FULL RECOMMENDATION
INDUSTRIAL RELATIONS ACTS, 1946 TO 1990 SECTION 26(5), INDUSTRIAL RELATIONS ACT, 1990 PARTIES : DEPARTMENT OF HEALTH (REPRESENTED BY HEALTH SERVICE EMPLOYERS' AGENCY IRISH BUSINESS AND EMPLOYERS' CONFEDERATION) - AND - IRISH NURSES' ORGANISATION SERVICES INDUSTRIAL PROFESSIONAL TECHNICAL UNION IRISH MUNICIPAL, PUBLIC AND CIVIL TRADE UNION PSYCHIATRIC NURSES' ASSOCIATION DIVISION : Chairman: Ms Owens Employer Member: Mr Pierce Worker Member: Mr Rorke |
1. Pay and Conditions of Nurses.
BACKGROUND:
2. In their submissions, the Unions listed 5 claims which they would be addressing. The 5 claims are as follows:-
- (1) The abolition of the proposed lower entry points for the staff nurse grade:
(2) That the salary scale for the grade of staff nurse should equal the grade 5 administrative officer (AO) at the maximum of the scale.
(The Unions are seeking a 12 point scale ranging from £14,382 to £22,200 as of June, 1997).
(3) That full incremental credit be granted to temporary nursing staff.
(4) That the dual qualified nurse scale be applied/extended to cover registered mid-wives and registered sick children’s nurses.
- (5) Claim for the application of retirement for all nurses in the same manner as it is presently available for psychiatric nursing staff:
i.e. the right to retire at age 55 years (subject to a minimum of 20 years’ service).
Claims 2 and 5 were seen to be the major issues.
- There are approximately 26,000 nurses involved in the dispute, of whom 16,000 are members of the INO. The Unions claim that the last major review of the pay of nursing grades was in 1980. There was a gradings and differential claim lodged in 1990 and a statement of claim submitted in 1993. There were a number of discussions on pay under the terms of the Programme for Competitiveness and Work (PCW) and the Programme for Economic and Social Progress (PESP).
Talks took place with the Irish Congress of Trade Unions (ICTU) at the end of January 1996. The talks were convened to discuss a special claim by the nurses under the terms of the PCW. Management claims that an offer costing £20 million was tabled but was rejected by a ballot of the members.
Following negotiations at the Labour Relations Commission (LRC) in March 1996, an improved set of proposals, costing £33.5 million was again rejected by ballot. The Unions had agreed to defer a ballot on industrial action to allow LRC talks to take place.
Talks took place on the 4th June, 1996, between representatives of the Departments of the Taoiseach, Finance, Health and the H.S.E.A. and the I.C.T.U. No agreement was reached. It was, however, agreed that any outstanding issues would be referred to the Adjudication Tribunal which was set up in September, 1994. The Adjudication Tribunal issued its findings (the “Blue Book”) on the 23rd of September, 1996, and found in favour of the nurses on the following issues:-
The bringing forward of the date of payment of pay increases to the Ward Sister, Nursing Officer and related grades;
Introduction of an early retirement scheme which would enable, within criteria to be agreed, 100 nurses per year to retire at age 57 provided they had at least 35 years service;
Preservation of the existing location and qualification based allowances which were to be discontinued;
Postponement of the introduction of the lower points on the salary scale for those starting a nursing career; and
Commitment to a review of the position of the Directors of Nursing and Nursing tutors within a specified time frame.
Management estimated the cost of the new proposals at £45 million pounds. The proposals were accepted by SIPTU and the PNA, but rejected by the INO and IMPACT.
Following rejection of the proposals by its members, the INO served strike notice to take effect from Monday, 10th February, 1997. The other 3 Unions subsequently served strike notice in support of the INO.
It was in this context that the Labour Court invited the parties to attend a Court hearing in accordance with Section 26(5) of the Industrial Relations Act, 1990. A Labour Court hearing took place on the 5th February, 1997.
The present dispute has arisen as a result of Management’s refusal to deal with a number of claims on behalf of the nurses. The last major review of the pay of nursing grades was in 1980. In 1990 the staff side formally lodged a claim for a major review of nurses’ pay and differentials. This effectively marked the beginning of the process which has resulted in the present dispute.
