Seanad Éireann díospóireacht -
Tuesday, 10 Nov 2009

Vol. 198 No. 1

Hospital Staff.

Senator Pearse Doherty

I wish to raise a serious issue that has escalated in recent weeks, although it has been ongoing for more than four years in Gaoth Dobhair.

Áras Ghaoth Dobhair, a 41 bed care of the elderly community nursing unit, was established in 2004. It is funded by the HSE with contributions from Údarás na Gaeltachta and people and businesses locally. The vast majority of funding, however, comes from the HSE. One bed is private while the rest are funded by the HSE, which also pays all of the running costs and has two nominees on the board of directors, while the director of nursing is seconded from the HSE. The problem for the facility is that the workers in Áras Ghaoth Dobhair are not treated similarly to employees in nursing homes in the public sector.

The argument made by the HSE is that the centre is not a HSE centre, it is community-run, something we all understand. Nearly everything paid for by the centre such as the staff, food, toilet rolls and disinfectants is funded by the HSE. However, the differential in payments between what staff receive in this centre and a HSE-run facility a couple of miles away is massive. The majority of the staff have decided not to accept these conditions any longer and have embarked on work stoppages. The first took place at the beginning of last month after talks broke down between management and staff representatives. Earlier this week they were again involved in a two-day stoppage. This boils down to a number of problems. First, there is a problem with pay and conditions but primarily pay. The discrepancy between the basic rate of pay for a carer in this centre compared with any of the HSE-run centres in County Donegal is approximately €6. I am informed that no overtime or unsocial hours allowance is paid in the centre and that there are no pension rights or sick leave arrangements. However, the centre is almost exclusively funded by the HSE.

I seek the intervention of the Minister for Health and Children in the dispute. The staff are clear that their issue is not with the board of management of Áras Ghaoth Dobhair. The members of its board of management were the visionaries who came up with the idea of having a 41-bed unit in Gaoth Dobhair which is located in the centre of the Gaeltacht and provides an excellent service for the elderly of the district and neighbouring communities. The issue is with the HSE. This model of private nursing home has been created in order that the HSE will not be obliged to pay the wages or provide for the conditions that members of staff of HSE-run centres receive or enjoy. Therefore, this issue pertains to driving down wages and conditions and the representatives will no longer stand for it. I have spoken to the workers on the picket line and they are determined to see this through. This is a source of great anxiety for the workers, patients, the board of management and, I am sure, the HSE. No one desires this dispute, particularly in the run-up to Christmas. A way should be found to enable HSE representatives to negotiate with staff representatives to reach a compromise. This is all about compromise; both sides must find some common ground on the issue, although I understand the Government's difficulties in respect of the country's current financial problems.

The matter has been brought to the Labour Court which has made a number of recommendations that would incur a financial cost on the employers. I am informed the employers will not agree to fulfil these recommendations on issues such as sick pay, premium pay and pension schemes. They have told the staff representatives that they will not honour the Labour Court decision. Moreover, even at that point, the staff representatives were not satisfied that this was the middle ground required. Consequently, there is a need for intervention. I hope the Minister can show experience and provide leadership on the issue.

Deputy Martin Mansergh

I thank Senator Doherty for raising this issue, as it provides me with an opportunity to outline the background to the current position. Government policy is to support older people to live in dignity and independence in their own homes and communities for as long as possible. Where this is not feasible, the health service supports access to quality long-term residential care.

The Health Service Executive in its support for the provision of health and personal social services nationally, provides grants for extensive numbers of organisations in the community and voluntary sectors, as well as purchasing services from private health service providers. These provisions do not entail the HSE taking responsibility for the terms and conditions of employment or other costs associated with the organisation or company. These are matters for the individual organisations or companies or both as the direct employer.

Áras Ghaoth Dobhair is a 41-bed private nursing home situated in Gweedore with a special focus on providing services for native Irish speaking patients. It is made up of 20 nursing beds, 20 beds for Alzheimer's disease patients and one palliative care bed. The nursing home is subject to the new national quality standards for residential care settings for older people and the new care and welfare regulations for nursing homes introduced in July. I understand a complement of 46 staff are employed at the home, or 36 in whole-time equivalent terms.

The Department of Health and Children has been informed that Áras Ghaoth Dobhair is a private company which is registered as a private nursing home. The company receives revenue from the contracting of beds by the Health Service Executive and through the provision of care for private patients. The total level of annual funding provided by the HSE for contracted beds is €1.428 million. While it receives funding from the HSE, direct responsibility for the terms and conditions of employment of its employees is a matter solely for the employer, namely, Áras Ghaoth Dobhair.

I understand the dispute concerning terms and conditions of employment of staff at Áras Ghaoth Dobhair has been the subject of a conciliation conference under the auspices of the Labour Relations Commission. As the parties concerned did not reach agreement, the dispute was referred to the Labour Court and the hearing took place earlier this year. I understand the Labour Court, having examined the oral and written submissions of both the union and the company, did not recommend in favour of concession of the union's claim for the application of HSE rates of pay, terms and conditions of employment for the grades involved, namely, non-nursing grades. It did, nonetheless, recommend improvements to the conditions of employment in respect of both premium pay and sick pay. It also recommended that the employer should introduce a pension scheme.

The Minister does not consider it appropriate that she should intervene in an industrial dispute such as this. She is particularly concerned that the safety and welfare of the residents in the home are not compromised as a result of the dispute. She has been assured by the Health Service Executive that it is monitoring the situation closely and that it will take the necessary steps to provide accommodation for the residents should the need arise.

Senator Pearse Doherty

I thank the Minister of State for his response in the early hours of the morning. One point contained in my original Adjournment matter request was not answered: whether the Minister would support the absorption in full of the centre into the HSE scheme. That obviously would solve the problem. The Minister of State also referred to the Labour Court recommendation. The problem in this regard is that the centre is community-run and the employers have no source of income, apart from what comes in from the HSE and a single private patient because the 40 beds are contracted to the HSE. Consequently, they cannot live up to the Labour Court recommendations because all the money comes from the HSE. Unless the HSE provides them with the money, they have no money to give. The statement made recently by the employers was to the effect that honouring the recommendations would be financial suicide for the company set up to deal with the centre.

The Minister of State has given an accurate account but the problem is that the board of management cannot deal with claims for pension schemes, sick pay or premium pay, even in the limited fashion recommended by the Labour Court, unless the HSE agrees to increase its funding in order that it can so do. The employees only seek that the cost of implementing them be structured in a better way to meet their needs. While I do not expect the Minister of State to reply to my comments, perhaps he will relay some of my points to the Minister of Health and Children in order that the issue can be revisited. It is a horrible sight to see workers who only have their patients' interests at heart out on strike early on a Monday or Tuesday morning. They really would prefer to be caring for their patients and the local board of management is caught in the middle.

Deputy Martin Mansergh

I understand the points made by the Senator regarding the limited capacity of the company to pay. Realistically, however, having read the Minister's reply on her behalf, it does not appear as though its direct absorption into the HSE is contemplated. I will pass on the concerns expressed by the Senator.

The Seanad adjourned at 2.20 a.m. until 10.30 a.m. on Wednesday, 11 November 2009.