The committee will now deal with the motion submitted by Deputy McManus on the issue of emerging industrial unrest between the HSE and the nursing and midwifery unions, namely the Irish Nurses Organisation, INO, and Psychiatric Nurses Association. If the motion is agreed, the committee must make a report to both Houses on the matter.
Industrial Relations: Motion.
On a point of order relating to procedure, the Vice Chairman mentioned that a report would have to be made. Will the Vice Chairman outline how this will be done, the procedure and where the report will go?
It is only if the motion is adopted. Whatever the joint committee passes in the form of a resolution would be sent to both Houses of the Oireachtas.
That is considered as the report.
Yes.
I move:
That the Joint Committee on Health and Children notes, with concern, the emerging industrial unrest between the Health Service Executive and the nursing and midwifery unions, the Irish Nurses Organisation and Psychiatric Nurses Association.
It is clear to the committee members, from representations received, that the professions hold a deep sense of grievance with regard to their hours of work and relative pay position within the health service.
Nurses and midwives are among the most flexible of public servants who provide essential care to the community on a seven day, 24-hour basis. They are an essential part of our health service.
The joint committee believes they hold substantial grievances, are prepared to engage in significant reform towards improving patient services and are seeking accommodations in line with those provided for other public servants.
On that basis, we call on the Taoiseach, Minister for Finance, Minister for Health and Children and the Health Service Executive, and its employer organisations, to engage with the INO and PNA and to take all reasonable steps towards ensuring equitable conditions apply in the health service and, therefore, avoid a potentially damaging dispute in our already challenged health service system.
I consulted the Chairman, Deputy Moloney, before putting down the motion as I appreciate it is an important matter which needs to be dealt with sensitively. I appreciate the committee has no direct role in industrial relations. The INO and PNA have met with all the political parties, and I hope with the Independents at this stage, to set out their concerns. It is a matter of general concern if we end up travelling a road into a major industrial dispute and nobody would wish this to happen.
This motion is designed to ensure there is engagement between the two sides and whatever possible reasonable steps are taken at this stage. It is clear there are particular issues, which have been highlighted to me, and I know other parties are familiar with key issues, including the 35-hour week and differences in pay.
We do not need another major period of industrial unrest in the health services. I hope we can have cross-party support on this issue and I certainly do not wish to make any political capital from it. I hope we can, as public representatives, urge for this response so that some progress can be made to ensure we do not go down a route most of us have been familiar with in the past. Such a direction would not be helpful currently, if one considers what patients are experiencing in some elements of the health service with regard to pressures and congestion. It is important we try to ensure these issues can be resolved in a fair and equitable way.
I support the motion. The state of the nursing services currently is ridiculous. What other profession would tolerate what is going on, where somebody subordinate to an individual, who has power of decision in many matters, would earn less than the person reporting to that individual? Many, if not all, professions, with the exception of the nursing profession, are working a 35-hour week. Most of us are serious and appreciate the service of the nursing profession. As a result, from a sense of fair play if nothing else, we would have to support the grievances of all the nursing disciplines.
The health services are being challenged but it is rising to many of these challenges. With an increasing and aging population, many new services have been brought on stream, but it is reasonable that pressure would come on to the health services. The nursing service plays a pivotal role in the delivery of health services and I do not have to lecture any member of this committee or those in the public gallery on the grievances. We all know them. It is incumbent on us all as legislators and public representatives to try to ensure that fair play wins out in this case, which is all that is being sought.
The emphasis has to be on the phrase "ensuring equitable conditions" and that is the reason I fully support the motion. Representations have been made to us on the 35-hour week and as other health professionals are working such weeks, I do not understand why nurses should be an exception. We already know that some people are working in the health field who are less qualified than nurses but earn more, which is clearly unacceptable. For all these reasons I hope we can get unanimity within the committee on the motion. This sensible motion speaks for itself and I hope there will be no political divide on it.
If the motion requires formal seconding, I would like to do so.
That is fair enough. It has been seconded.
We must recognise that the nurses in our hospitals and working in the community feel undervalued and overworked. No matter how many we are producing we should be aware that we are very short of nurses within the health service. We have to go abroad to try to recruit nurses and I query the morality of going to the developing world to do so, where there are already grievances over the practice.
