Medical Council

2. The IMO calls on the Medical Council to reverse its decision to remove Intensive Care Medicine and Pain Medicine from the CSCST in Anaesthesiology, given the actual role of consultant anaesthesiologists under the Model of Care for Anaesthesia in Ireland, and given the immediate implications for patient safety and ICU service provision.

Status: Carried

 

3. The IMO call on the Medical Council to engage in wider consultation on the Ethical Guidelines so as to ensure a focus on clinical ethics in any amendments and to proactively engage on any significant changes that will impact on the clinical practice of the profession.

Status: Carried

 

Long Covid

4. The IMO calls on the Department of Health, the Department of Public Expenditure and Reform and the HSE to rescind its decision to stop payments to healthcare workers under the Long Covid Scheme and to immediately engage with the relevant Trade Unions to put in place appropriate long term arrangements for those workers.

Status: Carried

 

5. The IMO calls on the HSE and Department of Health to fund and staff increased clinical care and research for post Covid syndrome, which continues to have a detrimental effect on individual patients and on society as a whole.

Status: Carried

 

Graduate Entry Medical Students

6. Recognising the urgent need to train and retain more doctors in Ireland, the IMO calls on the Minister for Health and Minister for Further and Higher Education to abolish fees in excess of undergraduate medical student fees for Graduate Entry Medical students. The current system is a barrier to ensuring students from all socio-economic backgrounds can avail of this pathway and adds a huge debt burden to medical students at the end of their studies.

Carried as Amended

Amendment

Recognising the urgent need to train and retain more doctors in Ireland, the IMO calls on the Minister for Health and Minister for Further and Higher Education to ensure that graduate entry medical students and undergraduate medical students fees are the same, and to allow access to SUSI funding. The current system is a barrier to ensuring students from all socio-economic backgrounds can avail of this pathway and adds a huge debt burden to medical students at the end of their studies.

 

HPAT

7. The IMO calls upon the Minister for Higher Education to end the failed experiment that is HPAT and instead to look at more effective ways of broadening access to medical school places

Status: Carried

 

Climate and Environment

 

8. Effective climate action is urgent and of critical importance for our current and future populations. We call on the government to implement effective sustainability and adaptation actions and to improve their Climate Action Plans to achieve this.

Status: Carried

 

9. The Healthy Ireland framework will end next year. The IMO calls for a review of its impact in terms of addressing the determinants of health. We urge government to examine how poor health is influenced by corporate entities and the commercial determinants of health, whose profits are significantly dependent on the consumption of products with negative health impacts.

Status: Carried

 

10. The IMO calls on the Government to ensure that all Government Departments carry out and publish comprehensive and meaningful Health Impact Assessments, as recommended by the World Health Organisation when developing policies or major projects so as to improve and protect the health of our citizens. In particular HIAs should be meaningfully considered in the context of air pollution, environmental hazards and the social determinants of health.

Status: Carried

 

11. Doctors are expected to have very high standards and be accountable for any negative effect on health that might occur under their care. Considering the wider determinants of health, which are outside of doctors’ control, are responsible for most illness, those who make decisions that may adversely affect the health and well-being of people should be expected to have similar high standards in terms of ethical training, and accountability. The IMO calls on Government to reflect these standards in their decision making.

Status: Carried

 

12. Recognising the detrimental impact on physical and mental health arising from homelessness and inappropriate housing, the IMO calls on the Government to ensure that all efforts are made to provide safe and secure housing for the most vulnerable in our society and in particular the homeless and those seeking international protection.

Status: Carried

 

Gambling

 

13. In the interest of the health and wellbeing of our citizens, this meeting calls on the Government to ban gambling advertising from television, radio, cinemas, magazines, social media, websites, newspapers and in public spaces.

Status: Carried

 

14. Given the devastating impacts of gambling, and the growth in online gambling, this meeting calls on the Government to impose mandatory deposit limits on personal gambling accounts , which can only be increased after robust customer safety checks.

