Inaugural AGM

The Medical and Dental Consultants Association (MDCA) held its inaugural AGM on April 2,2022, having been established in June 2020 and incorporated in August 2020. At a very well attended meeting in Dublin, issues of concern regarding patient care and hospital practice were addressed at length. Mr Fergal McGoldrick was elected as the Inaugural President.

The MDCA primary focus is patient directed advocacy and maintenance of continuity of patient care. The new Association welcomes Consultant Specialist members of the Medical and Dental profession who practice in Private Hospitals and Clinics. The Association especially welcome patients seeking advice and information, if they wish to attend individual Consultants. Relevant information is accessible on the webpage.

Orla Conlon, Brian Lucey

The Association began as a loose group of like-minded doctors in April 2020. The Private Hospitals Association (PHA), at the time of the anticipated Covid pandemic, signed up to an HSE government. The confidential HSE leased private hospital agreement immediately changed these private hospitals into public only institutions. Overnight, 2.2 million patients representing 45% of the Irish population were denied their normal care pathway and doctors could not provide continuity of care.

While generally initially welcomed, as a means of addressing urgent bed capacity issues in the Public hospitals, it became immediately apparent that independent Consultants were unexpectedly placed under enormous pressure to sign up to a Public only contract preventing maintenance of continuity of their patient care.

This had particular relevance for their patients normally seen in the outpatient office setting, including amongst others, patients suffering from serious Cardiac disease, Cancer, Neurological conditions, Autoimmune disorders etc. Access to continued inpatient care was further hindered by temporary withdrawal of State indemnity. This had particular resonance for the processing of Gynaecological biopsy samples undertaken by Independent Consultants who were working pro bono. This concern was successfully addressed by the then Opposition Health spokesperson.

Doctors declined to abandon their patients, opting to provide, at personal expense and time, pro bono care to the highest medical and ethical standards.

Helen Hegarty, Maeve Durkan, Gordon Pate

A direct meeting with senior Department of Health officials and Minister at that time was unfortunately unproductive. Doctors and Dentists campaigned and lobbied on behalf of their patients engaging with TV, Radio, newspapers and social media. Weekly bed occupancy data was published showing repeated poor value for money and low utilisation. The HSE contract of indeterminate duration was rescinded by the Government after 3 months ending in June 2020.

As previously stated, the primary objectives of MDCA are patient centred advocacy and maintenance of continuity of care. With modern bureaucratic healthcare, despite the best intentions, this can frequently get lost in translation. We are all aware that there are chronic waiting lists for Consultant assessment and Inpatient treatment. This has deteriorated further during the Covid pandemic with no obvious solution. We have all learnt a lot of lessons. As a result, there has been increasing pressure placed on the Private Hospital network to help ameliorate these complex problems. Notwithstanding these added external pressures, MDCA members have continued at all times to provide the highest standard of care to their patients.

John Burke, James O’Reilly, Mark Mulhern

It is self-evident that the private hospital network has been highly important in the last two years. Despite operating on a much more modest overall budget compared to the public hospital system, productivity has remained high while simultaneously having to operate under the exact same Covid constraints as public hospitals without causing significant bed closures, etc. Given the ongoing long-term public hospital capacity issues many of which predate Covid, it is likely that the independently run private hospital network will continue to partner and supply assistance.

Covid has changed how Consultants practice. Nonetheless, throughout this very challenging time, MDCA members have maintained direct one-to-one Consultant care. MDCA members seek to maintain and advance this high level of efficient patient centred care. Highly trained Consultants will continue going forward to offer the highest professional standard to their patients. It is a one-to-one Consultant/Patient driven service as opposed to a Consultant-Led service.

Ken Patterson, John Clarke, Ronan Walsh

Unfortunately, increasingly many young highly trained and experienced Consultants will not now return to Ireland because of their well voiced contractual concerns that go back as far as 2012. MDCA will support and encourage young Consultants noting that are now many different options available.

MDCA seeks to represent the professional character and professional well-being of Medical and Dental Consultants and to provide them with all relevant services to the development of a caring and effective health service, putting the patients at the centre of its activities.

MDCA members promote, encourage and support the advancement of the practice of healthcare in all specialties and areas to enhance the improvement of healthcare in Ireland. Members seek to raise the standards of best practice within the Medical and Dental profession with a strong focus on relevant education. To that end, MDCA has instituted educational webinars.

From a research and scientific perspective, MDCA will procure and compile relevant information and statistics calculated to be useful to persons engaged in the provision of Medical and Dental services and will publish such information and statistics in such a manner as will enhance medical care in Ireland. In that context, the Medical and Dental Consultants Association in April 11, 2021 strongly endorsed the use of LFA, lateral flow Antigen testing when it was being significantly resisted and long before it was finally introduced in late 2021.

Rory O’Hanlon, Edward Cotter

MDCA will continue to advocate similar scientifically evidence-based proven diagnostic tools and treatments.

Medical Indemnity costs in Ireland are some of the highest in the world leading to protracted litigation and unnecessary defensive medical care. While motor insurance costs have been recently addressed, medical indemnity has been excluded.

MDCA has been co-signatory with the Royal Colleges and representative bodies seeking to encourage MedicoLegal Tort reform in a letter forwarded to the Minister for Justice, Ms McEntee. MDCA continues to hope and wait for a positive expectation that constructive tort reform will occur to the benefit of all parties.

From an educational and administrator perspective, Medical and Dental Consultants Association uniquely, has partnered with Smurfit Business School. Its first educational course “Business and Leadership Skills in the Healthcare sector” is designed to help Consultants establish and administer their practice in an efficient and productive manner. This course began its first intake in April 2022. Details are available from MDCA and Smurfit Business School.

In conclusion, as healthcare moves forward on a background of a dysfunctional two-year Covid period, it is self-evident that there is a now a real role for both Public and Private hospitals to work in closer collaboration and partnership for the betterment of universal patient care. The Medical and Dental Consultants Association will seek to enhance and develop that care pattern in a holistic supportive advocacy, placing the patient constantly at the centre.