THE first rumblings of the war to come on the health front emerged yesterday as two of the main contenders to be the next Health Minister came face to face with doctors, dentists and pharmacists at a meeting in Dublin.
It was all very controlled as Fine Gael's Dr James Reilly and Labour health spokeswoman Jan O'Sullivan took centre stage along with representatives of the other political parties to lay out their plans to transform the health service.
But there were already hints of troubled days ahead as all three unions -- the Irish Medical Organisation, Irish Pharmacy Union and the Irish Dental Association -- were told new contracts would have to negotiated if the dream of free GP care, universal healthcare insurance and more community facilities was to be realised.
There were reassuring phrases that the health professionals will be "part of the solution not the problem".
And the hoary old chestnut about "stakeholder engagement" was also thrown into the mix. But the soft-focus presentation of how to "fix" the ailing health service meant there was no mention of the plan to take €75m from the pay of consultants to help fund free GP care.
The few GPs present at the Royal Irish Academy sat in silence as they were told some of their lucrative work, like delivering vaccines, will be given over to pharmacists.
Attempts were made to console them with promises that they would get other business such as looking after diabetes patients. But what about those GPs who don't have the facilities and staff to cater for these patients?
Dr Reilly, a former president of the doctors' union, later refused to be drawn on whether consultants would each have to give up €30,000 of their salary to help pay for free GP care. But he said while consultants were entitled to a good salary after years of study and training, they would no longer be able to top it up with private fees of €300,000 once universal healthcare insurance was introduced from 2016.
None of these medical aristocrats were present yesterday -- they were all too busy in their surgeries and private suites. But there is no doubt they will have to share the pain.
Doctors are already expressing fears about changing the way hospitals are funded -- paying them per patient.
Sean Tierney, a surgeon based in Tallaght Hospital and president of the doctors' body, warned that quality could be sacrificed for quantity if safeguards were not introduced. He also questioned the accuracy of the wild sums ascribed to consultants' private earnings.
But given it took five years to negotiate the last contract with consultants, many of those present yesterday were doubtful the diplomacy will last for long.