Status: Carried

 

HSE Recruitment Freeze

 

15. The IMO call on the HSE to immediately lift the recruitment embargo on medical grades as it poses a serious risk to patient safety at a time when we have increased demand and one of the lowest doctor:patient ratios in the OECD.

Status: Carried

 

Capacity and Workforce Planning

 

16. Our population continues to grow and will likely reach 5.5 million by 2028, the minimum requirements of 2,600 beds identified in the 2018 Health Service Capacity Review were never and will never be enough. We need an urgent medium term plan to increase acute hospital bed capacity by 5000 beds to meet current and future needs front-loaded with 1,600 beds in 2024

Status: Carried

 

17. The IMO calls on the Department of Health and the HSE to update the future medical workforce requirements taking into account :

• predicted geographical and demographic changes in population

• new clinical programmes and models of care

• strategic requirements such as laid out in Sláintecare

• demand should be based on Whole Time Equivalents (to take into account part-time working and predictable attrition rates).

The IMO further calls on Government to develop a plan with associated resources to implement the medical workforce requirements.

Carried as amended

Amendment

17. The IMO calls on the Department of Health and the HSE to update the current and future medical workforce requirements taking into account :

• predicted geographical and demographic changes in population

• new clinical programmes and models of care

• strategic requirements such as laid out in Sláintecare

• demand should be based on Whole Time Equivalents (to take into account part-time working and predictable attrition rates).

The IMO further calls on Government to develop a plan with associated resources to implement the medical workforce requirements.

 

Investment in Digitalisation of Health Services

18. E-health and digitalisation of the health services holds the promise of enhancing patient safety, quality and integration of care. The IMO calls on the Department of Health to provide an economic evaluation of the Health Information Bill and to allocate sufficient resources for the roll out of digitalised health service.

Status: Carried

Social Media

19. The IMO calls on the Department of Education to institute a ban (from the start of the next school year) on Smartphone use by pupils within all primary schools in Ireland.

Status: Carried

20. The IMO calls on the Department of Health, in light of the US Surgeon General’s Advisory on “Social Media and Youth Mental Health” , to urgently develop a well-funded public health strategy modelled on successful “tobacco free” policies to combat social media addiction, use and harm.

Status: Carried

21. The IMO calls on the Attorney General and Department of Justice in light of the case taken by 42 US Attorneys General against Meta for their product’s detrimental effect upon youth mental health to urgently investigate the allegations and publish opinion on whether a similar case should be taken in Ireland.

Carried as amended

Amendment

The IMO calls on the Government, in light of the case taken by by 42 US Attorneys General against Meta for their product’s detrimental effect upon youth mental health to urgently investigate the allegations and publish opinion on whether a similar case should be taken in Ireland.

 

Mental Health Services

22. Recognising that prisons are not a suitable environment to treat people with serious mental disorders this meeting calls for;

• Rapid pathways for those who require an acute psychiatric bed in NFMHSH

• Increased staffing of psychiatrists and mental health professionals in prisons

• Provision of comprehensive addiction services within prisons

• Increased support for those to access care on release

Carried as amended

Amendment

Recognising that prisons are not a suitable environment to treat people with serious mental disorders this meeting calls on the Minister for Justice and the Minister for Health to develop

• Rapid pathways for those who require an acute psychiatric bed in NFMHSH

• Increased staffing of psychiatrists and mental health professionals in prisons

• Provision of comprehensive addiction services within prisons

• Increased support for those to access care on release

 

23. Given that no medical body was consulted in the development of “Sharing the Vision” The IMO calls on the Minister for Health to urgently intervene and commission a review, independent of the HSE Management and Clinical Leads, of the current dispersed community based model of the delivery of Psychiatric Services and further calls for that review to prioritise the views of Consultant Psychiatrists and General Practitioners.

Status: Carried

24. The IMO calls on the Minister for Health to directly intervene and end the current age discrimination and set a clear plan to develop Old Age Psychiatry Services both in and out of hospitals to ensure that each is seen by their age specific specialists.

