A number of doctors will bow out of politics come the next election but there are also several medics vying to either retain Dáil seats or win seats for the first time, writes Eithne Donnellan, Health Correspondent.
The next general election may still be the best part of a year away but already most observers agree health will be one of the key issues on the campaign trail.
Candidates who stand are likely to be tackled on the doorsteps about everything from intolerable conditions and waiting times in A&E to the lack of breast cancer screening and radiotherapy services in certain regions.
And while many families may be exercised about these inequities, so too are a number of doctors who have decided to put themselves forward for election in the hope that, if they succeed in winning a Dáil seat, they may be able to change things.
One of these is Dr John Barton, a consultant physician at Portiuncula Hospital in Ballinasloe, Co Galway.
He confesses to always having had an interest in politics but says the two issues which "broke the camel's back" and made him make up his mind to stand in a general election were the Hanly report on hospital reorganisation and the Government's policy of using taxpayers' money to subsidise the building of more private hospitals.
"I have been driven into it. All I want to do is deliver a better health service. Inequality in healthcare is a huge issue. Everybody is talking about it but nobody does anything about it," he says.
He is to run for Fine Gael, a party which has four other doctors also contesting the next election, including the sitting Wexford TD Dr Liam Twomey who is the party's health spokesman.
Barton admits most people think he is mad to contemplate abandoning a job as a hospital consultant to join the sometimes murky world of politics. The way he sees it is life is short, his children are grown up and he would like to "make a contribution to the nation in terms of developing a health service that goes right up to the top of the premier league".
"I can't be a single issue candidate going into national politics but the main reason I'm doing this is to see a better health service. I believe getting it sorted involves political will. The last thing we need is blaming people in the health service. They are demoralised enough."
And he believes he has a 50:50 chance of being elected. "Not wishing to be boastful or anything but I'm a popular guy down here. Nobody in Portiuncula wants to see me leave, neither do patients. That at the end of the day might work against me."
Dr Jimmy Devins, a Sligo GP elected to the Dáil for Fianna Fáil in 2002, sounds a word of caution for Dr Barton and other new entrants into politics, saying nothing changes overnight. "Anybody who goes into politics and thinks they can change things overnight will be in for a surprise," he says.
Devins, unlike some other doctors who, after being elected to the Dáil, continue to keep their hand in medicine, says he decided after being elected to opt out of medicine completely. This was because if he saw a patient in Sligo on a Monday and they weren't improving and wanted to return to see him on a Wednesday or Thursday he wouldn't be there.
Now he finds he is so busy politically he believes he wouldn't have time. "I made a very conscious decision I would do one or the other. I feel you couldn't do both."
He too was always interested in politics and was a member of the Kevin Barry Cumman while at college in UCD. Politics is also in his blood. His grandfather, Seamus Devins, was a TD way back in the second and third Dáils. And when he started working as a GP he felt he was seeing a lot of problems like inadequate housing which he couldn't change.
He decided entering politics might help him change things. He entered local politics first and was elected as a local councillor in 1991.
While he is passionate about getter better health services including a satellite radiotherapy service for the people of Sligo he insists nonetheless he isn't a single issue candidate. He stresses he has campaigned also for an inner relief road for Sligo, among other things.
The Mayo Independent TD and GP Dr Jerry Cowley couldn't be considered a single issue candidate either, having been to the forefront in supporting the Rossport Five. But his primary goal in running for election for the first time in 2002 was to see health services improved.He has raised the profile of many issues including the lack of cancer screening and cancer therapies in some regions and the long waiting times to access certain specialities like rheumatology in the west.
"In the Dáil you have a great platform. You can get issues on the national agenda. If I remained as a GP that would never have happened.
Dr James Reilly is another GP who is sick of highlighting problems in the health service from the outside. "I spent 20 years on the outside trying to change things. I want to try to change things from the inside now," he says.
The North Dublin GP stresses however that he is also concerned about education and people queuing for days to get their children into schools, transport infrastructure and crime on our streets.