Many units rely not on nurses but on nursing aides to bring them up to the full complement and this is undesirable. It was very difficult for the nurses to go on strike the first time and I remember this because I worked with them. It will not be difficult for them next time, if they are not listened to, because their complaints are very reasonable. It is important to remember that today's nurses are university graduates and it is very easy for them to get jobs in other areas here and abroad. Like the other members, I hope there is unanimous support for this motion.
It is not often I find myself in agreement with Deputy McManus and I am glad to say that I do on this occasion. The way the Deputy outlined the purpose of the motion is very appropriate in terms of trying to establish engagement to deal with this industrial relations issue. Industrial strife is not in anybody's interests.
We were all briefed by the INO and the PNA and one could not but feel for them given their grievances. We must consider this matter in the broader context in terms of the benchmarking process and Sustaining Progress. It is particularly unfortunate that, time and again, nurses have not been accommodated within that process and are now driven to the point where, to get themselves heard, they must resort to the final weapon, industrial action. Nobody, including the nurses, wants to go down this route and a way must be found to include their claims in the benchmarking process. The terms of reference must include them because it is not fair to have such a vital group within the health service left outside with this grievance festering for many years. I think there will be unanimity of support in the committee.
Senator Henry alluded to morale within the nursing profession and we do not value the profession as highly as we should. Account has not been taken of the increased "professionalisation" of nursing and this is our opportunity to do so. The Minister for Health, Deputy Harney, is to enhance the role of nursing, with regard to prescribing, and this demonstrates how nurses are accommodating change, doing exactly what benchmarking requires. The role of nursing is evolving and being redefined and there is an onus on Government to acknowledge this interest in embracing change so I support the motion.
I also formally support the motion. It is worth remembering that there was a previous dispute, not many years ago, relating to nursing services and many nurses believe it was never fully resolved. Morale is quite low among nursing staff and, to an extent, the public still treats nurses as Florence Nightingales. People forget that nurses are employees in a job and deserve to be paid because when they sit at the negotiating table, they are not really treated as people in employment.
Nurses are the only health professionals who still work a 39-hour week. All their colleagues work fewer hours, with some working 33 hours and others 35 hours per week. Benchmarking was meant to do many things for nursing grades and nurses feel they have been let down badly in this regard. There are nurses in highly specialist grades and the type of work carried out has moved on, but they have not been compensated and we should examine this situation.
Handing over time is another bone of contention. When nurses come to the end of their shifts, they are relieved by a colleague to whom they give a handing over report. Often this report can take up to half an hour to complete, yet it is taken as given within the nursing profession, which is grossly unfair. Due to their professionalism, nurses will complete these reports but if a nurse decided to leave as soon as his or her shift ended, it would not be good enough. Very regularly a good, accurate verbal report is required and this is a matter which is taken for granted that we must address.
Many unqualified members of staff do excellent jobs in terms of communicating with patients and do not receive the praise they deserve. Sometimes they wish to take the next step and get a formal qualification. This is evident in houseparents who wish to qualify as nurses. However, they find their earning power diminishes on gaining a recognised nursing qualification and this presents a difficulty.
The concept of acting up is another issue in the nursing profession. Each ward has a ward sister and a deputy ward sister but frequently nurses are asked to act up to ward level and deal with consultants. Nurses receive no extra pay for this work although it is a huge responsibility.
Nursing earnings are enhanced through night duty and weekend work, which can constitute 20% of a nurse's salary. This is only right, given the inconvenience of such work. If a nurse wishes to progress and gain promotion to a nine-to-five, Monday to Friday job, he or she will lose this 20% supplement and may be required to take a drop in salary to advance his or her career. We talk about community services and so on but this is particularly relevant to the psychiatric service where there is no incentive for promotion. In fact, there is a disincentive for people who work nights and weekends and have time off during the week. One would expect monetary reward for a person who wishes to progress in a profession and such matters have never been addressed.
Employers in the health service use agency staff for nursing and heavily depend on them. This is much more expensive than taking on young nurses on a permanent basis. It is one of the great tragedies of our time that young nurses are qualifying and not receiving permanent positions. There was a time when nurses, having completed the demanding training, could look forward to the offer of a permanent position in the health service. We are now regularly allowing young, trained staff to go elsewhere for employment while we are, at times, looking overseas to recruit nurses on one and two-year contracts. We should examine this issue and ask why young, qualified nurses are not given the option of permanent positions.
The committee this morning discussed the fact that no employment ceiling exists in the health service. There may be no employment ceiling on administrators but there appears to be one affecting the number of people delivering hands-on care.
