Col Ó Murchú, you are leaving CMU after only a year in command to take up the role of Director of Strategic Planning in DFHQ. Most of us are aware that you come from a solid soldiering background, but would you care to elaborate on your career prior to the CMU for our readers?
I joined the DF in 1982 as a member of the 59th Cadet Class, which means I have almost 35 years’ service. Though I am a line infantry officer, my background includes service with the Army Ranger Wing (ARW), Military Intelligence and in the Military College - Infantry School, Cadet School and UN Training School Ireland (UNTSI). I hold a degree in French and English literature from UCG (as it was then), a Masters in International Liaison and Communication from the University of Westminster and I am a graduate of the French École de Guerre in Paris. I have service overseas with the UN and the EU in Lebanon, Somalia, Western Sahara, Israel, Chad and the Ivory Coast. My last appointment overseas was in Brussels - two years as Military Assistant to a French 4* general. His role was as Chairman of the EU Military Committee and senior military advisor to the EU, and I worked as his assistant at the political/diplomatic level. Since then I have been School Commandant of UNTSI, before being promoted Colonel a year ago and appointed as OC of the DF’s Central Medical Unit.
Could you explain a little about the organisation of the medical corps and just what role the CMU plays?
What used to be known as the Medical Corps was divided into two separate but closely related elements in the DF reorganisation of 2012. The DMC became the Director of Medical Branch (DMB) and works as head of the medical policy and governance branch in DFHQ, reporting directly to the Deputy Chief of Staff (Support). He or she is the DF’s chief clinician and acts as the chief medical policy advisor to the DCOS and the General Staff. Areas of responsibility include inter alia clinical oversight and governance and the granting of practice privileges. The second element of the Medical Corps since 2012 is the CMU, which is responsible for service delivery, budgets, accounts and the general management of medical services, personnel and support. The CMU is divided into a HQ based in St. Bricin’s Hospital (like DMB), three detachments (1 Bde CMU Det based in Cork, 2 Bde CMU Det based in Dublin and the DFTC CMU Det based in the Curragh Camp). Each garrison in the DF has a Medical Aid Post (MAP) staffed by personnel from these detachments. The Medical School in the DFTC is also part of CMU. The overall unit is commanded by a line colonel (i.e. not a Medical Officer) – this has been my role for the last year.
At last year’s ISMM Annual Scientific Meeting you articulately laid out your vision for the CMU. How have things progressed since then?
I am happy to report that we have made substantial progress across a range of organisational and capability areas. Some examples (though not all) of this progress includes;
Doctrine – A joint DMB/CMU team are working on a new medical doctrine for the DF, and have recently made a joint submission on a pathway for the training and certification of Special Operations Forces (i.e. Army Ranger Wing) medics. This will establish a pathway of the training required to qualify ARW medics to the appropriate PHECC and NATO SOF standards.
Organisation – The key organisational improvement has been in the rollout of our electronic healthcare system ‘Socrates’, which has been amended for military use by Clanwilliam. This has significantly improved our patient and records management, and provides ‘business analytics’ that have proven invaluable in the management and planning of service delivery.
Training & Education – A real milestone has been achieved this year with the approval of a Military Medicine scheme for the DF, whereby doctors who are one year postgrad will be commissioned as Lieutenants and spend several years working towards qualification on the specialist register of military medicine. This project has been facilitated by the ICGP and led by DMB and is worthy of an article all on its own (perhaps you could talk to my partner in crime Col Gerry Kerr?!). Apart from that great news, we are currently running a competition for the next class of 25 Combat Medical Technicians, which should start their diploma course in UCD in September. We also recently held the first Medical Corps Concentration for several years.
Materièl – We are working on improving our personal protection and clothing issue for medical practitioners. CMU is also purchasing a stock of customised DF First Responder handbooks for issue to all future MFR and FAR students.
Personnel – CMU has recently made a detailed submission to DFHQ making the case for an additional 16, targeted appointments for CMU. In the meantime, DOD is providing a number of civil servants for procurement, finance and medico-legal work across the HQ and CMU locations. This will release the medics who are currently doing this work for more front-line medical service provision. One final piece of good news – a PDF line officer (Comdt Cathal Berry) has just made history by starting work as a Medical Officer after completing his medical studies and three years postgrad experience.
