asked the Minister for Health if he is now prepared to give full incremental credit for service to single temporary nurses.
5.
Ceisteanna—Questions. Oral Answers. - Nursing Service.
4.
asked the Minister for Health if he is now prepared to agree that all temporary nurses whether single or married should be given the same salary.
6.
asked the Minister for Health if he is now prepared to recommend a 40-hour week for all nurses.
7.
asked the Minister for Health if, having regard to the fact that many auxiliary hospital personnel work a 40-hour week while nurses are still working an average of 42½ hours, he will now take steps to reduce the working hours of nurses and to bring working hours within matters to be negotiated under the conciliation and arbitration scheme; and if not why.
8.
asked the Minister for Health if he is aware that the Irish Nurses' Organisation has been obliged, because of staff shortages, to request the Dublin Health Authority to close further hospital wards immediately; and if he will therefore authorise the health authority to offer improved salary rates and conditions of service to temporary nurses with a view to attracting qualified nurses back to the profession.
9.
asked the Minister for Health why a more effective system of granting incremental credit for previous service has not been devised; and if he will ensure full and free and equal mobility between voluntary and local authority hospitals in all grades.
11.
asked the Minister for Health why a nurse in the staff nurse grade category loses salary if she moves from a voluntary hospital in Dublin to a local authority hospital in Connacht or Munster.
12.
asked the Minister for Health if in view of the expected shortage of nursing staffs during the summer months he would take special measures to deal with the critical situation facing many hospitals.
13.
andMr. T. O'Donnell asked the Minister for Health if he is aware of the growing unrest among nurses throughout the country; and, if so, when he proposes to make decisions on the various requests made to him by the Irish Nurses' Organisation on pay and conditions of employment.
16.
asked the Minister for Health if he will give discretion to health authorities to employ single and married temporary nurses at rates higher than the minimum rate.
With your permission, a Cheann Comhairle, I propose to answer Questions Nos. 4 to 9, 11 to 13 and No. 16 together.
Heretofore standard practice in the local health authority service was that a nurse, on first appointment to that service, entered the appropriate salary scale at the minimum and then proceeded by annual increments—subject, of course, to satisfactory service—to the maximum. If she moved, without break in service, from the service of one health authority to another, she carried accrued incremental credit with her. A departure from the standard practice was authorised some little time ago for persons accepting permanent appointment in the basic grade of staff nurse who now may enter the salary scale with the benefit of up to five increments in respect of previous experience elsewhere than in the health authority service. This concession applies also to married nurses accepting temporary appointments in local authority hospitals other than psychiatric hospitals and I have now decided, in consultation with the managers, to extend it to married general trained nurses serving in psychiatric hospitals.
In deference to representations made to me in recent weeks by the Irish Nurses' Organisation, I have arranged to advise health authorities that a nurse in any grade transferring from an Irish voluntary hospital to the health authority service may be granted full incremental credit, with effect from 1st April, 1970, in respect of previous experience in the grade in such voluntary hospital. In other words, she will be treated as if her service in the voluntary hospital had been in the local authority service and this means that henceforth any nurse transferring from a voluntary to a health authority hospital may do so without a reduction in salary.
I do not anticipate a shortage of nursing staffs during the summer months other than that occasioned by the normal incidence of annual leave, but I am keeping the position under constant review. Permanent appointments as staff nurse are readily available to unmarried and widowed general trained nurses, especially in the Dublin area. Many such nurses prefer, however, for their own reasons, to remain temporary. While this situation persists I would not feel justified in offering special inducements.
I understand that arrangements are in train for early discussion between the Irish Nurses' Organisation and the County and City Managers' Association on the subject of conditions of service—including a further reduction in working hours—for nurses. Deputies may be assured that any settlement emerging will have my immediate attention.
As to the question of salaries, Deputies are doubtless aware that nurses are a party to the scheme of conciliation and arbitration for local authority officers. I understand that a current claim by nurses for increased remuneration is to be heard by the arbitrator. Should a mutually acceptable recommendation emerge it will receive my prompt attention.
Deputies might wish to know of improvements which have taken place in the remuneration and conditions of service of nurses since 1964. I propose, a Cheann Comhairle, with your permission, to circulate with the Official Report such a statement in relation to the basic grade of general trained staff nurse.
The following is the statement:
GENERAL TRAINED STAFF NURSE
(a) Annual Salary.
|
1/1/64 |
— |
£465-£600 |
|
1/2/64 |
— |
£520-£670. |
|
1/4/64 |
— |
£590-£840. |
|
1/6/66 |
— |
£629-£879. |
|
1/6/68 |
— |
£700-£925 |
|
+£70 long service increments— |
||
|
£1,055. |
||
|
1/6/69 |
— |
£765-£1,050 +£70 long service increments— £1,120. |
Percentage increases in the period at minimum of scale 64.5 per cent and at maximum of scale 87 per cent.
