A solid base for future of NCHDs

IMO AGM Special: Whenever ‘Irish NCHDs — A History’ is finally written, 2009 will be marked down as a momentous year, writes NCHD Committee Chairman Dr Matthew Sadlier

If anyone was ever to write a history of Irish NCHDs, which I admit is unlikely, 2009 would more than likely be noted as one of the most significant years. When we sat in Killarney this time last year the threats of industrial action, court cases and other dramas were hanging over our heads.
Between April and January we were on an emotional roller coaster swinging from highs to lows, perceived victories and perceived defeats coming in quick succession. One event that symbolised this for me was the evening when the ballot on the rostering arrangements to allow for the European Working Time Directive was counted.
The decisive nature of the ballot was a tremendous endorsement of all the Committee’s work, and we decided to stroll from IMO House to the nearby Leeson Lounge for a celebratory drink.
On walking into the Lounge, however, our joy quickly changed as the television screens announced the sudden death of the ‘King of Pop’.
The conflicting emotions that many of us had on that day, as we balanced the genius of the music which provided the sound track of our school days against the sordid allegations of his lifestyle, relegated our industrial relations issues into second place.
Satisfying endorsement
The rest of the contract process played out throughout the autumn and into January when we again received a satisfying endorsement for our efforts from members.
Along with the collective agreement over training hours and rostering I feel that we have established a solid base from which we can now move forward, which is important because there remains a lot more work still to be done.
The main reason for that is the fact that 2009 saw the greatest change to Irish medicine in generations with the implementation of the Medical Practitioners Act.
The changes to the register with the establishment of the training register in July had great implications for NCHDs across the country.
Great credit must go to the staff of the Medical Council who managed to process thousands of applications in an efficient manner and reduce the distress such a change invariably creates.
However, this change did not come without consequences; the most notably to those doctors from overseas who now have to have their visa renewed every six months.
While most of us agree with the thrust within the new Act of mandating all doctors to be engaged with either training or competence assurance programmes, it is in the logistics of how this is to be implemented that difficulties arise.
And for NCHDs who will remain on the general register, we have yet to see exactly how competence assurance programmes will be organised. But we wait anxiously.
For NCHDs who are on the training register, a complex chain of command has now been created. NCHDs now find themselves in the centre of a very complex regulation and employment structure.
The Medical Council, the postgraduate training bodies, the HSE, the local hospital management as well as the NCHD’s own supervising consultant all now have an input into an NCHD’s daily life and career.
While the various agendas of all of those bodies are aligned, the life of the NCHD will be relatively simple. But while the Medical Council and the training bodies now have a much stronger legislative hold over each NCHD, it remains the HSE who pays the salary and determines the day-to-day conditions. So when the chips are down it may become hard to see exactly who wields the most power. Thus it is in all NCHDs interests that the chips remain very much up.
As part of this process, the IMO held a number of very useful and productive meetings with a number of the training bodies as well as with the Medical Council.
Over the next number of months as the new arrangements for funding of training are being established, we hope to continue this engagement. Of course, we will all be looking forward to the session at the agm on Saturday regarding the training of doctors in the new environment.
Grass roots
I would sincerely like to express my appreciation of all NCHDs who helped in each of the various campaigns over the past 12 months. All of the hospital reps and others who volunteered or came to meetings or sent in e-mails — all of it was appreciated.
As I have alluded to above, while there may not be as many headline-grabbing events over the coming 12 months, we still need support in our efforts.
I also would like to extend special thanks to those who volunteered for the various court cases; it cannot have been an easy choice to make.
The best part of the last year has been working as part of the current Committee. Irish NCHDs are blessed to have such energy, enthusiasm and intelligence being applied to solve their problems. I would also like to thank the staff of the HSE, who always show such professionalism and humanity in any dealings we have had with them.
Finally, I would like to express my thanks and appreciation to George McNeice and all the staff in the IMO. Without them we would be in a much darker place right now.
Now all I need is get a publisher for my book. ‘Irish NCHDs: A History’?