Facilities – Work has been completed on renovating two Medical Aid Posts (Limerick and Galway), with planning on-going for the renovation of the MAP in Cathal Brugha Bks. We have completed an audit of all our medical facilities, and just last week made a detailed submission on our infrastructural requirements. We hope that this will be integrated into the DF’s medium to long term infrastructure plan.
Leadership – RCSI conducted a leadership course for our key leaders earlier this year, and we plan to run a Standard Medical NCOs course in Q4 or Q1 of 2018.
Interoperability – At home, we continue to enhance our strategic partnerships with a range of national stakeholders, including inter alia UCD, the HSE/NAS and the RCSI. On the international side, a CMU team competed in the recent Arduous Serpent competition for Combat Medics in the UK, which was also attended by teams from the US and Canada.
Despite all this progress, challenges do remain. For example, the continuing lack of sufficient Medical and Dental Officers remains the key inhibitor for the effective delivery of medical and dental support to the DF.
How do you encourage innovation within the CMU?
The importance of innovation and initiative was underlined in my written command philosophy, circulated in Nov of last year. The main way in which we try to encourage innovation was to facilitate a ‘team of teams’ approach in CMU. I was very lucky to work with an excellent group of team leaders. As an infantry man, I had to rely on their expertise and I did as much as I could in my short term in command to encourage and empower these key leaders to drive innovation in their own areas of responsibility. For example, when I arrived in CMU, several specialist team members (e.g. of the dental or nursing teams) told me that they rarely get together for in-house team-specific CPD or to discuss matters of mutual interest. For this reason, we have now established a three monthly ‘battle rhythm’ for team meetings (internal CPD). This means that each team gets together once every quarter, to upskill, enhance their own situational awareness and to drive innovation in their own sphere. The first of these quarterly meetings took place in Q1 this year, during which each team carried out and presented a ‘SWOT’ analysis. This presentation by each team of its own Strengths, Weaknesses, Opportunities and Threats gave team members a voice, and ensured that at a minimum I understood their concerns and opinions. While I acknowledged on the day of each presentation that I didn’t have a magic wand to solve all these challenges immediately, the SWOT exercise did help me to focus on priority issues (e.g. the lack of communication from CMU HQ, which was part of the reason for the establishment for our quarterly Medical Corps newsletter). Finally, the Medical School continues to host at least one multidisciplinary CPD training day per month. All this innovation, and much more, is helping us to work towards our strategic aspiration - to be the best, small military medical service in the world. From what I have seen in my very quick year in the CMU, we are already a long way towards achieving that goal.
Do you think that there is an awareness of the fundamental importance of the work of the medical corps among the General Staff – and are resources allocated accordingly?
The current General Staff are acutely aware of the pressing need to have a modern, efficient and effective Medical Corps as part of the 21st Century DF. This has been shown by the support that I have received for several initiatives over the last year, for example in rolling out a new model for first responder training for inductees to the DF. That is not to say that I have total autonomy or an unlimited budget, but in general there is a realisation at the strategic level that medical support is a key enabler for all aspects of DF capability, whether on land, sea or air, at home or abroad.
A wide diversity of experience in different aspects of the Defence Forces would seem to be an important prerequisite for an Officer’s advancement. On the other hand, does a relatively rapid turnover of staff affect the administration of the unit? Do you think the CMU has structures or processes in place to guard against any resultant loss of ‘corporate memory’?
There is no doubt that the relentless turnover of staff (primarily caused by promotions and the filling of overseas lists) has resulted in challenges in the areas of corporate knowledge and continuity in our transformation process. My own departure from CMU after only a year in command is a case in point. That said, the ‘team of teams’ approach helps to mitigate this challenge, and the other initiatives that we have taken this last year ( e.g. the promulgation of a written command philosophy for the CMU and the establishment of a quarterly newsletter for the Medical Corps) will help to tackle any loss of corporate memory that results from high staff turnover.
The shortage of medical officers seems to be a perennial problem. I have to point out to readers that the terms and conditions to take on the ‘traditional’ short service commission Medical Officer are still not agreed and because of this the recruitment of MOs is presumably held up. Do you think that the MO shortage is a problem that the Defence Organisation as a whole actually tries to address seriously enough?
