Last Thursday's announcement by the Public Health Doctors Committee of the Irish Medical Organisation that strike action would begin in two weeks represents a serious threat to our collective health. It is also a reflection of extreme frustration by 300 public health doctors at the failure of the Government to complete a much delayed review of public medical services in the State.
The drawn-out dispute has its origins in 1994, when new public health structures were put in place. However, both the Department of Health and Children and the Health Services Employers Agency (HSEA) have since failed to implement a number of recommendations aimed at restructuring the pay and responsibilities of public health doctors.
With an ever present danger of infectious disease, not to mention the ongoing need to promote public health, the consequences of a strike are potentially grave. Despite its origins in south east Asia, the Republic has experienced the direct impact of Severe Acute Respiratory Syndrome (SARS).
A current epidemic of measles in the eastern region has so far been contained by the active involvement of public health doctors. Regular meningitis outbreaks require intervention by these specialists to ensure that preventive antibiotics are administered to family members and others in close contact with the victims of a potentially fatal illness.
And now with a war in Iraq, the possibility of a bioterrorist attack - including the risk of the deadly smallpox virus - means we simply cannot function without specialised "medical detectives".
The Republic has built up a top-class National Disease Surveillance Centre; now that it is established, it seems odd that we are still relying on the goodwill of its staff to offer an out-of-hours service, gratis.
The HSEA was set up partly to address the poor history of industrial relations within the health sector. However, it has failed to prevent a number of industrial disputes involving doctors and nurses in the public service. And now we are faced with another strike which would remove a vital protective layer from the system.
It has taken both the HSEA and the Department of Health from 1994 to 2002 to complete a review of public health services. One year later, both agencies appear unable to follow through on other essential elements of an overall package to which they are signatories.
Yet again, at a time of increased threat to our public health, it is necessary to highlight the poor management of health services in the State.