Status: Carried

25. This meeting calls on the Department of Health to urgently resource the CAMHs service to ensure that the correct staffing levels and appropriate structures are in place to ensure equitable and timely access for patients.

Carried as amended

Amendment

This meeting calls on the Department of Health to urgently resource the CAMHs and AMHs services to ensure that the correct staffing levels and appropriate structures are in place to ensure equitable and timely access for patients.

26. The IMO calls on the Minister for Health to immediately ensure that every Level 3 and 4 Hospital Emergency Department has access to on-site consultant led psychiatric services.

Status: Carried

 

Physician Assistants/Associates

 

27. The IMO call on the Department of Health and the HSE to engage with the IMO and other stakeholders in regard to establishing a clear and definitive role for the grade of Physician Assistant/Associate appropriate to their level of training.

Status: Carried

28. The IMO call on the Department of Health and the HSE to engage with the IMO and other stakeholders in relation to the governance and reporting relationships attached to the grade of Physician Assistants/Associates and their role within the context of multidisciplinary teams.

Status; Carried

29. The IMO call on the HSE to issue instructions to all HSE funded healthcare settings advising that Physician Assistants/Associates cannot be used to cover doctors shifts or included on medical rotas.

Carried as Amended

Amendment

The IMO call on the HSE to issue instructions to all HSE funded healthcare settings advising that Physician Assistants/Associates cannot be used to cover doctors shifts or rotas.

30. The IMO calls on the Minister for Health and the Government to confirm that the Medical Council will remain solely a body to register and accredit Registered Medical Practitioners and that any new health profession (such as Physician Assistants/Associates) will be accredited by different avenues.

Status: Carried

Consultant Contract

1. The consultant committee calls on the HSE and Dept of Health to clearly and categorically state their support for protected time, and its recognition in job planning, in the consultant contract, particularly in light of the recommendations of the National Taskforce on the NCHD workforce.

Carried as amended

Amendment

The consultant committee calls on the HSE and Dept of Health to clearly and categorically state their support for protected training time, and its recognition in job planning, in the consultant contract, particularly in light of the recommendations of the National Taskforce on the NCHD workforce.

2. Noting that the Public Only Consultant Contract provides for rosters over extended hours and days, the IMO calls on the HSE and the Department of Health to ensure that, in line with the Rostering Principles, any amendments to work plans over the extended period must ensure that there are sufficient medical and allied health services available at that time and that such changes will not negatively impact on services at other times.

Status: Carried

3. The IMO calls on the Minister for Health and the HSE to publicly acknowledge that consultants, on all types of contract, currently provide 24/7 care through the provision of on call commitments.

Status: Carried

4. This meeting calls on the HSE to ensure that every consultant is provided with sufficient resources, including capacity and support staff, so as to enable them to do their work and deliver timely care to patients.

Status: Carried as amended

Amendment

This meeting calls on the HSE to ensure that every consultant is provided with sufficient resources, including capacity and support staff, so as to enable and facilitate them to do their work and deliver timely care to patients.

Capacity

5. This meeting calls on the Government to publish a rapid expansion plan, with ring fenced funding, to increase acute and beds, theatre and diagnostic capacity in our public health services. Failure to invest in capacity causes harm to patients and staff, and will continue to manifest in: • Long waiting lists for care

• Dangerous overcrowding in Emergency Departments

• Difficulties in recruiting staff to our public health services

Status: Carried as amended

Amendment

This meeting calls on the Government to publish a rapid expansion plan, with ring fenced funding, to increase acute and rehabilitation beds, theatre and diagnostic capacity in our public health services. Failure to invest in capacity causes harm to patients and staff, and will continue to manifest in: • Long waiting lists for care

• Dangerous overcrowding in Emergency Departments

• Difficulties in recruiting staff to our public health services

 

HSE Recruitment Freeze

6. The IMO calls upon the HSE to rescind the Recruitment Freeze which represents a serious threat to patient care. At a time when the labour market for healthcare workers has never been more competitive, and WHO estimates a projected shortfall of 10 million healthcare workers by 2030, it is all the more absurd that the HSE has decided that a recruitment embargo is a reasonable policy.

