With hospital consultants adamant they will not accept a new contract that restricts or prevents advocacy on behalf of patients, the Irish Medical Organisation (IMO) has identified being an advocate as a key role of the doctor in the Republic.
In a position paper published at its annual meeting at the weekend, the organisation has identified the role of advocate as "one of the most important duties and responsibilities of each and every doctor".
The issue of advocacy remains a major stumbling block in contract talks chaired by Mark Connaughton SC, with IMO director of industrial relations Fintan Hourihan saying "we will not agree a contract that does not include the right to advocacy." The Irish Hospital Consultants Association is also opposed to a contract that contains any form of gagging clause.
"The role of the doctor in Ireland" identifies five key functions for doctors: diagnostician; continuous scholar; advocate; communicator; and teacher and mentor. The position paper was drawn up following a consultation process with IMO members.
It points out that doctors engage in advocacy at many different levels.
In terms of the individual patient, the document says that is is a doctor's duty to advocate on behalf of individual patients.
It reads: "to diagnose and treat illness confers a duty on the doctor to advocate on behalf of individuals, whether the doctor be a general practitioner who helps a patient to secure a medical card, a hospital doctor who seeks resources and services for patients or a public health doctor in the community who seeks the appropriate and required ancillary services or care packages for patients."
At the level of the health service, the IMO says that doctors have a clear vision of the structures and services required to deliver optimal care for patients.
"A key requirement of the advocacy role relates to lifestyle and social issues which are adversely affecting the current and future health outcomes of the wider community", the document states, in reference to advocacy at the societal level.
In his address to the organisation's annual meeting in Killarney, IMO chief executive George MacNeice said that doctors are the best informed to know what is needed to improve healthcare.
"At the end of the day, with their diagnostic skills and clinical expertise, doctors are best placed to know what is required to improve the health and and wellbeing of the community," he added.
Referring to the consultation process which preceded the drawing up of the position paper, IMO president Dr Paula Gilvarry told the meeting that respondents gave maximum importance to the welfare of their patients, to professional integrity and to advocacy.
"(Doctors) are beleaguered by patients that they cannot fasttrack to hospital services or treat in hospital because the accident and emergency admissions have filled all available beds.
"They are angered by a lack of resources and frustrated by their inability to influence how and where resources go," she said.