The end of the beginning?

In his inaugural address as IMO President Dr Padraig McGarry referred to the new GP deal as the “end of the beginning”. He was talking, of course, about the end of FEMPI, and the potential that this offers for a new dawn for general practice. As chair of the IMO GP Committee, he was a leader in the negotiating team that achieved the deal. Only weeks after the deal was announced, Dr McGarry could not have chosen a better time to become President.

The financial impact of FEMPI affected GPs at all levels of their careers, forcing even those in their 40s and 50s to search for work abroad, as they didn’t think there was a viable career for them in Ireland. Although the deal still has to be ratified by members and then accepted by individual GPs, it received a positive response during the IMO AGM. At the same time, Dr McGarry and the IMO leadership were at pains to stress that this was just a first step. There was no suggestion that all the problems of general practice have been solved. The need for a new GP contract has not gone away. But the prospect of an end of the pain of the FEMPI-era means that for the first time in a long while, there is hope for the future of general practice in Ireland. The future of the NAGP, which was a product of this period of cutbacks, is also uncertain, with the announcement that the Council of the Association was resigning due to concerns about governance, as MI was going to press.

Change is also on the horizon for other groups. During the consultant meeting, delegates warned of the potential for industrial action if the Government does not end the pay discrepancy for new-entrant consultants. The detrimental effects of this pay cut, which applies to new consultants appointed after 2012, is seen in the high number of vacant posts throughout the country. In his speech to the conference, Minister for Health Simon Harris recognised the problem. He told delegates that a process would be established to deal with new-entrant pay. Dr McGarry welcomed this announcement in his own speech later that day. He said the IMO will be writing to the Minister in the coming days to seek a formal start to this process. He stressed the Organisation is looking for the issue to be addressed as soon as possible.

Another group that believe they have been treated unfairly over the years are public health doctors. The recent Crowe Horwath report into public health medicine in Ireland, recommended what the specialty have been demanding for years – that the group be granted consultant status. Negotiations will take place between the IMO and the Department of Health to make this happen. First, a HSE group, led by HSE Chief Clinical Officer Dr Colm Henry, has been established to implement the structural recommendations from the report. Again, the final outcome of negotiations, and the work of the group, remains to be seen, but these are positive developments for the specialty after years of frustration.

The economic recessions had a catastrophic impact on the country. Doctors did not escape the financial fallout. Looking at the progress being made, or promised, across the different groups, it seems the profession as a whole could be about to turn a corner and consign this era to the past. There are, however, clouds on the horizon. The darkest cloud is the potential fallout from Brexit. Progress cannot be taken for granted. Economies are fragile constructs; recoveries can end not long after they begin. But when Dr McGarry spoke about the “end of the beginning” it was with an optimism that has seldom been seen in the medical profession in recent years. And if a profession is not only to survive, but thrive, it needs optimism.