Status: Carried

National Treatment Purchase Fund

7. The IMO calls upon the Minister for Health and NTPF to ensure that all outsourced work at consultant level is carried out by doctors registered on the specialist register of the Irish Medical Council and that such care is in line with National Models of Care and provides for MDT follow up rather that a single episode of care.

Status: Carried As Amended

Amendment

The IMO calls upon the Minister for Health and NTPF to ensure that all outsourced work at consultant level is carried out by doctors registered on the specialist register of the Irish Medical Council and that such care is in line with National Models of Care and provides for MDT follow up rather than being treated as a single episode of care.

 

8. The IMO calls upon HIQA to investigate the current arrangements around outsourcing of patients on waiting list to private operators to ensure that the safety of the entirety of the patient journey is considered, rather than single episodes of care.

Carried as amended

Amendment

The IMO calls upon HIQA to investigate the current arrangements around outsourcing of patients on waiting list to private operators to ensure that the safety of the entirety of the patient journey including complications arising from that treatment is considered.

 

National Ambulance Service

9. IMO calls on National Ambulance Service to develop appropriate bypass protocols for patients with acute psychiatric needs to ensure such patients are conveyed to emergency departments which have acute psychiatric on call services, ensuring that patient is brought to right service first time and avoiding requirement for secondary transfers. We further call on the NAS to ensure requests from Emergency Departments to transfer patients from ED to appropriate psychiatric services are facilitated.

Status: Carried

Services for Older Persons

10. The IMO calls on the Minister for Health to directly intervene and end the current age discrimination in hospital based psychiatric services and develop in-house Psychiatry of Old Age Liaison Services that operate along same lines as there General Adult Services and ensure that Psychiatry of Old Age (which is a recognised specialty by the Medical Council) are integrated into all models of care involving older adults, to ensure that each person in hospital is seen by their age specific specialists.

Carried as amended

Amendment

The IMO calls on the Minister for Health to directly intervene and end the current age discrimination in hospital based psychiatric services and develop in-house Psychiatry of Old Age Liaison Services (which is a recognised specialty by the Medical Council) are integrated into all models of care involving older adults, to ensure that each person in hospital is seen by their age specific specialists.

11. The IMO calls on the Minister for Health and the HSE to set standards for transitional care units for older adults to ensure that they can provide rehabilitation as per international and national standards to prevent the loss of function that can accompany older adults’ admissions to hospitals.

Status: Carried

Clinical Services

12. Welcoming the women’s health action plan 2022-2023 the IMO encourages the Dept of Health to ensure a holistic view of women’s health is taken and that appropriate resourcing and investment is made to ensure the distinct needs of women are addressed across all disciplines of healthcare and not just those traditionally associated with the term women’s health.

Staus: Carried

13. The IMO calls upon the HSE to develop a national strategy to provide appropriate multidisciplinary care across the country for patients with functional gastrointestinal disease with specific emphasis on dietary therapies.

Status: Carried

Expansion of Undergraduate Medical Training

14. The IMO calls on the Government to establish a cross departmental group to plan for and fund the appropriate number of undergraduate medical training places so as to ensure that our future medical workforce needs are met.

Status: Carried

PMOs and SMOs

1. This meeting calls on the HSE and Department of Health to recognise the specific challenges facing the PMO and SMO grade (in both public and community health) and to address the discrepancy in salary that has arisen between these roles and other medical roles as a result of the non-implementation of the 2010 benchmarking award.

Status: Carried

2. This meeting calls on the HSE and Department of Health to conduct a review of the SMO role with a view to improving the terms and conditions, career pathway and training opportunities associated with the role.

