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The new head of the GP union is younger than Simon Harris - and has a big battle on his hands

Ireland’s newest doctors are fleeing the country – but the latest head of Ireland’s GP union, the NAGP, Maitiú Ó Tuathail is only 29.

shutterstock_438295003 Shutterstock / Bacho Shutterstock / Bacho / Bacho

THE WORLD IS not a particularly rosy place for Irish general practitioners at present.

Diminishing returns, over-work, a State contract which is commonly accepted to not be fit for purpose, and the exodus of Ireland’s brightest new medical minds to more lucrative positions in other countries has the profession at crisis point. It’s commonly accepted that a GP staffing crisis is imminent. No one wants to do the job.

Yet, the new head of the National Association of General Practitioners (NAGP), Ireland’s GP union, is just 29 years of age.

The reason? It’s because 29-year-old Maitiú Ó Tuathail has had a long-term goal of becoming his rural community’s (he’s from Leitirmóir, in the Connemara Gaeltacht, 50 miles west of Galway) GP in residence for years.

While that ambition hasn’t changed (he’s currently based in Rathfarnham in south Dublin), a conversation with Ó Tuathail shows he has no illusions about the sheer scale of the issues facing Ireland’s health services.

“My plan was always to replace the current GP in my home place when he retires. I’ve been through six years of college and four years of training in order to achieve that. But the system is absolutely dysfunctional as it stands,” he tells TheJournal.ie.

The guy I’m hoping to replace, who’s in his 60s, he’s after working a 56-hour weekend from Saturday morning to Monday evening. As a 29-year-old I don’t even know if I can do that. The demands on GPs are completely unrealistic.

Ó Tuathail points out that two of the GPs in his home locality have recently quit. Not retired, quit. Due to the strain on their physical and mental health, among other things.

“GPs have to go through years of, horror I would describe it as, to qualify. So it’s not like they’re not resilient. So if they’re quitting that should be raising red flags,” he says.

mat Maitiú Ó Tuathail Twitter Twitter

One of the main issues facing the profession is the current contract GPs have with the State. It dates from 1970 and is, as the department itself would probably admit, not fit for purpose in an era of modern medicine.

‘Insulting’

“This contract, it was designed for a different era. Where the practitioner is referred to exclusively as ‘he’ and ‘him’, because it was expected he’d be a man. It’s archaic. But the problem is we don’t know what the future plan is,” says Ó Tuathail. “We don’t know if we’re heading for universal primary care, the SlainteCare report (on the future of the Irish health service) hasn’t been in any way implemented 12 months later. The current contract is frankly bananas. The whole system is totally fractured, broken. And people don’t want to work in that system.”

He cites recent examples of care he himself has been forced to give – telling a woman suffering from migraine he could refer her publicly for an MRI, and wait two years for an appointment, or advise her to do it privately and pay €300; referring a nursing home patient to hospital where their care will cost €1,000 a night because he, as a GP, is not allowed to administer intravenous antibiotics.

“It’s insulting. Ten years of training and we’re not allowed to work properly as doctors, to achieve our potential. The most basic tests, we’re not allowed to do,” he says.

Regarding the issue with locums in Ireland, where inflated rates are paid by the HSE to agency staff to cover hospital shifts around the country, Ó Tuathail agrees it’s an example of the short-term thinking of Ireland’s health services.

“The locums situation is because the HSE will pay ‘whatever’ in order to ensure cover,” he says.

Meanwhile a GP gets a set amount of money from the HSE and has to cover all resources. Since Fempi (Financial Emergency Measures in the Public Interest) in 2008 we’ve had our resources down 40%, but with the same overheads. Now I’m hearing from GPs that they’ve to take out loans to cover their tax bill. They can’t take a day off. The HSE should be funding locums to cover GP services, as they already do in the hospitals.
Fempi has to go. It already has for all other public servants. But GPs are told it has to happen for us with terms and conditions. Fempi has to be the first thing to go. But even that just puts us back to where we were in 2008. Then the contract has to come next. We just want to be treated like equals.

Stalled discussions

He says he’s “disappointed” that discussions on the contract have stalled once more (“there’s no movement – two years later and we’re already two months behind”). However, he does believe that Health Minister Simon Harris is “genuinely concerned at the state of the health service”.

“He’s young, only a year older than me, he’s energetic. But I’m not sure our issues can be solved by one person. And I think he fundamentally doesn’t understand general practice, and that’s worrying,” Ó Tuathail says. “If there’s to be reform then he has to gain that understanding.”

He says that he doesn’t believe the “political will” is there to bring about change in the health service, to enact SlainteCare. “We need to reorient the service to focus on primary care, not the hospitals. As the saying goes, for every dollar spent on primary care you’ll save four in the long run.”

