Public health doctors across the State will return to the picket lines for a second day of strike action today after no moves to resolve their dispute were made yesterday.
The 300 or so doctors, who work to monitor and prevent the spread of infection and disease, are protesting over pay and working conditions. They are picketing health boards and the National Disease Surveillance Centre.
Last night the Health Services Employers Agency (HSEA) wrote to the Irish Medical Organisation (IMO) expressing concern at the level of emergency cover being provided during the strike. Emergency cover is being provided from 9 a.m. to 5 p.m. only.
The HSEA's head of industrial relations, Mr Brendan Mulligan, said the strike was unnecessary and urged the IMO to return to talks at the Labour Relations Commission.
The IMO's director of industrial relations, Mr Fintan Hourihan, said the doctors would only return to negotiations when the HSEA agreed an agenda in writing.
He said the doctors had received a lot of support on the picket line and were resolute they would not return to work without their demands being met. There is also a possibility of the dispute escalating, with the IMO saying it reserves the right to apply to ICTU for an all-out picket of health care workers.
During the strike there will be no monitoring of the spread of infectious diseases such as SARS, meningitis or measles. But the doctors say there have been no proper structures in place up to now to monitor them on an out-of-hours basis and this is partly what the dispute is about.
On the picket line outside the National Disease Surveillance Centre yesterday, its director Dr Darina O'Flanagan said the public didn't realise up to now that they had been getting "a raw deal" in terms of their public health service.
"The appropriate infrastructure has not been in place despite repeated requests to the Department to put these in place over the last nine years," she said.
She revealed this had led to a number of instances where disease outbreaks had been "mismanaged".
"I'm aware where things haven't been managed perhaps as well as they should have been, where people who should have been given antibiotics in relation to outbreaks of meningitis didn't get them until a couple of days later, or indeed where people maybe got them when there was no need for them to have got them. So there have been instances in the past that have been mismanaged," she said.
She said it was her first time on the picket line and she felt "absolutely dreadful" about it.
"I never thought in my medical career that it would come to this but the level of frustration is so high. We've been talking and talking and talking for years and its like hitting your head off a wall.
"We've been getting no response so people are really driven to this out of sheer frustration. Unfortunately it looks as if we will be here for the long haul. That's not what we want but we can't continue to paper over the cracks".
Her colleague Dr Paul McKeown, said the service was as essential as a fire service but there was no proper on-call structures.
"We deal with outbreaks, they are like little fires and we want to prevent them spreading. It would be like the Australian fire service being rung up on a Saturday morning and a member of the public saying my house is about to be burnt down by a fire and them saying we'll deal with it on Monday when we come in. That would be unacceptable in the same way as it would be unacceptable to allow a small infectious outbreak to grow and become a much larger outbreak over a weekend when there should be structures in place to prevent it growing".
The Minister for Finance, Mr McCreevy, said his department would be making no new money available to the Department of Health to meet the doctors' demands.
Labour's health spokeswoman, Ms Liz McManus, urged the Minister for Health, Mr Martin, to intervene, while Fine Gael's Ms Olivia Mitchell called on both sides to negotiate as a matter of urgency.
PUBLIC HEALTH DOCTORS
Who are they?
They are specialist doctors who work exclusively in the public service, mainly to prevent the spread of infection and disease. Their work includes the implementation of vaccination and screening programmes and the surveillance and control of infectious diseases, such as meningitis, measles and SARS. There are less than 300 of them in the State.
Why are they on strike?
They claim the Department of Health has failed to honour a commitment made nine years ago to implement changes in the structure of the public health service. These changes would include rostering public health specialists to work out-of-hours. For years they have been working out-of-hours on a goodwill basis and receive no extra pay.
What do they want?
A structured out-of-hours public health service as recommended last year by an independent review of the service chaired by Mr Declan Brennan, former secretary general of the Department of Education.
Salaries of specialists and directors of public health to be equivalent to that of hospital consultants. At present public health specialists are on a salary of €78,233 while directors of public health get €81,914. The consultants' pay scale ranges from €114,718 to €142,406.
They also want pro rata increases for lower grade public health doctors, including area medical officers who earn between €48,470 and €56,129 and senior area medical officers, who earn from €54,466 to €62,246.
Their employers say talks should be reconvened at the Labour Relations Commission. The doctors say no. Why?
The IMO says it would attend further discussions if the Health Services Employers Agency (HSEA) put in writing an agreed agenda for those talks. They say this hasn't happened.
What do their employers say?
The HSEA says the strike is unwarranted and unnecessary and has urged the doctors to return to negotiations.