The plan to place extra beds in existing hospital wards to ease the crisis in hospital A&E units was taken because crisis situations deserved a crisis response, the Minister for Health insisted yesterday.
She was responding to delegates attending the annual conference of the Irish Nurses Organisation (INO) in Killarney, who have expressed serious concern at the proposed move.
Joe Hoolan, an A&E nurse, told her the proposal was tried and had failed in the past.
Ms Harney put it to the nurses that they had described the A&E situation as a crisis.
"You describe it as an emergency crisis . . . crisis and emergencies deserve crisis and emergency responses," she said to laughter from the floor.
Ms Harney said the Health and Safety Authority had carried out a report on A&Es, and it was a matter for those running hospitals to decide where patient safety was best served - in overcrowded A&Es or in certain circumstances in extra beds on wards.
The Minister got a cool reception when she arrived, with delegates particularly incensed at a threat to withhold a 3½ per cent pay increase due to them at the beginning of next month over the INO's alleged failure to co-operate with a new training module for healthcare assistants.
She was met with a line of delegates holding placards proclaiming people wanted beds not trolleys in A&E. Otherwise there was silence in the conference room.
The greeting was in marked contrast to that accorded minutes later to INO president Madeline Spiers, who was loudly applauded and received a standing ovation when she went to address the gathering.
Ms Spiers put it to Ms Harney that she was mistaken in her belief that nurses would not co-operate with the concept of healthcare assistant grades. The INO wanted to be consulted on the changes so that the best interests of patients were served.
Ms Harney put it to the delegates that no reform in the health service would take place without all sectors and all professions being willing to change.
"Nothing will change for the better if each of us sees every change as a threat to our interests. The challenge is to make change work together."
She added that both sides had to be honest and frank with each other, and there was no point in her coming to the conference and only saying things the nurses wanted to hear. Just as no teacher loses out from a special-needs assistant joining the school staff, no individual nurse would lose out from having a healthcare assistant available.
There were many more healthcare assistants to nurses in the UK than in the Republic, she added, stating that this State had some catching up to do. It was a case of: "A lot done and a hell of a lot more to do."
During a question-and-answer session with delegates, she was asked what she thought of one nurse having to look after 40 patients from 5.30pm to 8.30am at Áras Carolan, a community nursing facility for the elderly in Mohill, Co Leitrim.
Ms Harney said it was not acceptable, but it was a rostering issue. This was met with howls of "No" from the floor.
Ms Harney appealed to the delegates to be fair, saying there were more nurses per head of population in the Republic than in many other places.
There were 12.2 working nurses per 1,000 people in the Republic, which was about 50 per cent more than the EU average of 8.5 per cent.