Regarding the issue of the possible result of the Eighth Amendment referendum on 25 May, Ó Tuathail stresses that the NAGP is taking a neutral stance on the vote.

But regarding Harris’s previous suggestion that any abortion service will be GP-led – that’s something he doesn’t believe is viable.

“We’re not in a position to provide a GP-led abortion service. I don’t believe we can do it. No other country in the world does it, to the best of my knowledge,” he says.

We haven’t got the resources, like ultrasound machines even.
The bottom line is we don’t have the resources, and nowhere else expects its GPs to do this. I don’t think that GPs can provide it, and I don’t think a GP surgery is the place for it.

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18 Comments
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    Mute justasheedy
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    Nov 30th 2018, 1:53 PM

    Nob

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    Mute Trevor Hayden
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    Nov 30th 2018, 1:53 PM

    Your loyalty is turning a blind eye when and where we tell you.

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    Mute Brinster
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    Dec 1st 2018, 12:02 AM

    @Trevor Hayden:

    Wasn’t he the first in Government to turn on. Callinan?

    Rightly called him out for his “whistleblowers are disgusting” comment?

    Inconvenient I know for you.

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    Mute Cormac Ó Braonáin
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    Dec 1st 2018, 2:05 AM

    @Brinster: ‘first in government’ – I presume what you meant to say is the first in Parliament. Either way you’d be very wrong either way.

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    Mute Brendan Coyne
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    Nov 30th 2018, 2:00 PM

    It would be great if he practiced what he is preaching

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    Mute Skybloo
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    Nov 30th 2018, 3:37 PM

    @Brendan Coyne: That’s what I thought also … his blind loyalty to his mate, Frances Fitzgerald comes to mind

    221
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    Mute Tony O Neill
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    Nov 30th 2018, 9:33 PM

    @Skybloo: she was cleared of any wrong doing by the tribunal so he did right to stand by her

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    Mute Donal Desmond
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    Dec 1st 2018, 2:13 AM

    Report cleared her? Scandal after Scandal dogged her and her predecessor, Like the report concerning Naughten nothing to see here move on… What happened to the investigation relating to the millions missing in the Templemore?.. What happened with the written off penalty points?.What happened to the missing mobile phones and laptops?. The deputy leader of the blueshirts Michael Martin very quite on these subjects.

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    Mute mursim
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    Nov 30th 2018, 1:55 PM

    Will Socky be attending the National Housing Demonstration tomorrow?

    275
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    Mute Patrick Nolan
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    Nov 30th 2018, 2:30 PM

    @mursim:
    Will anyone be attending the national housing demonstration tomorrow?
    Jeremy Kyle is on

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    Mute Gulliver Foyle
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    Nov 30th 2018, 3:05 PM

    @Patrick Nolan: I’ll be in the North West for the weekend, is there any regional events on, you know … where there is absolutely no problem with homelessness. Why call it “National” when it is a Dublin specific issue?

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    Mute Socky Varadkar
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    Nov 30th 2018, 3:20 PM

    @mursim: wait and see

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    Mute restinginmyaccpaddy
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    Nov 30th 2018, 3:42 PM

    @Patrick Nolan: indeed.

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    Mute European Bob
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    Nov 30th 2018, 4:37 PM

    @Gulliver Foyle: Gone on up for the Lundy burning?

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    Mute Picture This
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    Nov 30th 2018, 2:00 PM

    That’s why nobody is being prosecuted for harassing a whistleblower almost to his death. Same for the garda in the pub with the rat effigy of MacCabe. No prosecutions ,and that ain’t out of loyalty to the state.

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    Mute Karen Wellington
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    Nov 30th 2018, 2:02 PM

    @Picture This: what would you charge the effigy guy with?

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    Mute blackcoffee
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    Nov 30th 2018, 2:13 PM

    @Karen Wellington: super hero!

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    Mute blackcoffee
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    Nov 30th 2018, 2:15 PM

    @Karen Wellington: Sorry Karen. That was meant to call Maurice McCabe a superhero

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    Mute Picture This
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    Nov 30th 2018, 2:17 PM

    @Karen Wellington: the images were posted online so online harassment what else ?

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    Mute Gulliver Foyle
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    Nov 30th 2018, 3:12 PM

    @Picture This: I don’t think online harassment is a crime, unless it is tied into a wider (non-online) harassment. Phoning an individual up repeatedly is harassment, while repeatedly posting malicious lies online isn’t (again, due to early precedence when judges didn’t get computers being their interpretation of offences against the person)

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    Mute Picture This
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    Nov 30th 2018, 4:04 PM

    @Gulliver Foyle: ask the blogger that was stopped at Dublin airport by detectives for writing negatively about Regina Doherty… by the way its alleged a commissioner sat in a politicians car in a shady car park meeting to tell him your man a kiddy fiddler and you in serious trouble, any excuses for a criminal investigation being initiated there… so regardless to what illegal or not it seems our politicians don’t have an appetite for justice.

