Health service dispute - Consultants row will only deepen crisis

AS THE bitter dispute between nurses and the Health Service Executive gets ever deeper, the Government faces another major row as highly-paid consultants threaten to thwart its bid to smash Ireland’s two-tier health system.

In this explosive scenario, patients are the unwitting victims of rapidly deepening cracks in the health service. Increasingly, they are at risk.

Luckily, no major incidents occurred during yesterday’s one-hour work stoppage by nurses at hospitals in Dublin and Clonmel. But with the nationwide work-to-rule continuing, and further disruptive action due to hit hospitals countrywide, including Dublin and Roscommon tomorrow, the danger of a tragedy looms.

If a fatality happens, it will backfire on the country’s 40,000 nurses who still have a remarkable degree of public support. While cancer, palliative care services and Warfarin clinics are running as normal, hospitals have managed to provide safe levels of cover for critical care areas and emergencies.

Ironically, the message from the INO, the nursing union, is that patients have never received better service now that staff have withdrawn from administrative work. If anything, this demonstrates the weakness of their two-pronged demand for a 10% pay rise plus a 35-hour working week. Arguably, if patients are getting a better quality of service during a work-to-rule, the obvious question is why should nurses get more money for shorter hours?

Squaring that circle is the challenge facing the National Implementation Body (NIB) which held talks about talks yesterday in a second bid to resolve this row. Ominously, three weeks of earlier talks chaired by the NIB, the trouble-shooting unit overseeing the social partnership agreement Towards 2016, failed to secure agreement between health service employers and the two nursing unions.

While the HSE and nurses agree talks should get under way, the trick will be to find common ground for a deal acceptable to both sides. Given the militancy of the nursing unions, there is a growing sense the HSE will have to make a significant shift in its negotiating position. This means the executive would have to get the green light from Government to go some way towards conceding the 27-year-long demand by nurses for a 35-hour week.

Whether a deal is achieved through bench marking or some other vehicle, surely it should not be beyond the resources of management and unions to work out a formula capable of putting nurses on a par with other sections of the public service. Meanwhile, nurses have signalled their willingness to compromise on the 10% pay rise.

A large part of the problems besetting the health service is the imbalance of under-staffing in hospital wards and the degree of over-administration at management level.

With an election looming, and with the fortunes of the Coalition already waning in opinion polls, Health Minister Mary Harney is under intense pressure from jittery backbenchers to draw the sting from the health nettle before they start knocking on doors.

Compounding the minister’s headaches, salary negotiations with high earning hospital consultants are on the verge of break-down. In its bid to dismantle Ireland’s two-tier health system the Government intends recruiting hundreds of new consultants, beginning next Tuesday, if consultancy contracts worth around €200,000 are not accepted by then. In reaction, consultants are set to withdraw cooperation in certain areas.

Ultimately, both disputes will have to be resolved. The sooner heads are knocked together and common sense prevails, the better it will be for nurses, consultants, the health service, the public and, above all, beleaguered patients and their anxious families.