He is a newcomer to general elections but is no stranger to the cut and thrust of medical politics, having served as president of the Irish Medical Organisation. He is standing for Fine Gael.
"I'm not going to improve my income by this move. I will probably lose out, but I believe when you see things going so badly wrong and when you know that the country is wealthier now than ever, you have to form the opinion that the situation can be improved."
Dr Bill Tormey, a consultant at Beaumont Hospital, is also standing for Fine Gael. Possibly among the most controversial of the doctors in the field next time out, he has already been in the news in recent weeks for questioning the findings of the State Pathologist Prof Marie Cassidy on the cause of death of Brian Murphy, who died following a fracas outside the Burlington Hotel in Dublin in August 2000. And comments he made on legalising drugs and having compulsory medical tests on returning missionaries who left their "concubines" behind them drew the wrath of the Justice Minister Michael McDowell last week. Even Fine Gael's Dr Liam Twomey distanced himself from Tormey's remarks.
But Tormey says the party leader, Enda Kenny, has always been supportive of him and he is determined to go on speaking his mind.
He has already run in several local and national elections and says he wants to run again to try to do something about the increasing gap between the rich and poor, the fact that young people can't get on the housing ladder and the rise in anti-social behaviour which he describes as "the plague" of a lot of Irish communities.
He has been a Dublin City councillor since 2004 but even if elected to the Dáil, he will never give up medicine. He believes he can combine a life as a doctor and as a politician because he uses his spare time wisely. "A lot of people spend their time in golf clubs and pubs hanging around. I do none of that."
Dr Leo Varadkar, a junior doctor at Tallaght Hospital and a member of Fingal County Council, hopes he will also be able to continue to combine medicine with politics if he gets elected to the next Dáil.
But why would a young medical graduate want to have anything to do with politics? "I guess I want to change the world," comes the reply.
"I suppose I can't complain about the health service, the environment or the traffic and not do anything about it. It's my personality I suppose."
Already he works around 60 hours a week as a junior doctor and "pretty much all" his free time is spent on politics.
"It's tough but I'm managing it so far. I do plan to complete my training. I'd like to work as a GP in the community and be a politician at the same time. I think I'd be able to combine the two. The Dáil only meets 80 days a year," he says.
Politics, he says, needs people from all walks of life. But he says with health being the biggest issue on the doorsteps, doctors have an advantage inthat they have an insight and an understanding that people having no contact with the health services wouldn't have.
He stresses he is an "all round candidate". Just as well then because, according to Twomey, no candidate will get elected on health issues alone.
But he says doctors have a wealth of experience they can bring to politics, not just regarding the state of the health services but also in relation to the social problems people experience.
Though extremely busy as a front bench spokesman he continues to try to do some out-of-hours work as a GP when he returns to Wexford at weekends. This is to keep up his skills and keep in touch with what is going on.
He too has discovered since his election that nothing changes quickly. "You have to hammer home your message over and over and eventually you will change the way people see things but you must sell what you are doing to people and put a good argument behind it."
The sitting Fianna Fáil TD and former Minister Dr Jim McDaid is one of six doctors in the current Dáil and has easily been the most controversial. He has hit the headlines many times over the years for things as diverse as comments he made on suicide to his conviction for drunken driving and his decision to give alibi evidence on behalf of a man accused of IRA-related activities. However, he announced recently he will not contest the next election and will return to his medical practice in Donegal.
Another doctor sitting in the Dáil but planning to retire come the next election is the Dublin Central Fianna Fáil TD Dr Dermot Fitzpatrick. But the former health minister and Ceann Comhairle, Dr Rory O'Hanlon, is staying on.
Although he will be 72 next year, he said recently he does not intend retiring when the election is called but will exercise his right as Ceann Comhairle to be automatically returned to the Dáil. As Ceann Comhairle he has to disassociate himself totally from party politics.
The last doctor to serve as Minister for Health was Dr John O'Connell who held the portfolio from February 1992 to January 1993. But whether one of the seven doctors who have already declared their candidacy for the next election will be the next medic to be given the job at some stage, no one knows.