The staff side was willing to negotiate on a number of changes (details supplied to the Court) which would have involved different ways of managing the nursing workload and ensured cost savings. Management had no constructive agenda of its own. Promises to establish a commission to review the nurses’ role were never carried through. Management used these promises of an “imminent review” to ensure that no sectoral claims would be successful. Labour Court Recommendation No’s 12839, 13363 and 13358 are examples of this.
- Statistics sourced from the Department of Health show that the number of admissions rose from 612,932 in 1982 to 708,891 in 1993, an average increase of 16%. They also show that nurses helped reduce the length of stay of each patient, engaged in more intense nursing practices and put more people through out-patient clinics. During this same period the number of nurses working in the health service as a percentage of the total number employed dropped from 52% to 43%.
- The 5 issues
(1) The abolition of the proposed lower entry points for the staff nurse grade:
Management have proposed 2 lower entry points of £1,000 and £500 respectively below the current starting salary of £13,822 effective from the 1st January, 2000. This is devaluing a profession which is already synonymous with lower entry points.
In October, 1994, a pilot programme on completely redefined student nurse education programme was initiated in University College/Hospital Galway allowing student nurses to access both the registered nursing qualification and a diploma in nursing studies from UCG. This programme was extended to many other training hospitals and third level institutions. Nurses are now expected to accept lower entry salaries parallel to enhanced academic qualifications.
The initial loss would be maintained throughout the individual’s nursing career if they stayed in the grade of staff nurse. The savings to management would be enhanced by the fact that the number of student nurses entering the profession has been reduced by 33%.
(2) That the salary scale for the grade of staff nurse should equal the grade 5 administrative officer (AO) at the maximum of the scale.
In 1980, Arbitration Board Report 045 placed the maximum of scale for the staff nurse equal to the grade 4 administrative officer.
All aspects of the work of nurses have changed considerably since the last pay review in 1980. Education qualifications for entry into the profession have increased. There are fewer nurses to deal with more patients. The pay movement of comparable grades e.g. social worker, community welfare officer, radiographer and grade 5 AO shows that staff nurses have lost ground. Nurses work a 39 hour week whereas the other grades work a 35 hour week. Nurses work unsocial hours Monday through Friday with no shift allowance, premiums or unsocial hours payments. The self-development, professional and educational programmes undertaken by nurses are at their own expense.
(3) That full incremental credit be granted to temporary nursing staff.
There are presently 5,500 nursing posts filled in a temporary capacity. Management accepts that this number is too high. The present system does not give full recognition to temporary nurses in terms of experience and knowledge. Nurses with less clinical experience can receive higher pay than temporary nurses by virtue of being permanent. The system militates against professional nurses who for social, domestic or family reasons were not able to obtain a permanent post.
(4) That the dual qualified nurse scale be applied/extended to cover registered mid-wives and registered sick children’s nurses.
Arbitration Board Report No. 146 determined that nurses who hold 2 or more of the following qualifications-
Registered General Nurse,
Registered Mental Handicapped Nurse or
Registered Psychiatric Nurse
would be placed on the dual qualified staff nurse pay scale. As of October, 1996, this shows a difference of £747 at the minimum of the 7 point scale and a difference of £635 at the maximum between staff nurses and dual-qualified nurses. There is no justification for excluding nurses who are registered mid-wives or registered sick childrens’ nurses. It is accepted that second and subsequent qualifications bring a broader depth of knowledge to the holder. Management points out the requirement of additional qualifications to those seeking posts but is slow to reward same.
(5) Claim for the application of retirement for all nurses in the same manner as it is presently available for psychiatric nursing staff:
The Unions are not aware of any other situation in the public service where an anomaly, similar to that between staff nurses and psychiatric nurses, exists. At present psychiatric nurses can retire at 55 years of age. Management's proposals in the "Blue Book" would mean that only 100 staff nurses could retire at 57 years of age. Recent proposals mean that secondary and community school teachers can now retire at 55, an option long open to their colleagues in the primary sector.
There are no longer valid reasons for a difference in nursing grades with regards to early retirement. Nurses are now working in a wholly integrated health service where conditions of employment should be identical.