I also support the motion and, like most people here, I met representatives of the INO and PNA some weeks ago. Following that, I wrote to the chairman of the committee, Deputy Moloney, on 16 January expressing my full support for their claims, which are fair and reasonable.
It should be borne in mind that the nurses tried to go through the normal channels in this matter under benchmarking but, unfortunately, their claims were outside the terms of reference and were not heard. They then tried to put down 14 amendments to the terms of reference for the next benchmarking process but these were rejected. They have found themselves in a situation where their claims could not be dealt with adequately through the benchmarking process and they have had to resort to the alternative methods that are now being used.
It is completely unreasonable, given that benchmarking has been set aside for many professions, that on 12 separate occasions in recent years an exception was not made in the case of nurses, as they have had a claim going back, in some cases, for 26 years. Many people have made reference to the reduction in working hours from 39 hours to 35. The Labour Court accepted back in 1980 — 27 years ago — that there should be a phased reduction in nurses' working hours. We have not seen that happen in 27 years. There is a clear unfairness about this issue.
I have spoken to hospital administrators and their working week is 33 hours, with much inbuilt flexibility that does not exist for nurses. Women make up 90% of the nursing profession and as a female member of this committee, I am particularly dissatisfied with the manner in which they have been dealt with over the years. It does not seem to be recognised that for the past ten years nurses have had to undertake a degree course to enter the profession. Yet, other members of the health service who undertake degrees, like physiotherapists, radiotherapists, etc., have a starting salary that is €7,000 above that of nurses. Reference has been made to the anomaly with child care workers. While such workers mainly report to nurses, their starting salary is €3,000 ahead of staff nurses and the anomaly continues along every point of the scale for ten years. The logic of this is beyond belief.
The nurses' claim is very fair and they have set it out in a balanced way. I am delighted that this committee has taken it upon itself, as I recommended to the Chairman a number of weeks ago, to be in a position to support them and bring this to the attention of the Minister. Perhaps we can then arrive at a juncture which permits serious negotiations to take place so that the nurses' valid claims are resolved before industrial action takes place.
I strongly support this motion. Now that we are entering the last 100 days of this Dáil, it is interesting to note the cross-party support. This emphasises the strength of the case being made by the PNA and INO. Like other colleagues, I have met with the groups both here in Leinster House and in Tallaght. I will not repeat the points which have already been well articulated, but I strongly support the case they make. It is good and significant that we are having this meeting. I hope it will be seen in a positive light.
I too support Deputy McManus's motion. It would be wrong for any Member to come here and not support this motion. There is a huge swell of emotion, support and recognition for the INO and PNA. As a former member of An Bord Altranais, I know at first hand the type of people with whom we are dealing. They are not people who would jump on the bandwagon and be out every other day shouting and roaring about conditions. They tread very carefully, know what they want and go about it in the right way. This is one of the reasons I support the motion.
As Deputy Cooper-Flynn said, it defies logic that nursing graduates with a four year degree start on a salary scale that is €3,000 to €5,000 less than some other health workers. It is also wrong that other health professionals have a shorter working week than nurses. It does not make sense even if one only takes the physical side of nursing — not to mention the mental burden attached to the job. Nursing in accident and emergency departments has now become a hazardous occupation and staff have threats made against them. Deputy Connolly will know what I am talking about when I say that those involved in psychiatric nursing are risking their own lives at times in the course of duty.
Later today measures to enhance and empower the profession by giving prescribing rights will be announced and I welcome that move. The commission on nursing report was published when I was a member of An Bord Altranais. This opened up the scope of practice for nursing and I am delighted to see it moving on.
I do not have any difficulty supporting this motion. We must make allowances for nurses, particularly in light of the issues which have been outlined at this meeting.
This motion is important and it shows there is all-party support for what is happening. There are two main issues, namely, the 35-hour working week and pay increases. It is important that we show solidarity with the nursing profession. We should also make sure to get a response from the Minister on this issue.
Huge changes are taking place in the nursing profession. They have up-skilled to an enormous degree in recent years and we are now talking about nurses being able to prescribe drugs. We must recognise these changes. Large numbers of nurses are leaving the profession and are being headhunted because of their expertise. We need to deal with this urgently.
As well as supporting this motion, I call on the Taoiseach and the Minister to resolve this issue quickly. This is one crisis that the health service does not need.
Is the motion proposed by Deputy McManus and seconded by Senator Henry agreed? Agreed. That it was agreed unanimously sends a very strong message.
Motion agreed to.