Dáil Éireann debate -
Tuesday, 12 May 1998

Vol. 490 No. 7

Adjournment Debate. - Health Service Staff.

Mrs. B. Moynihan-Cronin

This matter is of great concern to nurses who work in the ambulance services in the Southern Health Board area. In order to get information on this matter I tabled a parliamentary question to the Minister for Health and Children on 6 May 1998 — Question No. 199. The question read:

Mrs. B. Moynihan-Cronin asked the Minister for Health and Children the way in which the on-call system of work operates for workers under the remit of his Department; and if he will make a statement on the matter.

The Minister replied:

As the Deputy knows the public health system must provide a 24 hour, seven day a week service. This requires that certain grades of employee such as hospital consultants and radiographers provide an "on call" service, i.e. that the employee in question is available and is liable to be called in to work outside normal working hours should the need arise. I do not understand how the Minister can compare consultants with these nurses. Certainly, their rates of pay do not compare. The system works as follows: the nurses are paid 90p per hour only when waiting and are only paid adequately when they are in the ambulance on an emergency call.

Perhaps the Minister will answer the following questions to clarify the matter for the House. Must a period on-call follow a period of physical duties? Is the present system operated by the Southern Health Board as regards these nurses legal? When does the Minister intend to implement the recommendations of the ambulance review report? Is funding in place to implement these recommendations?

The ambulance review report was to be implemented in 1997. We are half way through 1998, but there is no sign of moves being made to implement same. The nurses who work on this service are doing a magnificent job and it is disgraceful that they are not getting decent pay. While they are waiting, they get 90p per hour. There are approximately 34 personnel affected and it is a disgrace that in a time of plenty the nurses who operate one of the most essential services in the health system are being dealt with in such a manner through lack of funding. If the ambulance service and the personnel who operate it do not deserve adequate funding, where are we going?

There is also a fear in my constituency of South Kerry that the health board is considering removing the night time ambulance service in the Kenmare area. I remind the Minister that if the Killarney ambulance service is to be expected to cover the Kenmare area in addition to its own area, the system will be in chaos. Is the Minister aware of the huge mileage involved? I hope he will assure the House that this proposal is only a rumour.

To return to the main issue of the ambulance nurses, it is appalling that they are not being paid adequately for the time they wait to attend an emergency. It is not their fault they must sit waiting for a call. This is most unjust and I urge the Minister to give a firm commitment to these wonderful nurses that a solution to their predicament will be found as a matter of urgency. It is the responsibility of the Minister to ensure that health workers who perform essential services to the community are given just reward for the work they do. I look forward to the Minister's reply.

Minister of State at the Department of Health and Children (Dr. Moffatt)

I thank Deputy Moynihan-Cronin for raising this matter on the Adjournment. As the Deputy did not refer to any specific grade or group of workers, I can only outline the general principles underlying the provision of on-call cover in the health service.

The Deputy will appreciate hospitals and other health and social service providers are expected to provide services to patients and clients on a 24 hour per day seven day week basis. The bulk of the care is provided within the normal working day and the majority of health service staff are rostered to be on duty during this period. However, provision has to be made to respond to emergencies which may arise from time to time. Emergencies may arise from a deterioration in the condition of patients already in hospital or from patients who are brought in to accident and emergency departments. For community and personal social services, there may be a need to respond to the urgent needs of children or the homeless.

In general, on-call services are provided by staff members who have finished their normal day shift. In a small number of instances a separate group of staff provide on-call services on a shift basis. Staff providing on-call services may be based in the hospital or may be on-call from their homes. Some staff, such as laboratory technicians in large hospitals, may be rostered to work for fixed sessions up to midnight to deal with emergencies and then be on-call from home for the remainder of the night. The basis on which staff are rostered for on-call services and the arrangements for paying for these services are the subject of agreements with the relevant unions and staff associations.

The arrangements for the provision of these services and the payment systems are kept to under regular review. There is a fine balance to be struck between ensuring that sufficient suitably qualified staff are available to deal with emergencies and ensuring that staff and other resources are utilised to maximum efficiency. The responsibility for manning on-call services is a matter, in the first instance, for local health service managers who are best placed to make judgments on the extent and nature of the emergency cover required for their particular institution.

The Deputy raised specific questions and in order to get replies, perhaps she might table a parliamentary question or raise the matter on the Adjournment and be more specific about the ambulance service, etc.

Mrs. B. Moynihan-Cronin

I raised it in my original parliamentary question, which the Minister chose to ignore.