Putting a price on price­less work of nurses

Yes, nurses are fan­tas­tic, but we need to set aside sen­ti­ment and con­cen­trate on in­dus­trial re­la­tions, writes Wil­lie Kealy

Sunday Independent (Ireland) - - Politics -

NURSES are great. We all love nurses. That’s what ev­ery­body says. And any­one who has spent any time un­der their care in a hos­pi­tal ward says it fre­quently. If that sounds a lit­tle sen­ti­men­tal, it doesn’t mean our ap­pre­ci­a­tion is any less gen­uine.

But the ques­tion we have to ask is: as a coun­try can we af­ford to trans­late our ad­mi­ra­tion for the mem­bers of the nurs­ing pro­fes­sion into pay­ing them what­ever money they feel they de­serve?

Right now 46,000 nurses are threat­en­ing a se­ries of one-day strikes in sup­port of a de­mand for a 12pc pay in­crease. And they have two ar­gu­ments to back up their case.

The first is the fact that the health ser­vice is in con­stant cri­sis with ab­nor­mally lengthy wait­ing lists for pro­ce­dures, and a se­vere short­age of beds which has led to the scan­dal of pa­tients ly­ing on trol­leys in cor­ri­dors, with all the at­ten­dant in­dig­nity and dis­com­fort.

The Ir­ish Nurses and Mid­wives Or­gan­i­sa­tion — by far the big­gest rep­re­sen­ta­tive body with 40,000 mem­bers — reck­ons that these prob­lems could be solved if there were more nurses, be­cause more nurses means more beds and more the­atre time. But be­cause the nurses are so badly paid, it is not pos­si­ble to at­tract and/or re­tain suf­fi­cient num­bers. So the only so­lu­tion is to in­crease nurses’ pay. That is their first ar­gu­ment.

Their sec­ond line of ap­proach is that old in­dus­trial re­la­tions line — rel­a­tiv­ity. Again, ac­cord­ing to the INMO, nurses are paid as much as €7,000 per an­num less than med­i­cal col­leagues who have what they say are com­pa­ra­ble qual­i­fi­ca­tions, such as ra­dio­g­ra­phers and phys­io­ther­a­pists.

On the strength of these two lines of ar­gu­ment, the INMO plans one-day strikes on Jan­uary 30, and Fe­bru­ary 5, 7, 12, 13 and 14. Their 6,000 col­leagues in the Psy­chi­atric Nurses As­so­ci­a­tion plan to ban over­time work­ing on Jan­uary 31 and on Fe­bru­ary 5, 6 and 7; and full strike ac­tion on Fe­bru­ary 12, 13 and 14. Both unions will sup­ply their hos­pi­tals with emer­gency cover, and home vis­its by pub­lic health nurses will con­tinue but will be se­verely re­stricted.

The third nurses’ union, Siptu, which has 4,000 mem­bers, does not plan any in­dus­trial ac­tion and will pass the pick­ets but say they will not pick up the slack to “frus­trate” the ac­tions of their strik­ing col­leagues.

Siptu has de­cided to stick to the ex­ist­ing pay agree­ment, which will see some restora­tion over the next few years (in­clud­ing this year) of pay lost in the re­ces­sion — a to­tal pay in­crease of up to 8pc — with the is­sue of nurses’ pay to be dealt with as a stand­alone is­sue in the next agree­ment. (as part of this agree­ment, mem­bers of the two strik­ing unions are en­ti­tled to these ben­e­fits also, but only if they re­frain from tak­ing in­dus­trial ac­tion).

This is what the Gov­ern­ment and the HSE is hop­ing they will be able to per­suade the nurses threat­en­ing strike to also ac­cept when they meet for talks on Tues­day.

It would have a price tag of about €20m and would in­clude in­creased al­lowances, bet­ter ac­cess to pro­mo­tional posts, and some mea­sures to help low­er­paid nurses. And there is the pro­posal from the Pub­lic Ser­vice Pay Com­mis­sion (which came out against the nurses’ de­mands last Septem­ber) for a re­view of nurses’ roles, re­spon­si­bil­i­ties, pro­fes­sional de­vel­op­ment and pay.

This lat­ter el­e­ment could be a so­lu­tion and one that the nurses might ac­cept, but un­for­tu­nately it seems the Gov­ern­ment does not feel able to en­ter into such a re­view any time soon, no doubt aware that it would al­most cer­tainly bring them speed­ily back to hav­ing to deal with the present de­mands.

What makes the Gov­ern­ment shy away from the nurses’ pay claim is the over­all cost, which they reckon could amount to €300m. But there is also that rel­a­tiv­ity bug­bear. When the “blue flu”-threat­en­ing gar­dai were given a spe­cial deal worth €50m two years ago, it cost a fur­ther €120m to buy off other pub­lic ser­vants who de­manded to be treated sim­i­larly. And al­ready Forsa, the big­gest pub­lic ser­vice trade union, has made it clear that any con­ces­sion to the nurses will be fol­lowed im­me­di­ately by de­mands for par­ity for other work­ers.

Look­ing at the work that our nurses do in such try­ing cir­cum­stances as cur­rently ex­ist in the Ir­ish health ser­vice, there is no doubt it is price­less.

But un­for­tu­nately we do have to put a price on it and at present, ac­cord­ing to the De­part­ment of Pub­lic Ex­pen­di­ture, that price is €31,110 ba­sic salary with al­lowances and premium pay bring­ing the fig­ure to more than €37,000.

So what is the Gov­ern­ment to do?

So far the is­sue has not be­come a po­lit­i­cal foot­ball. Fianna Fail’s Stephen Don­nelly con­ceded that there isn’t €300m avail­able to pay the nurses overnight, but added: “There is a gen­uine prob­lem with pay and con­di­tions... I think there is an op­por­tu­nity to evolve and im­prove the nurs­ing pro­fes­sion.”

And while Labour says it fully sup­ports the nurses’ de­ci­sion to go on strike, their health spokesman, Alan Kelly, re­stricted him­self to call­ing on the Gov­ern­ment to “sit down with the nurses to ad­dress their is­sues”.

There can be no dis­put­ing the con­tin­u­ing sorry state of the health ser­vice. But throw­ing money at the prob­lem as a prospec­tive so­lu­tion has been dis­cred­ited, with bud­get af­ter bud­get over­run, so that even­tu­ally you have to look at the sys­tem and the way the ser­vice is man­aged by those in charge.

No­body can deny the vi­tal role of nurses in the health ser­vice, the con­tri­bu­tion they make or the po­ten­tial they have to help im­prove the sit­u­a­tion. But it is doubt­ful if mak­ing it worse with one­day strikes to make it bet­ter is the best ap­proach.

And while they un­doubt­edly have the best in­ter­ests of their pa­tients in mind when they say that more nurses and an end to the ex­o­dus of young nurs­ing tal­ent from our hos­pi­tals is im­per­a­tive, link­ing their pay de­mands to the pay of oth­ers helps us see the pure in­dus­trial re­la­tions as­pect of this dis­pute.

So per­haps we should put aside all sen­ti­ment, so that the par­ties con­cerned can see it as a sim­ple in­dus­trial re­la­tions dis­pute for higher pay, with the nor­mal mech­a­nisms of the Labour Re­la­tions Com­mis­sion and the Labour Court avail­able, when the two sides sit down to talks this week.

‘Forsa, the big­gest pub­lic ser­vice trade union, has made it clear that any con­ces­sion to the nurses will be fol­lowed im­me­di­ately by de­mands for par­ity for other work­ers...’

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