I have come from Shannon Airport to hear Senator Taylor-Quinn speak.
Adjournment Matters. - Relocation of District Nurses.
There was no stopover in Shannon Airport this morning.
It does not come into effect until 28 March, a Chathaoirligh.
Somebody is being mischievous.
It is a pity the Minister did not stay in Shannon Airport because then he would have understood what I am about to say.
I am becoming indebted to you, a Chathaoirligh, for your generosity in affording me the opportunity of raising matters on the Adjournment.
My staff were getting worried about this situation.
I will forewarn you, a Chathaoirligh, that this may become a concern to some people.
As the Minister of State is standing in for the Minister for Health, he may not be aware that the Mid-Western Health Board propose to transfer district nurses in the west Clare area from their current health centres. For instance, a nurse currently operating out of the Kilrush health centre is being transferred to Kilkee while the nurse in Kilkee is going to Kilrush. Similarly, the nurse operating from Kilmihil is being transferred to Killadysert and vice versa. There are six nurses in total being relocated. I have had extensive discussions over the past ten days with health board personnel, both at local county and regional levels but, unfortunately, they have not given us a satisfactory hearing to date. That is why I thank you, a Chathaoirligh, for affording me the opportunity to raise this matter in this House.
The nature of the proposal is most unfortunate because the Mid-Western Health Board insist on proceeding along this route without first having engaged in full, open, extensive and proper consultation with the nurses involved. In essence, the health board is presenting the case as it intends to execute it. It is unfortunate that it has not engaged in the type of open and honourable discussion one would expect before action is taken. We must be concerned for the patients and the families in the district who will be affected by this proposal. Patients in the area are happy, secure and comfortable with the current position. A good understanding has been established over time between the nurses and their patients. I am sure the Minister will agree that this is an important ingredient in patient welfare.
The district nurses concerned in this dispute are dedicated, caring and committed and have an in-depth knowledge of their patients and their families. They are obliging, conscientious and are willing at all times to act above and beyond the call of duty.
It is unwise for the Mid-Western Health Board to proceed in such a cavalier fashion. The patients are very worried and concerned. They want the nurses they know. The nurses are reasonable people and will operate a change of district electoral divisions, but not a change in health centres. The onus is now on the health board to be conciliatory and reasonable to all concerned. The Minister may not be aware of this, but throughout the county district nurses have voted to take strike action in the event of there not being a satisfactory outcome.
Compassion and care for the old, the elderly and the sick at home in the west Clare area needs to be engendered at this point. It is fortunate the Minister flew over west Clare this morning; he would have crossed Loop Head to get to Shannon Airport; he flew over the district to which I am referring, a distance of 45 miles by 20 miles. This area is covered by six nurses. It is a huge area consisting with many old people living alone in isolated areas who over the years have established a rapport with their district nurse. In an area where there have been closures of post offices and Garda stations and a reduction in all types of services, a change of district nurse at this stage would further unnerve older and more vulnerable people. This would be unwise.
Why do the health boards feel free to move district nurses around? It would not move the dispensary or public health doctors around in the same fashion. Everyone should get a fair crack of the whip. Nurses should be treated with the same understanding and respect that is afforded to the general practitioners. The Minister may refer to terms of conditions of employment and contracts to be signed, etc., but there is an onus on the Department and the health board to ensure this matter does not get too legal and that a certain understanding and compassion are shown. I do not see any great advantage in adopting this practice for the patient, the nurses or the health board. The health board is creating confusion and concern and is upsetting many people for no good reason.
There is no benefit to be gained for any party from this move and it would be unwise to proceed down that road. I urge the Minister to contact the health board and tell it forthwith to restrain from transferring the nurses from their current health centres.
Having my roots in the west, I am aware of the issues raised by Senator Taylor-Quinn. County Clare looked as beautiful as ever this morning.
It is a sunny morning. We would have hijacked the Minister's plane had we known he was coming through Shannon Airport.
I know that.
I begin by expressing my appreciation and support for the valuable work which public health nurses carry out in the community. I would also like to assure the Senator that the Mid-Western Health Board tries at all times to look after the best interests of its clients.
There are many groups which benefit from the work of the public health service — the elderly, mothers and infants, children, mentally ill people and people with a mental handicap, as well as those who are terminally ill or others who require nursing care.
Public health nurses are normally based in a health centre and provide some of their services from there. In the case of people who, for whatever reason, are unable to attend the centre, the public health nurse will visit and treat them in their own homes. It is the policy of all health boards to try to locate the public health nurses in areas where the needs of the patient are greatest. In line with this policy the Mid-Western Health Board is revising public health nursing areas in line with changes in services and in the population in the Clare area where there has been a reduction in the population of west Clare between 1986 and 1991.
Some members of the public health nursing staff in west Clare who are members of the Irish Nurses Organisation have disputed the proposals of the board. The board has already revised nursing areas in south Clare without any distress or upset to the public. Most of the nurses in the county will continue to operate from their existing health centres and changes are small in a number of areas.
In an effort to reach a settlement, the board and the Irish Nurses Organisation have agreed to an adjudication of the dispute by an independent chairman today. Services to the public have not been disrupted in any way. In view of the adjudication hearing which commenced this morning, and is at present ongoing, it would be inappropriate for me to comment further at this stage of the negotiations. I trust the negotiations will be successful and that a resolution to the problem will be found.
Senator Taylor-Quinn chose the correct day to raise this matter.
They are meeting Mr. John O'Connell in the Glentworth Hotel as we speak. I sympathise with the Minister of State because he has only returned from the United States and he has been given a script from the Department of Health. He should tell the Department to take back the first page of the script because it is not relevant. Changes took place in south Clare, but the nurses concerned were not transferred from the health centres where they operated. A change was made in the district electoral divisions but the nurses remained in the health centres. The nurses in the west Clare area are also prepared to accept a change in the district electoral divisions, but they want to continue operating in the same health centres.
I will convey those points to the Minister for Health, Deputy Howlin.
The Seanad adjourned at 1.25 p.m. until 2.30 p.m. on Tuesday, 22 March 1994.