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    Mute marg fitzgerald
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    Nov 30th 2018, 6:35 PM

    @Karen Wellington: Personal injury

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    Mute Micheal McGee
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    Nov 30th 2018, 2:14 PM

    Your loyalty is to the State…by becoming a revenue generator…

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    Mute Joe Bloggs
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    Nov 30th 2018, 2:32 PM

    @Micheal McGee: how much revenue do you reckon the garda dragged down the road in Carrickmackross generated? Or the garda on the drugs squad in Store Street who had acid thrown at him?

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    Mute Cathal
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    Nov 30th 2018, 2:37 PM

    @Joe Bloggs: What’s the story on Carrickmacross? Seems to be some confusion as to whether the guard was in the car or being dragged by the car.

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    Mute restinginmyaccpaddy
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    Nov 30th 2018, 3:31 PM

    @Micheal McGee: indeed.

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    Mute Mary Garry
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    Nov 30th 2018, 9:42 PM

    @Cathal: It wasn’t Carrickmacross,it was Castleblaney

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    Mute Cathal
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    Nov 30th 2018, 10:38 PM

    @Mary Garry: Sorry ,just followed previous post. Didn’t notice it was wrong town.

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    Mute Colette Kearns
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    Nov 30th 2018, 2:44 PM

    Who’s Leo “ loyal “ to? It’s certainly not the people of this country!

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    Mute Gulliver Foyle
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    Nov 30th 2018, 3:14 PM

    @Colette Kearns: Officially, the taoiseach is loyal to the people. The difference is it is to ALL people, and not just those that share opinion with you (or me, for that matter). Don’t confuse loyalty with treachery.

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    Mute Patricia McCarthy
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    Nov 30th 2018, 3:17 PM

    Your loyalty is to the people of this country who pay your salary. Not to the suit or the person wearing it.

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    Mute peterw
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    Nov 30th 2018, 3:26 PM

    @Patricia McCarthy: I hope you’re one of those people that shout that at guards while you collect your dole…

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    Mute Dave Doyle
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    Nov 30th 2018, 3:39 PM

    @peterw: Why would you hope that?

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    Mute peterw
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    Nov 30th 2018, 3:53 PM

    @Dave Doyle: Because people who say “we pay your salary” to garda are absolute twits.
    You don’t say that to your nurse do you?
    The gardai are there to serve & protect and by in large do a decent job, they don’t need someone shouting nonsense at them.

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    Mute Patricia McCarthy
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    Nov 30th 2018, 5:16 PM

    @ppayment, Exactly my point. The Garda do not need a twit in a suit, who collects the largest social welfare payment, in this country shouting at them. And I don’t need his lackeys attempting to bully me on this page. Get back in your box little man.

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    Mute Adrian
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    Nov 30th 2018, 3:45 PM

    Its very hard to take leo at face value. Whatever he says, behind it, he’s probably thinking there’s one set of laws for himself and FG, and there are other laws for everybody else.

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    Mute Patricia McCarthy
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    Nov 30th 2018, 4:59 PM

    @Adrian: He isn’t wrong in thinking that. Politicians and their lackeys get a free ride over everyone else. A lawless unaccountable breed.

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    Mute Padraic O Sullivan
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    Nov 30th 2018, 2:34 PM

    One of the main reasons behind the falsified breath tests was a ‘lack of supervision’ . Ethical in all other aspects of the force of course.

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    Mute Socky Varadkar
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    Nov 30th 2018, 3:20 PM

    I hope to inspire the Gardai, to work as hard as me, to be the shield that protects the taxpayers from the hostile elements of society. I am confident my brilliant wisdom bestowed on these brave people will be used.

    Thank you journal for showing these pictures, I am truly Ireland’s most charismatic, most trusted and inspiring leader.

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    Mute David Corrigan
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    Nov 30th 2018, 3:46 PM

    @Socky Varadkar: Go on the Socky ya mad thing!!!

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    Mute Maggie O'Sullivan
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    Nov 30th 2018, 5:18 PM

    Sh ut up Leo

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    Mute John Declan
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    Nov 30th 2018, 3:09 PM

    Hitler said that first.

