I thank the Ceann Comhairle for allowing me to raise this very important issue on the Adjournment. I wish to share my time with Deputy Moynihan.
Adjournment Debate. - Threatened Strike in Southern Health Board Area.
Is that agreed? Agreed.
The impending strike in the Southern Health Board area which is due to take place on 13 July next will have serious and severe repercussions for thousands of workers in the hospitals and nursing homes in that area. More importantly, the patients in these hospitals and nursing homes will suffer needlessly if commonsense does not prevail.
I believe the issue involved is not so great that it cannot be resolved to the satisfaction of everyone. I realise that this House is not the place to discuss the pros and cons of an industrial dispute but it is the place to discuss the health of patients and the conditions for workers in the health service. Previous strikes by workers in the health services caused misery and suffering for many people. I understand that emergency services will be provided in the event of an all-out strike but, if possible, this strike should be prevented and confrontation avoided. I know the Minister does not like beating about the bush on such issues. I appeal to him to intervene in this matter and seek a return to the status quo, thus giving the union and management an opportunity to sit down together over the next few months and tease out the problems and anomalies in the system with the objective of reaching a satisfactory conclusion. I believe there is a great deal of honour and credit in people stepping back from the brink at this junction and putting the patients' welfare first. I know there is goodwill on the part of the workers on this very important issue. I appeal to the management to reciprocate that gesture by deferring action until further negotiations have taken place over the next two months.
I support the views expressed by Deputy O'Sullivan in regard to this matter. The threat of an industrial dispute in a hospital at any time evokes great worry and concern not only among the patients and their relatives but among the staff also. The limited number of times hospital staff have resorted to industrial action indicates their commitment to patients and to their jobs. I appeal to the Minister to intervene to prevent this strike going ahead. If this strike goes ahead, it will be very difficult to resolve.
The vote in favour of industrial action was carried by a massive majority. This demonstrates the uneasiness felt by the staff at the change in approach by management to the payment of sick benefit. As this is tantamount to a change in the wages structure it was bound to be resisted. The staff accept that there are anomalies in the scheme and are prepared to discuss the issue with management. The speed and manner in which management implemented this change, and not the substance of the matter is what has given rise to the threatened industrial action. As a doctor, the Minister is aware of the problems which can be caused in hospitals as a result of industrial action. He should appeal strongly to both sides to come together and resolve their differences on the basis of equality and justice. If the Minister does this, I am sure he will receive a positive response from the groups involved and the interests of the staff and patients will be protected.
I thank the Deputies for raising this very important matter. They are doing a great service to the people involved in raising it at this time. The escalating costs arising in the health services from the level of absenteeism among health staffs have been a cause of great concern for a number of years. Additional costs arise both from the operation of the sick pay scheme and the need to replace staff who are on sick leave. While there is a wide variation in the level of absence both between the categories of staff and between the different health agencies, the overall level of absenteeism has been found to be considerably higher than the level of absenteeism in other service employments.
The Health Efficiency Review Group who produced the Fox report, indicated that there was considerable scope for cost savings in the areas of absenteeism and sick pay in the hospitals which they studied. Pay costs make up approximately two-thirds of the total expenditure of the health services. Because of the high rate of replacement, either by locums or built into staff complements, absenteeism and sick pay account for a significant proportion of total pay costs.
Sick pay schemes are particularly generous to certain grades of staff. The level of benefit received while on sick pay can exceed 100 per cent of net pay. In the case of staff liable for Class A PRSI, sick pay provisions generally provide for payment of normal gross weekly earnings through a combination of social welfare disability benefit and employer "top-up". This often allows the employee higher net earnings while absent from work than he or she would earn while at work due mainly to the fact that the social welfare element of the sick pay is free from PAYE-PRSI charges. Apart from the additional cost to the taxpayer which this entails, it is an undesirable incentive to have incorporated in employment conditions.
Bearing in mind the financial constraints under which the health services have to operate and the need to reduce costs wherever possible, it is clear that the above situation could not be allowed to continue indefinitely. Following the issue of the Fox report, a hospitals' value for money group recommended that absenteeism levels should be monitored in a more consistent and more systematic way. They also recommended that arrangements should be put in place to eliminate situations where certain categories of staff, while on sick leave, receive in excess of 100 per cent of net pay. The value for money group decided that the simplest method to achieve this was to deduct social welfare entitlements from net pay. The precedent of deducting social welfare entitlements from net pay has already been established in both the public and private sectors. This means that an employee, while absent on sick leave, earns normal net take-home pay through a combination of social welfare entitlements and employer's "top-up" payment. A number of health boards have implemented these revised sick pay arrangements.
The Southern Health Board informed the unions in advance by letter of the impending changes in the scheme and, in addition, met the unions to explain the overall situation. The board then implemented the change from 8 April 1992. Following a meeting with the union on 24 June 1992, at which the union sought a return to the status quo, a course to which the board could not agree the union informed the board of pending strike action due to start from 13 July next. The board, by way of letter dated 25 June, invited the union to return for further discussions and are awaiting a response.
It is my view that both parties should resume their discussions and make further efforts to resolve the impasse which has arisen. The Programme for Economic and Social Progress commits employers, trade unions and employees to promoting industrial harmony and, where the parties cannot reach agreement through direct negotiations, established bodies are available to assist in such cases.
Without attempting to interfere in any way in this matter. I have asked the management to initiate negotiations with the unions. I recognise that what the Deputy has said is correct — this is the way to approach the matter. There is an opportunity for both sides to sit down and see how they can resolve their disagreement in the best interests of the patients, the public and the staff. I can understand what happened but I hope that a much more flexible approach will be taken in the interests of all concerned.