The foregoing takes no account of (a) 12th Round adjustment from 1/4/70 and (b) any adjustment which may emerge from pending arbitration hearing.
(b) Allowances.
Since 1/6/68 new or improved allowances are payable as follows:
£40 per annum to those holding special certificates in Midwifery, Paediatrics, Fevers, T.B., when actually engaged on that work, £40 per annum while actually engaged on Theatre duties, duty in Geriatric Units, Long Stay Hospitals or Units, County Homes and Intensive Care Units.
From 1/4/68 an allowance of 35s per week since increased to 38s 3d) is payable to nurses while engaged on night duty.
(c) Hours of Duty.
The working hours of hospital nurses were reduced from a 96 to a 90-hour fortnight in 1962, and were further reduced to an 85-hour fortnight in 1966. The question of a further reduction is now on the agenda for discussions with the County and City Managers' Association representing the health authorities. Any settlement emerging will apply also to voluntary hospitals.
(d) Annual Leave.
In December, 1966, hospital authorities were authorised to allow extra leave to nurses in lieu of public holidays worked by them.
Can the Minister say why he will not bring within the conciliation and arbitration machinery the question of the hours to be worked by nurses?
Because as at present established the conciliation and arbitration machinery does not cover hours and conditions of service. When the Minister for Local Government brings in the promised scheme of the complete conciliation and arbitration arrangements for the whole of the local authority and the health authority personnel, I understand these conditions will be included. At the moment they are not included.
Can the Minister indicate what he means by the phrase "permanent appointments are freely available especially in the Dublin area"? Why differentiate between the two? Surely the Minister will agree that, if they are freely available, they are freely available everywhere and that a nurse outside the Dublin area is in a different position according to his phraseology?
I was simply referring to the position of temporary nurses. We know that nurses remain in a temporary position for a number of different reasons. The reasons are so various and of such a kind that I would not wish to suggest any change in the present system at least without the recommendations of the nurses' organisation made to the appropriate authority. I was not comparing any one area with another. I understand that the bulk of the temporary nurses are in the Dublin area but I may be wrong about that.
Would the Minister not agree that if a nurse had been temporary for perhaps 20 years and then decided to apply for a permanent post which was available, the five years increment seems to be a rather niggardly offer?
That can always be a matter for negotiation. If Deputies read what has been done since 1964 they will realise that considerable progress has been made. I think the city and county managers are meeting this week to consider the conditions of service and the conciliation and arbitration machinery which apply to the remuneration of permanent nurses. I think the arbitrator will hear the case within a reasonable time.
I understood the Minister to say that the married nurses wish to be retained on a temporary basis. Has he any foundation for that statement?
Unmarried temporary nurses have various reasons, which I do not propose to outline, for wishing to remain in a temporary capacity.
Am I to understand that married nurses will not be given a permanent basis of employment?
I have already dealt on previous questions with the status of married nurses with health authorities. I said I would not be prepared to make or to recommend any change pending the report of the Commission on the Status of Women.
In view of the shortage of nurses and in the light of the possibility of mitigating that shortage by availing of the services of married nurses, is it not commonsense to reconsider the position rather than to stick one's head in the sand like the proverbial ostrich?
I am not sticking my head in the sand. For the first time— better late than never—An Bord Altranais are conducting a survey of the nursing position in the entire country. Circulars have been issued to 202 hospitals. Already, replies have been received from about 50 hospitals. This survey will delineate the entire position of the nurses and will enable us to draw more accurate conclusions than ever before. I would not agree that the shortage of nurses would justify my making any change.
10.
asked the Minister for Health if he will give a direction to all hospital authorities not to increase deductions from salaries of resident staffs in respect of residence and rations.
The last review of charges for the emoluments of accommodation and rations was made in 1964. The House will be aware that the Public Accounts Committee, in their report on the Appropriation Accounts 1966-67, drew attention to the fact that charges for services provided for resident hospital staffs had not been increased in recent years although salaries and wages had increased considerably. Against this background, I would not feel justified in giving the direction sought by the Deputy—especially since the present revised charges, which are still uneconomic, are based on the report of a firm of accountants who undertook a costing investigation.
Would the Minister not agree that a time when negotiation is going on and when nurses are dissatisfied is the wrong time to make any movement towards deductions from their salaries? Would such restraint not help to foster better staff relations?
As any increase in remuneration will include the first phase of the twelfth round this matter could be considered. It is simply a question of the remuneration of any official in relation to emoluments.
Deductions have already been made with effect from 1st April on the express instruction of the Minister's Department. Surely the proper thing would be to wait until this round of increases in wages and salaries was negotiated?
