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Dáil Éireann debate -
Tuesday, 21 May 1991

Vol. 408 No. 7

Ardkeen (Waterford) Hospital Dispute.

I should like to thank the Chair for allowing me to raise this very important health matter which is affecting patient care in the south east region and particularly in the new hospital in Ardkeen. It gives us no pleasure to raise these subjects but we have a crisis in the health services. Is the Minister aware of that crisis? The Minister should intervene immediately in this dispute which has led to a stoppage of work by nurses in Ardkeen Hospital.

I compliment the nurses for the way they acted in this dispute which was to highlight the difficulties in staff levels at the hospital. Their picket was not an allout picket. They also managed to introduce, with some assistance from their colleagues, a procedure whereby no patient was neglected today at the Hospital.

The decision by the nursing staff to have this one-day token strike was a difficult one for them. Bearing in mind the mounting problems facing them and the intolerable working conditions in Ardkeen Hospital they were left with no other option.

The nursing staff are demanding a minimum of an extra 14 nurses so that their nursing duties can be carried out in accordance with their medical training and their responsibilities. Last year the workload at this hospital — a new regional hospital — increased by a staggering 25 per cent in many faculties and by more in some. The increased activities affect all areas of treatment. This increase in workload has occurred in the paediatric unit, in the intensive care unit where consultant anaesthetists were increased from one to three, in medical and surgical wards, the neonatal wards and the day care wards.

Yesterday, 13 patients required beds in the day care ward but three beds were available. Like a game of chess the nurses had to move patients from beds to chairs such was the demand in the day care ward yesterday. Does the Minister expect the same service in this hospital to be maintained by the board when the activity of the hospital has increased by almost 25 per cent, when the allocation has not been increased in accordance with that and the nursing levels have not been increased to meet this demand? There have been some increases over the past two years but nurses are not able to keep pace with the demands.

The Minister has agreed to spend £36 million on this new purpose built 424 bed hospital. The Minister in the House this year, in reply to one of my questions, said: "This hospital is geared to the needs of the 21st century." Yet, at the same time, he expects the existing staff numbers to service the extra beds and units. It would appear rather contradictory that a Minister on the one hand is prepared to invest £36 million without providing the proper and adequate staffing. Surely, in the context of the overall cost of the hospital, the provision of a mere extra 14 nurses would be a reasonable request.

The decision of the staff in Ardkeen Hospital to go on strike to highlight the impossible working conditions they are expected to work under is a mere microcosm of events occurring in all health boards. I read today that nurses in the Mater Hospital have decided to work to rule next week and——

Deputy Ferris, you have permission only in respect of Ardkeen Hospital.

It is an example of what is happening throughout the country.

The Deputy should stick to the subject matter.

What will have to happen before the Minister takes note of the chronic financial circumstances in our health services? The South-Eastern Board, who are responsible for this hospital, have the worst nurse-patient ratio in the country. The Minister has been made aware of this by the board on numerous occasions yet he chooses to ignore it. The responsibility does not rest with the health boards — which the Minister is likely to say — but with the Minister and the Department of Health whose allocation to this health board is insufficient. I have said that before in the House.

The Deputy's time is exhausted.

Responsibility lies with the Minister and he must address this mounting crisis in our health services.

Ongoing negotiations between the South-Eastern Health Board and the Irish Nurses Organisation, have been taking place on claims by the INO for increased staffing levels at Ardkeen Hospital. The INO are seeking the creation of 14 additional nursing posts at the hospital.

Within the terms of the Department's personnel policy; agencies are provided with overall staffing ceilings, within which they must operate. Autonomy exists, however, to target staffing resources to areas of priority need, within the parameters of overall staffing levels, and the financial allocation. It is a matter, therefore, for the South-Eastern Health Board to determine the appropriate staffing levels, in each of their institutions and other services, within their approved employment ceiling, and their financial allocation.

Over the past two years 31 extra nursing posts have been created at Ardkeen. In addition 50 nurses employed in a temporary capacity at Ardkeen have been made permanent. The annual costs of these measures alone is circa £700,000.

I would like to confirm what Deputy Ferris said that a total of 13 day patients went through the day care unit yesterday.

With three beds.

I was referring to the turnover in a unit. The Deputy is not comparing like with like. How many people go through and how many can attend is a medical decision.

In the course of the ongoing discussions with the INO — the most recent meeting took place on 14 May, just one week ago — the South-Eastern Health Board agreed to the establishment of a joint management-staff committee to examine and revise duty rosters. This committee are at present examining the situation. The South-Eastern Health Board also sought the agreement of the INO to the reassignment of a small number of nurses within the hospital to areas of greatest need on an interim basis, pending the outcome of the discussions. Regrettably agreement could not be reached on this reassignment request.

Despite the ongoing negotiations on these matters, the INO decided to hold a 24-hour work stoppage on today, 21 May, to highlight their claims for extra staff. Emergency cover was provided. The South-Eastern Health Board regrets that the INO should have decided to adopt this action at this time during the negotiations. It is the intention of the South-Eastern Health Board to hold further meetings with the INO on the outstanding issues at the earliest possible date. I am sure the House and the Deputies present will share my concern that these discussions lead to an agreed solution to the problems involved and that all avenues of negotiation will be pursued before recourse is again had to industrial action.

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