What’s another year for burnt out medical scientists?
'Medical scientist' is the legally protected term held by the majority of scientific staff working in our hospital laboratories.
As we move into the early weeks of 2024, it feels appropriate to reflect on another tough year for medical scientists in Ireland.
Johnny Logan once famously sang “I’ve been waiting such a long time, looking out for you, but you’re not here, what’s another year.” He probably wasn’t referring to industrial relations processes in Ireland, but I can think of nothing more appropriate to describe them, especially in the case of medical scientists.
By way of example, let me outline the treatment of these dedicated scientists who are vital to the functioning of our health service.
'Medical scientist' is the legally protected term held by the majority of scientific staff working in our hospital laboratories. It is a highly specialised, dynamic and rapidly evolving profession of roughly 2,500 dedicated scientists nationally.
Medical scientists are an integral part of the healthcare workforce, involved in every step of the patient journey including screening for illness, infection prevention and control, risk stratification, acute presentation and management, diagnosis, monitoring disease progression and evaluating treatment efficacy, discharge protocols and palliative care.
An unseen and undervalued workforce, they are there for their patients 24/7/365 in every acute hospital in Ireland. Every time you have a sample taken, be it blood, a swab, a biopsy or anything else that can be taken as a sample, there is a medical scientist waiting to receive and test it.
A common mantra among the workforce is very true — without us, the doctors are just guessing.
95% of clinical pathways require input from laboratories. Which antibiotics will work on this infection? Which blood type can I transfuse this patient with? What chemotherapy regime will be most effective for this patient’s cancer? Does this patient have indigestion or are they having a heart attack?
These are all questions which are answered in the laboratory, and yet the patient will never know of the vital input of the medical scientist who answered it.
In April 2019, I was elected as chairperson of the Medical Laboratory Scientists Association (MLSA), the representative body for medical scientists in Ireland. The profession was in a state of crisis and had been for some time.
Some laboratories were reporting staff vacancies of up to 20%, with an average of 13% of positions vacant nationally. Graduates from the approved medical scientist university courses in Ireland had been going elsewhere for employment for a number of years, balking at the working conditions and onerous demands of such a high-pressure, low-reward career.
Morale among existing staff was stretched to breaking point as they tried to maintain services against a backdrop of increasing demand for more tests, new tests, increased specialisation of tests, and quicker turnaround times. The entire system lay on the brink of collapse; urgent action was required.
Throughout the remainder of 2019, the MLSA formulated a plan to claw our way out of the situation we were in. Membership of the association had dwindled to about 1,300 members throughout the austerity years as trade unions reeled from the effect of FEMPI legislation introduced in 2010 and 2013.
Unions were limited in what they could seek for their members due to public service agreements. Currently, the Irish Congress of Trade Unions (ICTU) are trying to negotiate the removal of this emergency legislation. Agreement has not yet been reached which may result in a full public service strike in the new year.
The MLSA campaign was rightly paused in 2020 due to the outbreak of the covid-19 pandemic. “Test, test, test,” said the WHO, and medical scientists delivered. As thousands died in Ireland, medical scientists were lauded far and wide for the enormity of their contribution.
By January 2021, the system could take no more. The entire workforce was burnt out and the challenging working conditions of medical scientists again came to the fore. 96% of MLSA members voted to reject Building Momentum, the next in a series of public sector agreements.
It should be noted that Building Momentum contained many pay rises for public servants, retracting the pay cuts forced on all by FEMPI legislation, yet MLSA members knew this would not be sufficient to address their recruitment and retention crisis.
Meanwhile, the government was reluctant to engage. In November 2021, MLSA members voted by a majority of 98% to take industrial action. The resulting negotiations again saw no movement from the employer side.
Notice was served for late March 2022, but then withdrawn to seek resolution through the Public Service Agreement Group (a body set up within Building Momentum to resolve dispute issues). Again the employer side would not budge and strike notice was re-issued, this time for May 2022.
This would result in the first strike action by the MLSA in its 60-year history. On the 18th and 24th of May 2022, the health service in Ireland ground to a halt as procedures were cancelled all over the country.
Lack of laboratory input meant that practically no patient care could go ahead. On the second day of the strike, a two-hour debate in Dáil Éireann was held on the plight of medical scientists. All recognised their massive contribution to healthcare.
A motion to grant the demands of medical scientists was defeated that day, voted down by the government in favour of Minister Stephen Donnelly’s amendment that “all sides use the established dispute resolution mechanisms of the State …… and suspend industrial action while this process is ongoing.”
The Labour Court intervened that day also and invited both sides to exploratory talks. In a letter to both sides, the court referred the issue back to the Workplace Relations Commission where the MLSA reluctantly agreed to an independent report to verify our claim.
After many delays from the employer side (they couldn’t find a technical assessor, they needed more time to consider their response to the draft report), that report was published in January 2023. Everything medical scientists had said was completely vindicated in the report, all that remained was to implement the recommendations.
However, it was not implemented.
By June 2023, the MLSA again pleaded the case of medical scientists to the Labour Court. Again the court ruled that the report be implemented. So here we are, still waiting. There is something terribly, terribly wrong with the way industrial relations issues are processed in this country in my opinion.
The MLSA was looking for equal pay for equal work, a cornerstone of any proper workplace practice, yet it has taken years of arguing the same indisputable case to progress the claim. No one disagrees with the claim, there is no argument against it, and yet it remains unresolved after all this time.
- Kevin O'Boyle is outgoing chair of the Medical Laboratory Scientists Association
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