The HSE has accused nurses of breaching the terms of their employment contract by continuing work-to-rule industrial action and said almost 500 hospital appointments had been postponed due to today's work stoppages.
In a statement issued today, the HSE said it was "disappointed" not to have received confirmation from the Irish Nurses' Organisation (INO) and the Psychiatric Nurses' Association (PNA) that nurses would resume duties such as answering telephones, using IT-based systems and attending meetings - which it said were "core" nursing duties.
St Vincent's Hospital statement
The HSE said it would write to all striking nurses and midwives today, giving them seven days' notice to confirm they would resume normal work or have their salaries reduced by 13.16 per cent, which represents the pay increase nurses and midwives received as part of Sustaining Progress.
The statement said: "The unions wish to characterise this action as a 'work-to-rule' with nurses simply not carrying out duties that they perceive as non-nursing duties. However, in effect, the action they are pursuing is much more disruptive to patient care and this 'work-to-rule' represents an actual withdrawal of nurses from their core functions."
This morning the Taoiseach moved to resolve the dispute with nursing unions by proposing to set up an independent review of the health service to bring about a 35-hour working week.
However, Mr Ahern remained adamant that those nurses unaffected by a pay anomaly, whereby some staff supervise higher paid workers as part of their duties, would have to pursue their demands for a 10.6 per cent pay increase through the benchmarking process.
Mr Ahern said the Government would resolve "immediately" the 10.6 per cent pay anomaly for those nurses directly affected.
Speaking at a Fianna Fáil press briefing on health this morning, the Taoiseach admitted: "We are at an impasse".
Mr Ahern said he was proposing an independent body, possibly from abroad, to examine how the 39-hour working week could be reduced to 35 hours on a cost-neutral basis, but he insisted it would have to be negotiated within the context of social partnership.
"If we go outside benchmarking, everybody [in the public sector] will put in a claim for a 35-hour week. This is a really serious issue," he said.
Mr Ahern said he accepted that the nurses had been "very helpful" in their proposals to meet flexible working requirements to achieve the shorter working week, saying: "They haven't been militant about this."
Asked had he informed INO general secretary Liam Doran of his proposal, Mr Ahern said: "I'm putting it out this way".
The Taoiseach called for nurses to be reasonable and engage with his "resolution and solution to this impasse", but he rejected suggestions that in return he should remove the HSE's threat to dock nurses' wages while striking.
"If we adopt this process I don't think it [docked wages] would be necessary. If we don't, it is inevitable," he said.
Following a HSE threat to cut nurses' pay unless they end a work-to-rule, unions said yesterday they would now stop engaging in overtime. Mr Doran said they would decide next week on a date for beginning the ban on overtime.
The plan to escalate the action next week was announced last night by the INO and PNA. It follows a decision by the HSE to dock the pay of their members by 13.16 per cent from this day week unless they abandon their action.
The INO and PNA said the move had made nurses more determined than ever pursue a 10.6 per cent pay rise and a 35-hour week. At present they work 39 hours.
Mr Ahern declined to give a timeframe for the delivery of the independent report into how the HSE could make a 35-hour week work within the health service, but he warned: "If we don't go this road, I think this dispute will go on for quite some time."
Today some of the 45,000 members of the INO and PNA are staging three-hour work stoppages in four counties.
Stoppages began at 9am today in St Vincent's hospital, Dublin, where more than 300 patient appointments have been cancelled; at Cork University Hospital, which has cancelled 24 patient appointments; at Limerick Regional Hospital, where 50 appointments have been cancelled; and at University College Hospital, Galway, where 34 patients due there have been told to stay at home.
In a statement, St Vincent's said "considerable difficulties have been encountered throughout the work-to-rule action due to lack of cooperation from the Irish Nurses Organisation and the impact of this on patients has been made known to the INO".
"They have been continually advised that patient safety issues have arisen and patient care has been compromised on an ongoing basis as a direct result of the very inflexible interpretation of the work-to-rule action.
"In yet another letter to the INO general secretary yesterday (10th May), the hospital expressed serious concerns about how clinical information is being communicated by nursing staff to doctors during the work-to-rule. The letter outlines 24 cases where nursing staff sent written clinical requests for doctors to a communications room rather than communicating directly with the doctor required," the statement added.
Three-hour stoppages are planned for Monday next at Beaumont, Naas and Sligo general hospitals and on Wednesday nurses across the State plan a two-hour work stoppage.