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    Mute Patrick James Walsh
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    Nov 30th 2018, 5:04 PM

    so Leo is now popping up at the cops passing out parades to give inane motivational talks to new recruits, what next will he be turning up at teachers and nurses conferring ceremonies ?
    If he is serious about reform in AGS, then we need less platitudinous blather and more action in relation to the wrongs uncovered by the disclosures tribunal , destined to gather more dust on another shelf in the DOJ

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    Mute Michael Kehoe
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    Nov 30th 2018, 4:49 PM

    What a tool, his loyalty is to himself and definitely not his position in Government. He makes Enda Kenny’s term as Taoiseach look reasonable. A dreadful leader of Government, caught up with spin and more spin and manipulation of the media. The men of 1916 must be turning in their graves. Country is soulless with the morons in Government and the tool from Cork is a disaster. A bumbling gobsh@te

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    Mute Martin Brennan
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    Nov 30th 2018, 4:40 PM

    What a plonker he’s worse than Bertie he’d turn up at the picking of a. Snot if he get a photo op and at least Bertie never looked down his superior nose at you – off course the uniform didn’t safe Maurice McCabe as it was those in uniforms who pilloried him

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    Mute Todd Hebert
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    Nov 30th 2018, 7:11 PM

    Their loyalty should be to the people of the republic of Ireland.

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    Mute European Bob
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    Nov 30th 2018, 7:03 PM

    In fairness, Leo would know a lot about loyalism, seeing as he’s been spending so much time recently wearing orange and meeting with his new BFFs in the lodge.

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    Mute European Bob
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    Nov 30th 2018, 7:04 PM

    @European Bob: *wearing orange socks ☺

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    Mute Frank Brennan
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    Nov 30th 2018, 4:56 PM

    Your suit says nothing about you Mr.Socks .

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    Mute Tony Kennedy
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    Nov 30th 2018, 6:12 PM

    FFS shut your trap Varadkar

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    Mute Rob Ryan
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    Nov 30th 2018, 3:54 PM

    Hypocritical gimp!

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    Mute Brian M
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    Dec 1st 2018, 12:12 AM

    Put TD pay increases aside and give the increases to the front line staff!

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    Mute restinginmyaccpaddy
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    Nov 30th 2018, 3:33 PM

    indeed

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    Mute Jake
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    Nov 30th 2018, 5:29 PM

    You tell them you unelected clown

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    Mute Declan Daly
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    Nov 30th 2018, 2:58 PM

    Your loyalty is to the uniform and not the person wearing it…

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    Mute Martello Mulligan
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    Nov 30th 2018, 8:00 PM

    Some lines from Shaw to stew on. Pick out your own gems but I like “not intelligent, only opinionated” and “not loyal… only servile” or, how about “not dutiful, only sheepish; not public spirited, only patriotic.”

    “Your friends are all the dullest dogs I know. They are not beautiful: they are only decorated. They are not clean: they are only shaved and starched. They are not dignified: they are only fashionably dressed. They are not educated: they are only college passmen. They are not religious: they are only pewrenters. They are not moral: they are only conventional. They are not virtuous: they are only cowardly. They are not even vicious: they are only “frail.” They are not artistic: they are only lascivious. They are not prosperous: they are only rich. They are not loyal, they are only servile; not dutiful, only sheepish; not public spirited, only patriotic; not courageous, only quarrelsome; not determined, only obstinate; not masterful, only domineering; not self-controlled, only obtuse; not self-respecting, only vain; not kind, only sentimental; not social, only gregarious; not considerate, only polite; not intelligent, only opinionated; not progressive, only factious; not imaginative, only superstitious; not just, only vindictive; not generous, only propitiatory; not disciplined, only cowed; and not truthful at all: liars every one of them, to the very backbone of their souls.”

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    Mute John Blessing
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    Nov 30th 2018, 9:30 PM

    Sodamite speaks

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    Mute Tony Byrne
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    Dec 1st 2018, 5:15 AM

    The gardi are a digrace to their uniform they should be disbanded as were the ruc
    Too much corupption for too many years,
    For people to have any respect for them they need a new name and a new begining
    And its the ones at the top of the force are poisoning the the ones at the bottom, terrible for a country not to have faith in their own police force, it demoralizes the whole country

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    Mute John Scully
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    Nov 30th 2018, 10:24 PM

    Loyalty to the people should be shown for the past as well as the present. It seems that the past has been forgotten about as far as Leo and Drew is concerned. I’m sure they know what I mean.

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    Mute Barry Foster
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    Dec 1st 2018, 10:22 AM

    It takes a lot of manpower to generate over 2 million fake breath tests and nobody lost their job over it. Appatently it was a crime too widespread to investigate !! No sacking over the Templemore financial wrongdoing . No sacking over the scrubbing of penalty points for Gardai and family members . GRA were quiet boys when Sgt McCabe was persecuted.
    A grossly overpaid bunch of whingers layabouts and incompetents.

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    Mute Briain O'Dochartaigh
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    Nov 30th 2018, 5:58 PM
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    Mute Shane Bradley
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    Dec 2nd 2018, 3:36 PM

    that’s a laugh coming from a man who is not even irish running our country into the ground

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