I do know that this issue features monthly and sometimes weekly both at the strategic and civil level. It is also an issue that is raised regularly by the representative associations (RACO for officers and PDFORRA for enlisted personnel). Both DMB and I raise it repeatedly at various fora, for example at all meetings of DCOS (Sp) Division and General Staff/GOCs conferences. Work is still ongoing behind the scenes to address this issue, and I am confident that it will be eventually solved (strategic patience is a virtue!).
A knock on effect of the shortage of MOs are that significant numbers of army medicals are to be outsourced to the private sector. Given the chequered history of outsourcing in the Public Sector, do you see this as a positive development or more a necessary evil?
Outsourcing is a fact of life, and is probably here to stay. As such, while it does present challenges and is certainly not a panacea for all our ills, I believe that partial, targeted outsourcing will be part of a comprehensive approach to medical service provision in the coming years and indeed decades. The key challenge is this – what to outsource, and to what extent? The ongoing reviews of the various parts of our medical services (e.g. mental health, pharmacy and radiology services) examine this issue. I can say that outsourcing of all of our services is not a foregone conclusion – it is widely known and acknowledged that in order to provide a flexible, interoperable and deployable DF, at home and overseas, a military Medical Corps is absolutely essential. Of course, the devil is always in the detail, and how much or how little of each component part of our medical services model is outsourced needs careful consideration. For my part I have tried to be an advocate for having a strong core of military practitioners at the heart of all our teams.
What the CMU does from day to day is of fundamental importance to the DF. Career risks also presumably come with the huge responsibility of the job. Bearing this in mind, did the job offer you much personal job satisfaction?
In a word, immense. I did not ask to come to the CMU, and was surprised when I was selected as its CO. That said, in the last year I have been very impressed by the people in the Medical Corps. I have witnessed at first hand the dedication, competence and professionalism of the personnel in the CMU 'Team', whether they were military, ANS or civilian. The Team is all the stronger because of the contributions of the very different personnel in it - medical officers, dental officers, psychiatrists, psychologists, nurses, pharmacists, physiotherapists, PHECC practitioners, medical scientists and operations, admin or logs staff. I have been particularly impressed by the work ethic of the members of our various teams, military and civilian, many of whom go well above and beyond the call of duty to get the job done. I have been touched by the care and compassion shown by our medical practitioners, and the enthusiasm for innovation and constant improvement shown by many. In hindsight, this should not have been a surprise to me, when I think back on my encounters with our Medical Services at home and abroad over the last 35 years. I am happy to admit that I underestimated the quality of the CMU and the excellence of the people in it. I suspect that, like me, many other people in the DF also underestimate the personnel in the CMU. That might have something to do with the fact that our members are so busy getting on with the job that they are sometimes taken for granted. I for one will not make that mistake again, and during my time as CO I did my best to ensure that the remainder of the DF and the military authorities were aware of the excellent work that they do.
How do you manage to maintain a good work life balance?
Not very well I am afraid – long hours have become the norm and I have often compared commanding CMU as like an overseas trip at home. I am an early riser and commute daily from Kildare to St. Bricin’s by early train, and often return long after the ‘normal’ working day is done. That said, it has been an immense privilege for me to command the CMU and the fact that it has been one of my career highlights to date helps to mitigate the long hours and the sometimes thorny problems. I try to get out for a swim or a long walk a couple of times a week, as much for my mental health as for my physical fitness, and I spend whatever spare time I have with my long suffering wife Dee and our two children Oisín and Síofra. They are adept at bringing me back to reality and at getting my mind away from the rigours of military life and the challenges of the day job. Finally, As President of the DF Parachute Club, I am still involved with the organisation of our sports parachuting activities, such as competitions and display jumps, and that gets me out of the office from time to time.
Col Ó Murchú, sincere thanks for taking the time to answer what we hope were some challenging questions! On behalf of the ISMM and our readers, we want to wish you all the very best in your new role in the DF. We would also like to thank you for your ongoing service to the Defence Forces and the state. We want to assure you it does not go unnoticed and is deeply appreciated.