Des McSweeney: It’s time to focus on what matters — people
When I first spoke out in the Irish Examiner on March 16, I was motivated by a concern for the wellbeing of people in need of mental health services. I hoped that by speaking out, I would not be a witness to another disaster in the HSE that could cost someone their life.
In my naivety, I thought the HSE would listen and that clinical issues would be finally addressed, paving the way for our new acute mental health unit to open, a unit, which, if properly staffed, can play a vital role in delivery of services to people in Cork City and county.
However, the building at CUH stands idle while the HSE maintains that they have “done everything we can” to address our concerns, arguing that their proposed staffing levels will be “safe and appropriate”.
The reality is that we are the people working on the ground and it is our contention that using healthcare assistants to boost staffing levels at the unit — the HSE has offered 10 additional nurses and five additional healthcare assistants — is not adequate. Healthcare assistants are not mental health nurses, and in a time of crisis, a mental health nurse is what the patient needs.
READ MORE: HSE clears outspoken nurse for return to work .
Despite making this point repeatedly through our unions, we feel our concerns have not been taken on board. Instead what we see is the HSE attempting to use the industrial relations mechanisms of the State to force a deal through. The HSE talks about “respecting the industrial relations process” while at the same time using this process to deal with clinical issues that will impact on the delivery of services to people and influence their chances of recovery.
As a Siptu shop steward, I have had numerous communications with the HSE in relation to this new unit where I have repeatedly requested that clinical concerns be reviewed. Instead, the HSE focus was on getting the matter to the Labour Relations Commission, and now the Labour Court, after nurses rejected the LRC recommendations.
Past form shows the Labour Court cannot make judgments on clinical issues. We were there in 2012 raising concerns about cuts to funding and staffing and plans to introduce “multi-task” attendants — who, despite no relevant qualifications, were subsequently introduced into the mental health service — but the Labour Court came down on management’s side.
In its recommendation at the time, the court said that clinical and care design, and policy issues involved in the dispute “were not matters for the court to decide.
Accordingly the court has confined itself to the industrial relations matters that arise in this case”.
The court also recommended that, in parallel with full co-operation with the introduction of changes management sought, that unions and management should engage and tease out details that “remain vague or ill defined”.
On foot of that experience, I don’t believe the Labour Court is the appropriate forum to decide on issues at stake here.
The LRC, where this matter has been discussed on a number of occasions since January, also stated that it does not have the capacity to make judgments in relation to clinical issues. So why has the HSE chosen this route? Is it because, having failed to convince the nurses that their concerns have been addressed, they now hope a body with no capacity for clinical judgement will come down on their side?
It has happened in the past and this frightens me, not just on account of the implications for our new unit, but also for services which, in the future, face a dilemma similar to ours.
We remain unhappy with the proposal to use healthcare assistants and to put on hold plans to open a six-bed high-observation unit. We remain unconvinced the HSE will source additional staff in the future should the unit come to pass. To date, they have not confirmed where these nurses would be sourced from, and it’s our belief nursing numbers will be reduced in other areas to facilitate the opening of the high-observation unit.
When the matter arose at the LRC, HSE management revealed they no longer had a budget to open the high-observation ward because the money had been spent elsewhere.
At the end of the day, confidence in the HSE is low. This is reflected in the strength of the no vote, which, despite incentives to 60% of staff through offers to regularise those in acting posts and to make permanent temporary staff, was resounding.
The challenge now facing HSE management is to take reasonability and finally address the clinical issues obstructing the opening of the unit, and to finally focus on what matters — people.
READ MORE: HSE clears outspoken nurse for return to work .
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