IMO CONFERENCE: As long as Charlie McCreevy remains Minister for Finance, the Government's Health Strategy is dead and buried, delegates at the IMO conference in Killarney told Dr Muiris Houston, Medical Correspondent
All seemed set for a calm and evenly paced meeting in the run up to this year's Irish Medical Organisation conference. There was no immediate industrial relations issue waiting to explode despite the continuing troubles of the health service.
But when GPs checked with their bank managers late on Thursday to ensure that outstanding back-payments had reached their accounts, as promised by the Department of Health, they got a rude awakening.
Despite "cast-iron" assurances that agreements reached last spring would finally be honoured, the bottom line was that each practitioner was still owed €10,000 and their union leaders were made to look foolish at a critical time.
Notwithstanding some strong signals to Department officials, no one in Hawkins House seemed able to produce the required executive letter of instruction which would allow the General Medical Services Payments Board to pay at least some of the outstanding money.
By 5 p.m. standing orders for the AGM had been suspended and GPs received the full backing of all craft groups for an emergency motion calling on doctors to impose a €5 token fee on medical-card patients with all monies raised to go to St Vincent de Paul.
Although some doctors worried that it was all a little unedifying, at least it provided a lively debate and some good quotes. Cries of "lies, lies, lies" and "let's shame the Department of Health into paying its bills", brought colour to the cheeks of many. With the Minister due to address the conference in less than 24 hours, the fuse was well and truly lit for an explosive confrontation.
But the drama was not over. Minutes before starting a live interview on RTÉ's Six One News bulletin, Dr James Reilly, the GP committee chairman, received an urgent phone call.
It was the secretary general of the Department of Health, offering his personal assurance that the issue would be dealt with early this week.
Doctors watching television in different parts of the conference venue wondered whether their pre-prandial drinks had been spiked. The entire episode is so typical of the poor management structures within the health service. How can you agree a deal in April 2001 and still not deliver it one year later?
What level of management naivety ensures that such an issue has not been settled in the run-up to a trade union conference?
Does it really take a whole year for the Health Services Employers Agency to communicate the details of an agreement to the Department of Health, who in turn must issue a simple letter of authorisation to the GMS Payments Board?
Despite all the talk of partnership, stakeholders working together and patient enpowerment, there is a huge sense of despair among medical practitioners.
Instead of moving forward and trying to rebuild the health service, it appears that management is incapable of even delivering the scaffording to shore it up.
Around the conference fringes, there was a consensus that the Minister for Health, Mr Martin, was being blocked by Mr Charlie McCreevy, and that as long as Mr McCreevy stays as Minister for Finance the Health Strategy is dead and buried. But there is also a strong feeling among doctors that without a major reform of the Health Boards and the Department of Health itself, the system is incapable of delivering meaningful change for the better.
The Deloitte and Touche Value for Money Audit of the Irish Health System has pointed the way forward in terms of reorganisation, the management of scarce resources and the impoverished state of information technology within the system.
In the run up to a general election, the health manifestos of all political parties will have to pass the value-for-money test if they are to have any credibility.
Otherwise, it will simply be a case of politicians continuing to fiddle while the health service burns.