A joint strategy committee of the Irish Nurses Organisation (INO) and the Psychiatric Nurses Association (PNA) will today consider whether the industrial action by 40,000 nurses should be escalated to include rolling work stoppages around the country.
INO general secretary Liam Doran last night said that the committee would review the first day of the work-to-rule, assess the feedback from members and decide on what further action, if any, should be taken at this stage.
He told The Irish Times that the unions had a mandate for action which included regional rolling work stoppages.
Earlier the deputy general secretary of the INO, David Hughes, said that the union was considering short rolling work stoppages. He said that the work-to-rule would continue indefinitely until there was a resolution.
Mr Doran said last night that there were no plans for fresh talks with health service management at this stage.
The INO and PNA in a joint statement yesterday said that it was their strong preference that talks with management would resume immediately on two key issues of the introduction of a 35- hour week and a pay claim of about 10 per cent to eliminate pay anomalies with other groups.
As part of the work-to-rule, nurses are refusing to answer non-essential telephone calls, carry out clerical, administrative or IT work or to open or close community health facilities.
Mr Doran said that all nurses and midwives were at work yesterday "performing all necessary direct patient/client care required to ensure their individual welfare and well-being".
He accused Minister for Health Mary Harney and health service management of employing "unnecessary scare tactics" in their comments on the impact of the work-to-rule on patient care.
"The decision to cancel non-urgent admissions/procedures has been made, unilaterally, by health employers and is a direct result, not of the work-to-rule but of their failure to put in place, despite 60 days notice, the necessary alternative/contingency arrangements," the unions said in their joint statement.
Ms Harney said yesterday that the only people who would be adversely affected by the dispute were patients.
"It is not correct to say that for example, by not taking a phone call that patients will not suffer. Clinical nurse specialists deal with patients every day, if bed managers are not going to co- operate, are we going to be able to transfer patients?
"Later this week for example we hope to transfer 35 patients from Beaumont Hospital, long-stay patients into Beaumont Convalescence Home. Will that be able to proceed?"
Ms Harney claimed that nurses were looking for pay increases that would amount to 32 per cent.
She said they would want the 10 per cent increase over 27 months available under the national pay deal as well as a further 10.6 per cent and a 35-hour week, which would effectively increase their salaries by about 11.4 per cent.
The dispute would only be resolved if the official industrial relations machinery of the State was used, she added.
Brendan Mulligan of the HSE- Employers Agency last night urged the unions to reconsider their position and have their pay claims processed through the benchmarking body. He said the disruption was not necessary and that the issues had been examined by the Labour Court, which had recommended that they should be addressed through benchmarking.
In a statement last night, the HSE said that the pay anomaly between nurses and social care grades which had been raised by the unions only occurred in seven locations.
"Following an extensive survey of employers in the intellectual disability sector, the HSE has identified seven locations where 50 staff nurses have social care workers - on a higher salary - reporting to them.
"Under the National Implementation Body, the HSE . . . has proposed upgrading all those staff nurses in the intellectual disability service who have social care workers reporting directly to them to clinical nurse manager grade 1," the HSE said.
Anatomy of the dispute
What is this dispute about?
Nurses have been pursuing about eight issues in relation to pay, conditions and allowances for some time now. However, the priority areas are the introduction of a 35-hour week and a pay claim of just over 10 per cent.
But don't we have State industrial relations machinery to head off such actions? Why can't it be used?
The nurses' claims have gone through all the industrial relations mechanisms in the State. The parties have been to the Labour Relations Commission and late last year the Labour Court rejected the bulk of these claims.
It urged that the pay issues be addressed through the benchmarking process, which is examining pay scales in the public sector. It also recommended that a process to reform organisational systems and work practices in the health service could allow for the issue of reduced working hours to be addressed.Several weeks ago a new forum was established, at the behest of the wider trade union movement, to look at these non-pay issues. Finally over the last three weeks, the National Implementation Body, the main industrial relations trouble-shooting body under the social partnership process, has chaired talks at Government Buildings aimed at averting the current dispute. Those talks failed on Sunday.
Are all nurses participating in the dispute?
No. The current action involves only members of the Irish Nurses' Organisation (INO) and the Psychiatric Nurses Association (PNA). They represent around 40,000 nurses. However, other unions such as Siptu and Impact also represent sizeable numbers of nurses. They are not participating in the current work to rule.
Why are they not involved?
Siptu and Impact have decided that the best place to argue their case for improved pay and conditions for nurses is in the benchmarking process. This is due to report later this year.
Some unions, such as Siptu, are also concerned that a damaging dispute in public hospitals could give ammunition to those who would like to see greater private-sector involvement in the health service generally.
Why are the INO/PNA opposed to benchmarking?
Essentially the unions say that they have no faith in the process and that it does not deal with their specific concerns. They maintain that the last benchmarking report was silent on a number of their claims and also resulted in some groups receiving more than nurses.
The INO also points out that a number of groups, such as radiographers and health service managers, have secured deals in direct negotiations outside of benchmarking.
Why can't the Government just do a deal with the INO and PNA?
The Government believes that to reach a deal with the nursing unions outside of the benchmarking process would undermine its entire public pay strategy.
Already some unions such as Impact have signalled that if the INO and PNA secure pay increases outside benchmarking that their members will want similar arrangements.
The Government is determined that, having found in benchmarking a way out of the system of constant leap-frogging pay claims by public sector groups based on historic relativities, it is not going to go back there again.
Why do the nurses believe that a 35-hour week is so important?
The INO and the PNA point out that it is now 27 years since the Labour Court first recognised the merit of a reduced working week for nurses. They argue that other professional groups in the health sector already enjoy a 35-hour week.
While there was some general agreement between the parties at the NIB talks over the reduction in nursing hours, there was no meeting of minds on when this should come about.
The INO and PNA wanted a specific date for the introduction of the 35-hour week. However, management said that there would have to be various risk assessments and studies carried out first. These could take a number of years.
Would introducing a 35-hour week cause problems for the health service?
Management has argued that reducing the working week to 35 hours would take around 7.7 million nursing hours annually out of the system.
The unions maintained that they would offer greater flexibility and work practice changes, including an expanded role for nurses, in return for the new arrangement.
However, the management view is that over 4,000 additional nurses would be needed to fill the gaps, and that even if the Government wanted to increase its nursing payroll in such a way, there would be great difficulties in finding these staff.
Management has also said that the immediate introduction of a 35-hour week would effectively represent an increase of around 11 per cent in the hourly pay-rate for nurses.
What about the pay claim? Aren't nurses paid less than other grades?
As a result of pay deals in 2001 some social care grades in the intellectual-disability sector are paid more than nurses. Some sources said that there is a difference of up to €3,000, depending on the point of the scale.
There is an obvious anomaly in this as some on the social care grades who earn more actually report to nurses.
Some sources close to the recent talks have maintained that the nursing unions sought not only to close this obvious gap, but also to restore the previous differential that existed between the two grades, hence the 10.6 per cent pay claim.
Management has offered to put in place some promotional positions to address the issue of nurses being paid less than those who report to them in the intellectual-disability sector.
Management says that fewer than 100 nurses are affected by this anomaly.
However, the nursing unions are seeking the 10.6 per cent claim to be applied to all nurses across the health service.
Where will things go from here?
There are no fresh talks planned and there are indications that the nursing unions could escalate their actions to include short rolling work stoppages. - By Martin Wall