In the light of the views of the Committee of Public Accounts, I did not intervene. I do not think it will prevent a reasonable settlement if the arbitrator's award is accepted. Any increase awarded to the nurses—which has to be announced by the arbitrator and consented to by me, with the permission of the Minister for Finance—will naturally take into account part of the twelfth round. With regard to nurses who live in, no doubt the nurses' organisation will have regard to this factor in negotiation.
In the light of the two major strikes at present proceeding in this country, surely staff relations are more important than emoluments and surely they are not improved when a disimprovement in conditions or emoluments is applied by the Minister before the final negotiations on that wage round are completed? Surely the Minister must agree that he has done wrong?
It would be well if Deputies would read the statement which has been circulated with the consent of the Ceann Comhairle. In the past 12 months, there have been progressive improvements. I do not think Deputies will feel there has been anything but a steady improvement in the conditions of this most valuable vocation in the community. I hope these negotiations will be successful.
This is the second deduction in income for these people this year. Stamps went up in cost for non-nursing personnel and nursing personnel. Furthermore, there was an increase in emoluments. Surely it should have been possible to defer this until the increase in wages and salaries had been fixed?
I have already answered the Deputy. I do not think I can say anything more. The first phase of the twelfth round will apply to the nurses from 1st April, 1970.
I do not think the Minister can say anything.
It is a blunder in staff relations.
14.
asked the Minister for Health the total number of female nurses who in 1969 resigned their established permanent posts due to the current marriage bar.
The information is not available in my Department, but it is being sought from health authorities in respect of their staffs for a specific period as part of the survey being conducted by An Bord Altranais and the social science department of University College, Dublin. The survey will take some months to complete.
Would the Minister not concede that it is quite retrograde and not in the public interest that nurses are discriminated against and, by virtue of their marriage, are obliged to resign their permanent established positions in the public authority?
I have replied on at least three occasions in the past six months to that point. Unless there is some grave situation we must await, in common with Ministers in charge of other Public Service Departments, the report on the status of women.
The survey will take some months to complete. There is a shortage of nurses. Would the Minister not consider that such nurses should be given an opportunity to remain in their posts on a permanent basis?
If anything really extraordinary or untoward happened in relation to the number of nurses available, I should naturally look at the situation again.
15.
asked the Minister for Health if he will introduce an official 40-hour week with adequate holiday relief for all public health nurses.
20.
asked the Minister for Health if he will limit the working hours of public health nurses who are now on a 24-hour call to the level recently approved for district medical officers; and, if not, why.
With your permission, a Cheann Comhairle, I propose to take Questions Nos. 15 and 20 together.
I understand that the County and City Managers' Association, representing the health authorities, are in touch with the Irish Nurses' Organisation about the claim submitted on behalf of public health nurses for the limitation of their working hours on the basis of a five-day, 40-hour, week. Should my sanction be sought to any settlement I shall be happy to consider the matter.
From where do the County and City Managers' Association derive their functions—I tried to get that information previously and was unable to do so. What Act or section of an Act vests all this authority in the association?
That is a separate question. The question deals with an official 40-hour week for nurses. The Deputy is discussing county managers.
It is not a separate question.
I am afraid I could not quote the Act because there are so many Acts involved in this kind of thing. The Deputy may know that conditions of service, as distinct from remuneration, do not form part of the conciliation and arbitration machinery as now arranged——
I put down a question about that previously.
——and, therefore, conditions of service are considered by the County and City Managers' Association and then referred to me and to the Minister for Finance for sanction. That has always been the case. There is nothing new in that. As I said before, the Minister for Local Government is considering legislation——
I do not think that body should have these powers at all.
——which would establish a single arbitration board.
17.
asked the Minister for Health when he will give a decision to have the night duty allowance applied to all student nurses in whatever hospital they happen to be employed.
19.
asked the Minister for Health if, having regard to the injustice done to student nurses in local authority hospitals by reason of the refusal of the County and City Managers' Association to grant a night duty allowance, he will now direct payment of such allowance to such student nurses on a level paid by voluntary hospitals and, if not, why.
With your permission, a Cheann Comhairle, I propose to answer Questions Nos. 17 and 19 together.
The County and City Managers' Association, representing the employing health authorities, have decided very reasonably that the question of payment of a night duty allowance to student nurses was one for determination by the Hospitals Commission, since the vast majority of student nurses are employed in the voluntary hospitals.
I understand from the Hospitals Commission that they expect to be in a position to make a recommendation to me within the next week. If payment of an allowance is approved, it will apply also to student nurses in the service of local health authorities.
Is the Minister not aware that most voluntary hospitals are paying this allowance and that the discrepancy arises because local authority hospitals are not paying what is being paid already by the voluntary hospitals?
I have answered the Deputy anyway. Nothing the Deputy has said contradicts what I have said.
