Following on from meetings held between the IMO and representatives of HSE Management (along with the Department of Finance and the Department of Health and Children) on November 17^th and December 3^rd, agreement has now been reached to commence the operational review of the Interim Public Health Out of Hours Service.

This review, which Management was unable to begin within the agreed time frame, will be assisted by Dr Charles Saunders, Consultant in Public Health Medicine, National Health Service (Scotland). Dr Saunders was a preferred IMO choice as it was considered that his clinical expertise in a country of similar size and profile to Ireland would enable him to understand the minutiae involved in delivering the Out of Hours service.  

As a result of the meeting that took place on 3^rd December the following terms of reference have been agreed for the review:

• Review of the operation of the interim service in the context of the Labour Relations Commission agreement and the agreed model and protocol for an interim Out of Hours service;
• Review the activity levels of the interim service;
• Review and give findings on the interim service with particular reference to the designated clinical and support services;
• Review and provide findings on the service with regard to manpower needs, having regard to activity levels and existing agreements and resources;
• Conduct consultations with the IMO and HSE Employers;
• Suggest possible improvements or amendments to the Out of Hours service in order to provide a safe and robust service;
• The review to be completed by 31^st December 2009.

At both of the meetings mentioned above, the IMO raised with HSE Management the need to exclude Specialists in Public Health Medicine and Directors of Public Health from the Moratorium on Public Sector Recruitment. The IMO made the point that the smooth running of the Out of Hours service was dependent on maintaining or improving manpower levels, as in some parts of the country the agreed 1 in 5 rota was not attainable with current staffing levels.  

The IMO Public Health Sub – Committee is presently working on a document to submit to Dr Saunders on Friday 11^th December 2009. It is hoped that Dr Saunders will visit Ireland in the week beginning Monday 14^th December 2009.

The IMO has agreed to the extension of the interim service pending the completion of the operational review.

A further meeting has been provisionally scheduled with representatives of HSE Employers for 14^th January 2010 to discuss Dr Saunders report and the pay issues arising from that report.