Nurses in their senior years should not be expected to carry out physical duties which could cause health problems. The average age of a nurse is getting older. The INO, in an independent study on stress carried out in 1993, found that stress levels among nurses were particularly high. Demands on nurses are constantly increasing as is the need to update their skills. Nurses have been waiting 13 years for parity with the psychiatric nurses on the issue of early retirement.
MANAGEMENT’S ARGUMENTS
- (1) The abolition of the proposed lower entry points for the staff nurse grade:
The proposed minimum salary point of £13,327 at June, 1997 compares favourably with starting pay rates for other occupations, including those requiring 3rd level qualifications. Staff nurses commencing their careers can enhance their earnings by up to 22% through premium payments and allowances. No existing staff nurse will be adversely affected by the proposals which will be deferred until January, 2000.
(2) That the salary scale for the grade of staff nurse should equal the grade 5 administrative officer (AO) at the maximum of the scale.
The nature of posts at grade 5 is one of overall responsibility for the management of a specific organisational function. It is a supervisory grade usually involving responsibility for administrative staff at 2 or more levels. There are only 385 posts at grade 5 in the Irish Health Service.
If the Unions’ claim was conceded it would involve special pay increases under the PCW of 25% approximately at the maximum of the scale and over 30% at the minimum of the scale. The total cost involved would be enormous. There would be major repercussive effects throughout the health service and also, possibly, in the public service.
(3) That full incremental credit be granted to temporary nursing staff.
Management attempted to deal with the unacceptably high level of temporary nurses by means of a confined competition in the early 1980s. However, by the end of the decade the number had increased again. An agreement was reached which provided for incremental progression for temporary nurses up to the 5th point of the nurses salary scale. Following the agreement an initiative called
“revised proposals for agreement” was devised. The purpose of the new agreement was to eradicate, as much as possible, the problems of long-term temporary nurses. The achievement of this is more desirable than concession of full incremental credit that the Unions are seeking. Permanent status for nurses would bring better opportunities for training, career development and promotion. Granting full incremental credit would hinder the progress of the initiative. Concession of the claim would cost approximately £25 million annually.
(4) That the dual qualified nurse scale be applied/extended to cover registered mid-wives and registered sick children’s nurses.
The most recent figures from the Nursing Board indicate that there are approximately 11,000 nurses with mid-wifery qualifications and 2,300 with sick childrens’ nursing qualifications. The possession of a qualification which has no relevance to the area in the health service in which a nurse is working does not merit payment on a higher scale. During talks between the parties it was agreed that the dual qualified scale be eliminated. The issue can be returned to at a later date.
(5) Claim for the application of retirement for all nurses in the same manner as it is presently available for psychiatric nursing staff:
Management proposed a pre-retirement initiative from January, 1997 which would facilitate nurses in reducing the amount of actual service commitment in the years immediately preceding their retirement. Anumber of nurses in permanent positions aged 57 years or over could make application to work on a job-sharing basis for a maximum of 3 years prior to retirement, with the 3 years in question to reckon as full-time service for superannuation purposes.
The Unions’ claim was considered by the Adjudication Tribunal. The Tribunal found that the claim for early retirement should be referred to the Government Commission on Public Service Pensions.
RECOMMENDATION:
- In making this recommendationthe Court would expect that the Unions would postpone the proposed industrial action pending the outcome of a ballot on these proposals. To pursue action at this stage would in the view of the Court damage, perhaps irreparably, relations between the claimants and their employers and inflict unnecessary hardship on the community.
The Court established early on that one reason for the present discontent in the Nursing profession was the failure to deliver on an earlier promise to establish a Commission to carry out a thorough investigation of the nurses’ role in the community and in the Health Service itself. This was first proposed in 1990 and again in 1991, 1992, and 1993 and on each occasion they were assured such an evaluation was imminent. It is worth noting that this assurance was given before the P.E.S.P. and P.C.W. national agreements but has never taken place. The Court believes that these earlier promises place the Nurses in a unique position vis-a-vis other groups where no such assurances were given. In the course of the investigation it became clear to the Court that nurses' grievances on this point are well founded. It was demonstrated to the Court that there have been extensive changes in the requirements placed on nurses, both in training and delivery of services, and on top of this that their scales have fallen significantly behind other groups. Accordingly, the Court strongly recommends that the proposed Commission become a reality within one month from acceptance of the Court’s recommendation. Both parties should be involved in agreeing terms of reference which would be wide ranging and include addressing such items as structural and work changes, segmentation of the grade, training and education requirements, promotional opportunities and related difficulties and a general assessment of the evolving role of nurses.