What I am saying is that the Minister does not have to wait for the Hospitals Commission to issue a report on it.
There must be some voluntary hospitals where they are not being paid; otherwise the Hospitals Commission would not have to investigate it.
18.
asked the Minister for Health the number of hospital interns in the last three years, the names of the hospitals which take interns; the total number of intern posts in such hospitals; and the number of such posts filled in 1969.
In view of the length of the reply, I propose, with your permission, a Cheann Comhairle, to circulate it with the Official Report.
Following is the reply:
The hospitals approved by the Medical Registration Council for internships are:
Dublin:
Adelaide Hospital, Peter Street,
Charitable Infirmary, Jervis Street,
Dr. Steeven's Hospital, Steeven's Lane,
Drumcondra Hospital, Whitworth Road,
Mater Misericordiae Hospital, Eccles Street,
Meath Hospital, Heytesbury Street,
Mercer's Hospital, Mercer Street,
Monkstown Hospital, Monkstown, Co. Dublin,
Royal City of Dublin Hospital, Baggot Street,
St. Colmcille's Hospital, Loughlinstown,
St. Kevin's Hospital, James's Street,
St. Laurence's Hospital, North Brunswick Street,
St. Michael's Hospital, Dún Laoghaire,
St. Vincent's Hospital, St. Stephen's Green,
Sir Patrick Dun's Hospital, Grand Canal Street,
Children's Hospital, Temple Street,
National Children's Hospital, Harcourt Street,
Our Lady's Hospital for Sick Children, Crumlin,
Rotunda Hospital, Parnell Street,
National Maternity Hospital, Holles Street.
Coombe Lying-in Hospital.
County Cavan:
County Surgical and Medical Hospital, Cavan.
County Clare:
County Hospital, Ennis.
County Cork:
County Hospital, Bantry.
Bon Secour Home and Hospital.
County Hospital, Mallow.
Mercy Hospital.
North Charitable Infirmary.
South Charitable Infirmary.
St. Finbarr's Hospital.
Victoria Hospital.
Erinville Maternity Hospital.
County Donegal:
County Hospital, Letterkenny.
County Galway:
Regional Hospital.
Franciscan Missionary Hospital, Ballinasloe.
County Kildare:
County Hospital, Naas.
County Kerry:
St. Catherine's Hospital, Tralee.
County Kilkenny:
County Hospital (St. Luke's).
County Laois:
County Hospital, Portlaoise.
County Leitrim:
Our Lady's Hospital, Manorhamilton.
County Limerick:
City Home and Hospital (St. Camillus).
Barrington's Hospital.
Regional Hospital.
St. John's Hospital.
County Louth:
Our Lady of Lourdes Hospital, Drogheda.
County Hospital, Dundalk.
County Mayo:
County Hospital, Castlebar.
County Meath:
Our Lady's Hospital, Navan.
County Monaghan:
County Hospital.
County Offaly:
County Hospital, Tullamore.
County Roscommon:
County Hospital, Roscommon.
County Sligo:
County Hospital.
County Tipperary:
County Hospital, Cashel.
St. Joseph's Hospital, Nenagh.
County Waterford:
City and County Infirmary.
Maternity Hospital, Airmount.
County Hospital, Ardkeen.
County Westmeath:
County Hospital, Mullingar.
County Wexford:
County Hospital, Wexford.
The total number of intern posts approved by the Medical Registration Council for these hospitals is 332.
In reply to previous Questions the Deputy was informed that information in regard to the number of internships filled was not readily available and would be sought from the health authorities and from the Hospitals Commission. The information obtained three months ago was that there were then 225 interns employed. I would not feel justified in again asking hospital authorities for this information in respect of the previous three years.
21.
asked the Minister for Health to state, as of the latest date for which figures are available, the nursing complement of Dublin Health Authority and the number of nursing posts filled by (a) permanent and (b) temporary nurses and the number vacant.
I presume that the question refers to hospitals other than psychiatric hospitals.
I understand that the Dublin Health Authority's current requirement of nursing posts for their hospitals is 844. The authority now has 370 permanent nurses, 316 temporary nurses, 200 part-time registered nurses who provide services equivalent to about 80 whole-time nurses, and 53 State-enrolled nurses. Over and above these nurses, there are 196 student nurses.
As regards the 316 temporary nurses employed by the authority, 137 of these are unmarried or widowed. Any temporary unmarried or widowed nurse may apply for a permanent vacancy, and, in the normal course, should have little difficulty in securing one.
22.
asked the Minister for Health if he will consider establishing an institute of higher education where nurses could take post-graduate courses in specialised subjects.
The establishment of a faculty for post-graduate nursing education is being considered by An Bord Altranais, the statutory body set up under the Nurses Act, 1950, to advise on matters appertaining to the nursing profession.
I am being kept informed of developments.