Status: Carried

 

Workforce Numbers

3. This meeting call on the HSE to proceed with recruitment into Community Health Departments to enable teams deliver their vital work in various areas including child development checks and the running of school vaccination programmes.

Carried as amended

Amendment

This meeting calls on the HSE to proceed with recruitment into Community Health Departments to enable teams deliver their vital work in various areas including the assessment and management of childhood developmental health and the running of school vaccination programmes.

 

4. This meeting call on the HSE to undertake an urgent review of the staffing in Community Health Departments to ensure that there are sufficient staff to deliver services given the increasing population and changing workloads.

Carried as amended

Amendment

This meeting call on the HSE to undertake an urgent review of the staffing in Community Health Departments to ensure that staff levels are increased in line with increasing population and changing and more complex workloads.

 

Public Health Reform Process

5. This meeting calls on the HSE to continue the implementation of the Public Health Reform process and welcomes the progress made to date with regard to the 84 consultant in public health medicine posts agreed with the IMO.

Status: Carried

6. This meeting notes the importance of appropriately renumerating senior clinical leadership roles. We call on the HSE to apply the Clinical Directors Allowance to the National Director of Public Health and Area Directors of Public Health in recognition of the role as senior clinical leaders providing management, governance and accountability responsibilities in line with the Clinical Director model, working across all domains of Public Health and to ensure future retention and succession planning for these posts.

Status: Carried

 

HSE Recruitment Freeze

7. In order for CPHMs in health Improvement/ Intelligence and Health Service Improvement to effectively perform their duties they need a full team in place. These teams are multidisciplinary in nature. They have not been put in place at regional or national level, leaving many new CPHMs struggling to perform their function. Some of these posts are also caught up in the recruitment ban. This meeting calls on the HSE to ensure rapid filling of all posts within multi-disciplinary teams supporting CPHMs.

Status: Carried

 

Disabled Drivers and Passengers Tax Relief Scheme

8. This meeting calls on the implementation of reforms regarding the Disabled Drivers & Passengers Tax Relief Scheme (Primary Medical Certificate) to ensure that applicants who require the support of the scheme can maintain their independence through the use of specifically adapted vehicles.

Status: Carried as amended

Amendment

This meeting calls on the implementation of overdue reforms regarding the Disabled Drivers & Passengers Tax Relief Scheme (Primary Medical Certificate) to ensure equity for applicants who require the support of the scheme can maintain their independence through the use of specifically adapted vehicles.

 

AMO Issues

9. This meeting welcomes the resolution of the longstanding Area Medical Officer issue through the bargaining unit process under Building Momentum. Given the significant delays which have been involved so far in this process and the long history of this dispute, this meeting calls on the HSE to implement the new terms without delay.

Status: Carried

HSE Recruitment Freeze

1. This meeting calls on the HSE to immediately rescind the recruitment freeze on NCHDs in non-training posts, so as to ensure that the integrity of the 2022 NCHD Agreement is upheld. This is essential, particularly in regard to the acknowledged need for targeted recruitment of NCHDs to ensure the HSE are meeting their legal obligations in respect of working hours.

Status: Carried

 

IMO NCHD Agreement 2022

2. This meeting condemns the HSE for its failure to ensure the terms of the NCHD Agreement 2022 are being fully upheld and implemented across all sites.

We call on the HSE to proactively audit all sites in relation to the implementation of agreed contractual terms including:

• Working Hours and Rostering Rules

• Provision of guaranteed Study Leave

• Payment for all hours worked

• Payment for compensatory rest and relocation expenses

Status: Carried

 

National Taskforce on NCHD Workforce

3. This meeting gives a guarded welcome to the Report of the National Taskforce on NCHDs and calls on the Minister for Health and the HSE to publish a fully funded implementation plan and to engage with IMO on same, so as to address the ongoing crisis of emigration, burnout and stress amongst NCHDs due to poor working conditions.