Prior to the Court’s investigation, the question of re-structuring had already been through two processes - one assisted by the Labour Relations Commission and the second by an ad-hoc Adjudicating Tribunal. Both sets of proposals were rejected and following the second rejection the Unions carried out a ballot for strike action. The size of the vote for strike is an indication of the anger and frustration felt by nurses, which cannot be ignored.
At the Court hearing stage the Unions named 5 items in their claim. A difficulty for the Court was that some of the items were not referred to by the Tribunal. In fact there is considerable doubt as to when some of the items were originally claimed.
Note:-For convenience the findings of the Tribunal are referred to hereafter as the
“Blue Book”.
Pay Scales: The Court recommends the following scale:
£
Staff Nurse ScaleYear 1 14,382
June,1997Year 2 15,102 Year 3 15,822
Year 4 16,542
Year 5 17,262
Year 6 17,882
Year 7 18,502
Year 8 19,122
Year 9 19,742
Year 10 20,350 Max.
Plus one long service increment of £650 after three years on the maximum of the scale.
The increases implied in this scale should be calculated so that half of the increased amounts be paid as from June 1996, excluding the effects of the last two phases of the P.C.W.
This scale should be used to calculate corresponding adjustments on the same basis to the basic scales for Psychiatric Nurses and Dual Qualified Nurses only.
Entry Point: The Court sees no merit in supporting the proposed lower entry point in the year 2000 and recommends its deletion. This would more properly be a matter for the Commission to address as part of its examination of training and educational requirements.
Early Retirement:Both sides accept that this is a very difficult issue. It is apparent that the Government is also concerned about the issue as witnessed by the setting up of the Public Service Pensions Commission.
The Court was informed that this body is due to report in 1998. The Court requests that the Pensions Commission give priority to Nurses’ pension claims. In the interim and without prejudice to what the Pensions Commission may decide the Court recommends that the proposals on early retirement set out in the Blue Book be accepted subject to an important adjustment - age 57 to read as 55 where it appears, and the limited quota of 100 p.a. be raised to 200 p.a.
The Court considers thePreRetirementInitiativeas novel and imaginative and it should also be accepted subject to a similar age adjustment i.e. 55 for 57.
Temporary Nurses:Initially the Unions claimed that Temporary Nurses be allowedto proceed to the 7th increment on the scale. Subsequently the claim was altered to the maximum of scale. The Court recommends concession of the original claim of the 7th point.
Both sides agree that the number of temporaries in the system is excessive. Despite efforts to reduce the number a few years ago the number has crept up and remains excessive. The Court recommends as an initial step that the 1700 posts recommended in the Blue Book to be transferred to permanent be increased to 2000. A targeted percentage of temporaries should be agreed, and the monitoring arrangements referred to in the Blue Book be put in place to oversee this.
During the course of the investigation a serious problem in relation to pensions on the transfer from temporary to permanent status was raised. The Court recognises this is a real difficulty for those involved. The Court, however, in the time available to it would not be competent to deal with the issue and recommends that it be referred to the Public Service Pension Commission as part of the general referral recommended above.
Dual Qualification: The extension of the Dual Qualification scale to holders of midwifery and child care qualifications was also claimed by the Unions. Again this does not appear to have been part of the original negotiations. As the Court envisages that all special payments will be examined by the Commission the Court considers it inadvisable to make a recommendation on this claim.
Summary:The Court has addressed the five items claimed in what it firmly believes to be a fair and just manner. On the evidence presented the Court is satisfied that the nurses have fallen behind other grades and the Court has attempted to remedy that position. The terms outlined above are the maximum which could be recommended.
Note:- The Court understands that all proposals in the Blue Book other than those amended by the Court will remain in place. This includes the pay scales listed in the Blue Book other than those already referred to at Page 3.
The Court urges both sides in the dispute to accept these recommendations.
Signed on behalf of the Labour Court
Evelyn Owens
7th March, 1997______________________
C. O'N/D.T.Chairman
NOTE
Enquiries concerning this Recommendation should be addressed to Ciaran O'Neill, Court Secretary.