Dáil Éireann debate -
Thursday, 6 Feb 1997

Vol. 474 No. 5

Adjournment Debate. - Nurses' Dispute.

Mr. Cowen

I welcome the decision by the Labour Court to issue a recommendation tomorrow night in the nurses' dispute and I hope a satisfactory resolution can be reached. The Labour Court is working under immense pressure and I wish it well.

However, it is a matter of great concern that the limited deal on cover which the Government claimed to have done with the nursing unions last week is already unwinding. Today we heard a specialist from a cardiac unit speak of the potential problems. Those difficulties will be replicated across the entire health services.

Even though the dispute has been looming for six months, it is only now that the Department of Health and the management of the health services are developing a contingency plan. A major mistake was made by the Minister for Health in leaving the development of cover procedures until the last minute. Trying to put these in place just days before potentially the most serious strike in the history of the State is very bad management. Efforts were made by the nursing unions some time ago to develop contingency plans for the health service but these did not receive a response from the Department of Health. Likewise, even though there is a provision for a code of practice in the Industrial Relations Act, 1990, for disputes in essential services, the Department of Health also did not act on this.

The Government's handling of the entire dispute is in doubt. Not one concrete proposal has been put forward since the Taoiseach announced three weeks ago, at the launch of Partnership 2000 that the dispute would have to be resolved. There is no apparent Government strategy to avoid the potentially most serious strike in the history of the State.

Fianna Fáil wants to see justice done to the caring profession. Nurses play a vital role in the health services. They are integral to its functioning and their work is of immense value. In the past, when Fianna Fáil has been in Government, there have been disputes where more rigid national agreements and more difficult fiscal conditions applied in the economy. Amongst these were disputes involving the ESB, radiographers, dental assistants, fire brigade staff and hospital doctors. In each instance the disputes were resolved with political will and imagination despite the limitations of the Programme for National Recovery and the Programme for Economic and Social Progress.

Fianna Fáil believes that the aspirations of nurses in relation to pay and conditions can be met over a reasonable timeframe. The party believes this would yield tangible improvements in health service delivery.

If a national nursing strike goes ahead, the entire health service will grind to a halt, probably within hours of the strike starting. The chaos that will result is unthinkable. The Minister for Health and the health service managers at the Labour Court must be conscious of this.

It is very unfair to leave the Labour Court in the unenviable position of trying to resolve this dispute at the 59th minute of the 11th hour. The Minister was wrong to remain at arm's length from the dispute for so long. After two rejections of the pay offer, he should have got directly involved and tried one last effort. He should have responded to the request from the unions to hold a direct meeting with them and he certainly should have taken up the offer from the General Secretary of SIPTU for a commission on nurses' pay and conditions. This could and probably will form part of the ultimate solution.

The Minister for Finance's intervention in the dispute on 10 November, when he told nurses they had made 'a gross error of judgment' was also a serious mistake. His comments were very insulting to nurses who work under immense pressure and have hardened attitudes in the dispute.

Ms O'Donnell

We are now on the verge of the first national nurses' strike. This situation is most grave and it is fitting that the Dáil should be informed at this late hour of the status of negotiations and the progress towards avoiding a strike.

Nobody doubts the catastrophic impact the strike will have. Today one of the country's leading heart surgeons voiced his concern at non-acute cardiac operations being postponed and said that he and his colleagues would face difficulties in deciding which patients deserved priority once the dispute begins.

On a human basis, most people accept that nurses have some genuine grievances and that there is legitimacy in some aspects of their claim. Spending on the health services has doubled over the past five years to £2.5 billion. It costs £25 million a week more to run the health services now than it did five years ago. Will the Minister explain how spending has increased to this extent without taking into account the nurses' grievances over that period? The nurses have been pressing for a revision of their terms and conditions since the early 1980s.

My party has met individual nurses and their union representatives. Traditionally, nurses have not been and are still not militant. They have proved this by their genuine concern to ensure contingency measures are put in place during the strike to protect those who are most ill. Their plight is not unrelated to gender. If the INO represented 26,000 men providing an essential service there would not have been such slow progress in addressing their grievances. In all walks of life, in and outside the home, women's work is undervalued. This lies at the root of the nurses' problems. The nursing profession has been taken for granted.

Will the Minister provide a detailed estimate of the £100 million gap which he claims exists between the nurses' claim and the offer the Government has made? Will he explain whether consideration has been given to the establishment of a commission to examine the nursing profession, with particular reference to the current claims? Will the Minister explain which particular aspects of the nurses' claim, apart from the pay aspect, are causing difficulties for the Government? Some aspects of the claim must surely not involve an extra cash outlay for the Government.

Does the Minister accept that much of the pressure for higher pay in the public service stems from the Government's failure to address seriously the issue of personal taxation? If my party's tax proposals were fully implemented the net increase in take home pay for a staff nurse would be about 15 per cent, even before a nominal increase in salary. At this late stage I hope the Minister can hold out some hope that the dispute will be resolved before the strike takes effect next Monday.

Minister for Health (Mr. Noonan

, Limerick East): As Deputies may be aware, I met representatives of the Alliance of Nursing Unions on 21 January last. Both sides availed of the opportunity to take stock of the current situation. The meeting also involved discussion of the contingency planning arrangements being made by hospitals and other health services providers.

Deputies will also be aware that an invitation from the Labour Court to talks on the dispute and the threatened strike has been accepted by both sides. Talks commenced on Tuesday evening and continued yesterday. The powers of the Labour Court under section 26 of the Industrial Relations Act have been invoked to make a formal intervention and both sides have made their submission to the court. Deputies may already be aware that the court announced this afternoon that it will make its recommendation to the parties not later than midnight on Friday, 7 February. The court is issuing this statement to allow the parties to the dispute to make arrangements to consider the recommendation prior to expiration of strike notice on Monday, 10 February.

On the issue of contingency planning, I have taken steps to ensure that the impact for patients should the threatened strike proceed be contained to the maximum extent possible. I am obliged to the Deputies for affording me this opportunity to set out the current position in relation to contingency planning arrangements for the nurses' threatened strike.

Health service managers held two meetings — on 14 and 31 January — with the Alliance of Nursing Unions to discuss the broad approach to ensuring that emergency and essential services will be maintained for the duration of the threatened strike. In tandem management in all health agencies have drawn up detailed contingency plans for their own organisations. These continue to be refined on the basis of ongoing discussions held with local strike committees. The principles on which an emergency service will be provided have been agreed with the union leadership in the discussions at national level and these have, to my understanding, been communicated to strike committees.

However, I have been informed that in some areas local strike committees are not honouring commitments given at national level by the nursing alliance in relation to contingency arrangements. This could put patient care at risk, particularly as some agencies consider that the level of service on offer is not sufficient to provide safe essential services. It is imperative that the outstanding issues in relation to these plans be resolved as a matter of urgency. Steps are being taken at national and local level to achieve this.

My Department is in direct contact with all the affected agencies and has identified all the high risk areas within the service. Eight regional centres have been provided to provide an ongoing flow of information on a daily basis to the Department in relation to service disruption, preparation of resources centrally and regionally and to deal with communications with patients, impending patients and their families. A co-ordinated media information campaign in relation to the impact of the strike is already under way.

In common with other Deputies, I do not want to see a nurses' strike. However, I am sure Deputy Cowen, whose party was one of the architects of the PCW, and Deputy O'Donnell, whose colleagues continually stress the need to control and reduce public expenditure, will agree that there must be a limit to the resources which can be committed to resolving the dispute. Every possible effort will continue to the made to avert the strike.