Dáil Éireann díospóireacht -
Thursday, 10 Apr 2003

Vol. 565 No. 2

Adjournment Debate. - Industrial Disputes.

Ms McManus

Next Monday 270 public health doctors will go on strike. These doctors provide an important service which is often undervalued but is crucial in protecting the public good. Unless the Minister for Health and Children takes action to resolve this dispute we are facing the prospect of a withdrawal of key medical personnel including those at the Disease Surveillance Centre, an end to safeguards currently in place to prevent the spread of infectious diseases and a block to the development of a strategy to protect this country from the spread of diseases from abroad. The need for such a strategy is now pressing in the context of the holding of the Special Olympics, a major international event involving over 35,000 people travelling to Ireland from many parts of the world.

The current threat of the SARS virus as well as other infectious diseases is greatly increased by travel yet we have no indication from the Government as to its intentions in protecting public safety. What steps is the Minister for Health and Children taking to resolve this dispute? His bland statement that this matter be referred to the Labour Court has been shown to be grossly inadequate. Is he aware of the complexity of the issues involved? Is he aware, for example, that public health doctors receive no payment for their out-of-hours work?

In view of the call by the EU Commissioner, David Byrne, today for an effective early warning system to be developed on an EU wide basis to deal with the threat of infectious diseases what is he doing to develop a good public health infrastructure in Ireland in line with other EU countries? What preparations are in place to carry out risk assessment in relation to the travel associated with the Special Olympics and what briefing is being done to inform the international delegations of the true nature of our public health infrastructure? Does the Minister for Health and Children agree that we cannot afford to wait for a crisis to occur before this issue is addressed and that the best approach to fears being expressed by members of the public is to implement a clearly understood and resourced strategy of public health measures?

Does the Minister also accept that his tardiness on this issue compares badly with the effective and well funded strategy which was successful in combating the threat of foot and mouth disease in animals and that it is hard to fathom why measures are still in place in our airports to counteract this disease among animals while there appears to be no measures in place to prevent the spread of infectious disease among humans?

Currently there are no special arrangements in place to prevent the spread of SARS in Ireland. Internationally the rate of spread has lessened but this should not be a cause of complacency. Countries like Canada, China and others in Asia are experiencing serious problems in terms of the containment and prevention of the spread of this disease. Already the World Health Organisation has criticised the failure of the Chinese authorities to provide full information on SARS. Is the Government satisfied that guidance given by the World Health Organisation is based on complete information? Will the Minister for Health and Children outline how he will ensure that public health doctors will be in place from Monday onwards and that there will be a mechanism in place to resolve the ongoing and long-standing difficulties in relation to their complaints to ensure they can be resolved? Will he ensure we have a clear and good public health infrastructure to protect the population here in terms of infectious diseases like meningitis or measles but also to deal with these new diseases like SARS, which has only recently become evident but clearly has attached risks that can lead to deaths in our population as it has led to deaths in other populations if it is not properly addressed?

Minister of State at the Department of Health and Children (Mr. B. Lenihan)

I thank the Deputy for raising this matter on today's Adjournment. In 2002, the public service benchmarking body recommended increases for public health doctors ranging from 2.5%, in the case of specialists in public health medicine, to 14.2%, in the case of the directors of public health medicine. In making these recommendations, the benchmarking body was determining the rate of pay which should apply to the various public health posts based on their duties and responsibilities as of 30 June 2002. However, the benchmarking body did acknowledge that it was not in a position to take account of the issues raised by the Public Health Review Group, the Brennan group, in relation to the restructuring of public health service provision.

The Irish Medical Organisation, the representative organisation for public heath doctors, has lodged a claim for a 30% pay increase, in advance of any discussion or agreement on future changes in work practices arising from the negotiations on the Brennan report or that will be required under the health and primary care strategies or the Prospectus report on structures in the health system. This claim is in addition to increases of up to 1% which have been approved by the public service benchmarking body and the 7% increase which will be paid under the terms of the new national pay agreement Sustaining Progress. As mentioned, the benchmarking body has determined the rate of pay to apply to the current duties of public health doctors and negotiations on any further increase could take place only in the context of changes arising from the recommendations of the strategies I mentioned. However, I wish to advise the Deputy that the Health Services Employers Agency has confirmed to the IMO that it is willing to make good any pay increases public health doctors may have lost out on because of the delay in completing the Brennan review, in addition to the pay increases recommended for public health doctors by the public service benchmarking body. These cumulative increases will amount to approximately 27% in the case of directors of public health, with the new national pay agreement providing a further 7%.

As the Deputy will be aware, the management position must reflect the recommendations of the public service benchmarking body and must comply with other elements of Government pay policy. Within these requirements, management has made a substantial offer of a cumulative 10.8% in recognition of outstanding pay elements. This offer has been rejected by the IMO.

Both the Health Service Employers Agency and the Department of Health and Children have written to the Irish Medical Organisation indicating their opposition to the current action and requesting the reconvening of talks, including the intervention of the Labour Court. The IMO decision to issue notice of strike action is unwarranted and especially inappropriate in view of the potential risk associated with SARS and the range of current health issues which require the involvement and co-operation of public health doctors. A management team, comprising officials from my Department, the Health Services Employers Agency and the health boards, held negotiations with the Irish Medical Organisation in the Labour Relations Commission on a number of occasions in recent months. I understand that the HSEA has accepted an invitation from the Labour Relations Commission to resume discussions and has urged the IMO to participate in this process. I have already requested the Irish Medical Organisation to return to these negotiations or to accept my invitation to attend the Labour Court. Both of these offers have been refused and I now again request the IMO to re-consider its position in this matter in an attempt to resolve the current impasse.

In the event of this strike going ahead on Monday next, the Health Service Employers Agency has sought confirmation from the IMO as to the level of emergency cover that will be provided by public health doctors across their range of responsibilities, including the SARS outbreak. At a meeting yesterday, the IMO indicated that the strike action will involve all public health doctors and that requests for emergency cover should be channelled to the IMO national strike committee, who will ensure that emergency cover will be provided in circumstances where that committee is satisfied that there is a real and immediate risk to human life. I understand that the Health Service Employers Agency is trying to arrange a further meeting with the IMO tomorrow in order to seek further clarification and assurances in relation to the provision of appropriate levels of emergency cover.

I again request the Irish Medical Organisation and public health doctors to withdraw from their proposed strike action, to resume normal working activities and to participate in the processes which are available to resolve this dispute.