Health service management has warned of severe disruption in hospitals and community-based services from today because of a work-to-rule by more than 40,000 nurses campaigning for improved pay and conditions.
Talks to avert the action, which had been taking place under the aegis of the National Implementation Body for the last three weeks, ended unsuccessfully yesterday.
In a hard-hitting statement last night health service management said the work-to-rule would put patient care and safety at risk. It said in many instances it represented a withdrawal from core functions.
The Health Service Executive (HSE) said it was inevitable that elective admissions to some hospitals would have to be cancelled, although the full picture would not be known until today.
Brendan Mulligan of the Health Service Executive Employers' Agency said because of the nurses' action services would be gradually wound down and patients awaiting services would not be treated.
Under the work-to-rule nurses will not answer telephones except in essential cases or carry out clerical, IT or administrative work.
The Irish Nurses' Organisation (INO) and the Psychiatric Nurses' Association indicated last night that the action could be escalated to include rolling regional work stoppages in the coming days and weeks. The unions are to consider this issue at a strategy committee meeting tomorrow.
General secretary of the INO Liam Doran said last night it would be "fairly safe to assume that you're looking at a group of people who are more frustrated, more angry than we were three weeks ago".
He said 42,000 nurses would go to work as normal today but would refrain from carrying out "non-essential duties". The action was geared at discommoding managers and maximising the nurses' and midwives' attention on the patient.
"What they will be doing is maximising their contact time with their entire patient population, so it won't be at the hands of nurses and midwives if there is inconvenience and delays. The responsibility for that, 60 days after the notice was served on them, is absolutely full square and 110 per cent on the health service employers," he said.
However, a briefing document prepared by the Department of Health for the minister, Mary Harney, in recent days said the planned disruption to services would be "as bad as a strike".
"In the event of the Irish Nurses' Organisation and the Psychiatric Nurses' Association's action going ahead there will be a severe disruption of services very quickly. Bed management services will be severely disrupted in many hospitals, quickly leading to a backlog in A&E. The ban on use of telephones and IT systems could have severe repercussions for vulnerable patients and clients. Day services for intellectual disabled/ psychiatric patients may be cancelled in some areas."
The HSE said the telephone ban could have implications for patients with cancer or diabetes who were managed at home. The action would also impact on the ordering of essential laboratory tests and diagnostic procedures and would "frustrate the return of results of clinical examinations, eg where urgent lab results are telephoned through to wards/units as well as causing delays in picking up abnormal results".
The talks at the National Implementation Body failed as a result of disagreements over a timescale for the introduction of a 35-hour week for nurses and a claim for a 10 per cent pay increase. No further talks are planned between the parties.
Ms Harney last night said the industrial action was unnecessary. She said it would have serious implications for patients and cause anxiety for families. She called on the unions to reflect on the impact the dispute would have on hospitals and community-based services.
Siptu, which also represents nurses but which is not involved in the action, said some progress was made at the talks but that the gap remained too wide to be resolved at this stage.