Status: Carried

 

Work Life Balance

4. The IMO #standingUP4NCHDs campaign identified Working Hours as the key barrier to NCHDs being enabled to achieve a healthy Work Life Balance. Both the National Taskforce on NCHDs and the Medical Council Workforce Intelligence Report support this evidence. Given that 77% of NCHDs continue to routinely work in excess of the legal limit of 48 hours per week, the IMO calls on the Minister for Health and the HSE to publicly confirm that this practice will cease and that the terms of the NCHD Agreement 2022 will be upheld across all HSE and HSE funded healthcare sites.

Carried as amended

Amendment

The IMO #standingUP4NCHDs campaign identified Working Hours as the key barrier to NCHDs being enabled to achieve a healthy Work Life Balance. Both the National Taskforce on NCHDs and the Medical Council Workforce Intelligence Report support this evidence. Given that the majority of NCHDs continue to routinely work in excess of the legal limit of 48 hours per week, the IMO calls on the Minister for Health and the HSE to publicly confirm that this practice will cease and that the terms of the NCHD Agreement 2022 will be upheld across all HSE and HSE funded healthcare sites.

5. Recognising the demographic of the NCHD workforce this meeting calls on the Department of Health and the HSE to engage with the IMO on improving and enhancing flexible arrangements for NCHDs; so that a greater work-life and family life balance can be achieved.

Status: Carried as amended

Amendment

Recognising the demographic of the NCHD workforce this meeting calls on the Department of Health and the HSE to engage with the IMO on improving and enhancing flexible arrangements for NCHDs; so that a greater work-life and family life balance can be achieved without a negative impact on career progression.

Childcare

 6. This meeting calls on the HSE to acknowledge the failure to support the provision of onsite childcare or to resource off site childcare to support their staff, including NCHDs, who are contractually obliged to work long and unsocial hours when childcare provision is not available. For those NCHDs who geographically rotate multiple times in their training programme the situation is even more difficult. We call on the HSE and the Department of Health to develop a comprehensive, funded plan to address this issue.

Status: Carried

 

New NCHD Contract

7. This meeting calls on the HSE and the Department of Health to immediately engage with the IMO on a new NCHD Contract with a focus on:

• Contractual issues around the structure and costs of training

• Improvements in working hours and enhanced rostering arrangements

• Addressing specific challenges faced by International Doctors

• Specific challenges for NCHDs in non-acute settings

• Measures to improve work life balance and family friendly policies

Status: Carried as amended

Amendment

This meeting calls on the HSE and the Department of Health to immediately engage with the IMO on a new NCHD Contract with a focus on:

• Contractual issues around the structure and costs of training

• Improvements in working hours and enhanced rostering arrangements

• Addressing specific challenges faced by International Doctors

• Specific challenges for NCHDs in non hospital based settings

• Measures to improve work life balance and family friendly policies

Physician Assistants/Associates

8. This meeting calls on the HSE and postgraduate training bodies, to engage with the IMO so as to ensure that any development of the role of physician associates/assistants does not compromise the training and competency attainment of general and specialist doctors in training (through the traditional or alternative pathway).

Status: Carried

9. This meeting calls on the HSE and the Minister for Health to guarantee that;

a) No NCHD post will be suppressed to facilitate the recruitment of PAs

b) PAs will not be rostered as part of any medical rota

Status: Carried

Valuing and Respecting NCHDs

10. NCHDs represent the largest percentage of the medical workforce; yet over 70% of them do not feel valued, respected or supported by the HSE. This is a key driver for NCHD emigration and the IMO calls on the HSE to recognise the dysfunctional culture within the HSE in relation to NCHDs and to engage with the IMO on implementing meaningful measures to address this.

Status: Carried as amended

Amendment

NCHDs represent the largest percentage of the medical workforce; yet over 70% of them do not feel valued, respected or supported by the HSE. This is a key driver for NCHD emigration and the IMO calls on the HSE to recognise the dysfunctional culture within the HSE in relation to NCHDs and to engage with the IMO on implementing meaningful measures to support NCHDs who are experiencing hardship.