The Government is set to take on the consultants but is wary of the nurses, writes Stephen Collins, Political Editor
The nature and timing of the war on three fronts currently being waged by the Minister for Health, Mary Harney, has everything to do with the looming election. The same is true of the attempt by Fianna Fáil backbenchers to wash their hands of the nurses' dispute and give the impression that they would like to adopt a more sympathetic line than the Minister.
Ms Harney has deliberately chosen to take on the consultants in advance of the election in order to demonstrate to the public that she is determined to reform the health service. Negotiations had dragged on for so long that she was faced with a choice of doing nothing and letting the whole thing drift into the lap of the next government or of taking decisive action at a time of maximum political risk.
She chose to take the risk in the knowledge that while her opponents are one of the most formidable interest groups in the country, they are also among the least likely to generate popular support. While the vast majority of consultants are individually liked by their patients, they have become highly unpopular as a group because of their intransigence and their enormous salaries.
Instead of serving to make the Minister cautious, the proximity of the election emboldened her, and so far her gamble of taking on the consultants and setting a strict time frame for the resolution of the negotiations on a new hospital contract appears to have paid off.
On Tuesday the Cabinet backed her decision to set a strict two-month time limit for the negotiations. Failing that, she will proceed with her plans to hire 1,500 new public hospital consultants on a new type of contract.
She has also been authorised to hold the existing consultants to their current contracts and to stop them exceeding their quota of using more than 20 per cent of beds for private patients.
The Cabinet decision did represent a small rowing back on the Minister's part. Two weeks ago she wanted to set Tuesday's Cabinet meeting as the deadline for the implementation of the new consultants' regime. However, the Taoiseach made an ambiguous intervention, stressing that negotiations were always better than confrontation. The consultants got the message and agreed to enter immediate talks. Still, by setting a deadline of two months Ms Harney has shown her intention of making the dispute an election issue if the matter is not settled by then.
With the Progressive Democrats struggling to carve out a clear role for themselves in the election campaign, it makes political sense for the Minister to stage a last-ditch confrontation. More importantly, it is the right thing to do, as a continuation of the current impasse is simply not acceptable to the wider public.
If the Minister wanted the confrontation with the consultants in advance of the election, the nurses were seeking their confrontation with the Minister at the same time for similar reasons. Unlike the consultants, the nurses are a popular group who are capable of evoking public sympathy, whatever the merits of their argument.
Their claim for a shorter working week, higher pay and a special allowance for those living in Dublin has been in the pipeline for over a year. The pay element of the claim was shot down by the Labour Court as it would have effectively torpedoed the current national pay deal agreed by the social partners. In response, the nursing unions clearly decided that the looming election was the time to apply maximum political leverage, and they voted in favour of industrial action.
Ms Harney also brought this matter to the Cabinet on Tuesday. In an attempt to avoid confrontation, ministers decided to address the non-pay issues of concern to the nurses. They agreed that issues such as work practices, extra responsibilities for nurses in line with their training and a new status for nurses should be up for negotiation. The Cabinet agreed that a forum for talks on these non-pay issues should be found through the social partnership process.
At the Fianna Fáil parliamentary party meeting on Tuesday evening, which was attended by the Taoiseach, a number of backbenchers and senators expressed the view that the Government should adopt a softer approach to the nurses. It was not specified whether they meant that this should involve pay as well as the other issues.
The problem for Mary Harney and the PDs is that the impression created by the reports of what took place at the meeting is that Fianna Fáil is more sympathetic to the nurses than the junior coalition party. "Nice Fianna Fail, Nasty PDs" was the subliminal message some of the backbenchers wanted to convey.
The reality, though, is that both Government parties are committed to the same policy on public pay, and it is a policy which has the support of the Irish Congress of Trade Unions.
Any attempt to change pay policy at this stage would not only create havoc with the funding of the health service, but would cause consternation right through the trade union movement.
Both Government parties are treading very warily when it comes to the nurses. The Taoiseach told the Dáil yesterday morning that his "colleagues on the Fianna Fáil backbenches are entitled, when they receive representations from interest groups, to report what those groups have said to them, and they did no more than that". Ms Harney herself adopted a conciliatory tone in interviews, even if that did not change the underlying reality.
With two big battles on her hands, the arrival of a third, in the shape of the confusion in the health insurance market, was not something the Minister had reckoned on. That will only be sorted out on the basis of legal advice, but the proximity of the election will act as a spur to get it resolved quickly.