FULL RECOMMENDATION
INDUSTRIAL RELATIONS ACTS, 1946 TO 1990 SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990 PARTIES : MID-WESTERN HEALTH BOARD (ST. ITA'S HOSPITAL) - AND - SERVICES INDUSTRIAL PROFESSIONAL TECHNICAL UNION IRISH NURSES ORGANISATION DIVISION : Chairman: Mr Flood Employer Member: Mr McHenry Worker Member: Mr O'Neill |
1. Implementation of review of staffing levels.
BACKGROUND:
2. The dispute concerns staffing levels at St. Ita's, a 160-bedded hospital for the elderly which is located at Newcastlewest, Co. Limerick. The Unions had, in 1997, sought to have increased by a quarter the complement of 44 whole-time equivalents (WTEs). Following industrial action by the Unions in December, 1997 and February, 1998, and, arising from conciliation under the auspices of the Labour Relations Commission, a proposal was agreed by the parties whereby an independent review would be carried out of the staffing levels, with 4 additional WTEs to be put in place in the interim.
The review was furnished to the parties in September, 1998. It recommended, inter alia, the allocation of ten additional staff, including the four already appointed and including 2/3 non-nursing staff. The recommendations were accepted by the parties. However, management indicated that it was not in a position to assign additional staff in the current year but would explore a 2/3 year timescale, while retaining the 4 additional staff already assigned and also implementing the non-staffing recommendations in the meantime. The 2/3 year timescale was unacceptable to the Unions and, accordingly, industrial action was again initiated.
The dispute was the subject of a further conciliation conference under the auspices of the Labour Relations Commission, at which agreement was not reached. The dispute was referred to the Labour Court, on the 7th of May, 1999, in accordance with Section 26(1) of the Industrial Relations Act, 1990. The Court carried out its investigation on the 27th of July, 1999.
UNION ARGUMENTS:
3. 1. A chronic staffing shortage exists at the hospital and the need for ten additional staff has been proven by the independent review which, in recommending additional staff, will allow for the development of patient-centred individualistic and holistic care.
2. The Board, at conciliation, would give no guarantee as to the time frame for implementation, other than a possibility of a phased 1 to 4 year timespan commencing in the year 2000.
3. The present staffing shortage is unfair and unhealthy from the point of view of nursing staff. Accordingly, patients cannot get the quality nursing care they deserve and are entitled to, in such an under-resourced hospital.
4. The nursing staff, who are committed morally, ethically and professionally to caring for patients, are frustrated to the point that they actually considered 'walking out' on the 15th of June, 1999. The Board, having allowed the situation to deteriorate to such a point, in spite of an independent review, has lost a sense of its mission and purpose in health care. In a buoyant economy, patients should not be made suffer in order to balance books and their interest should take priority in the allocation of resources.
5. The recommendation arising from the independent review will have little impact until the chronic staffing situation is addressed. Six nursing staff must, immediately, be appointed in accordance with the recommendations of the review.
6. The notion that the implementation of the review's recommendations was to be "self-funding" is rejected.
BOARD'S ARGUMENTS:
4. 1. The final paragraph of the terms of reference which governed the independent review clearly states that "... acceptance of such recommendations by the Mid-Western Health Board will be subject to the availability of the necessary revenue funding for any changes involved.".
2. Crucial to the Board's acceptance, in full, of the review's recommendations is the mechanism of "self-funding" for additional posts by re-assigning resources internally.
3. The Board has committed itself to significant improvements and developments in the elderly care services, as outlined in the Five Years Action Plan which should have the effect of shifting further the current burden of dependence on long-stay in-patient care by increasing the range of care options.
4. The Board does not see any prospect of obtaining additional funding to meet Union demands given the current over-provision of long-stay care beds in the region relative to the required norms contained in the Years Ahead (the Limerick catchment area alone is over-provided by 18%, i.e., 103 beds).
5. The Board does not wish to see any diminution in the range of services available to the elderly people of west Limerick, at St. Ita's Hospital. It is willing to engage with the Unions in a spirit of partnership and mutual co-operation to examine all the pertinent issues relating to the changes required in the traditional model for the delivery of services to the elderly, both at the St. Ita's Hospital level and throughout the Mid-Western region.
RECOMMENDATION:
It is clear that the parties have not accepted the Report of the independent expert as outlined, both sides accepting and rejecting elements of the recommendations.
The Court is concerned that the problems in the particular hospital have been ongoing for sometime and show no sign of being resolved.
Having considered the written and oral submissions made, the Court is satisfied that the recommendations put forward can form the basis of a solution even if elements of it are not acceptable to each side.
The Court, therefore, recommends that discussions commence immediately between the parties to resolve this dispute. These discussions to be completed within 4 weeks of date of this Recommendation.
The Court will, on request, if the parties fail to agree, make a recommendation on the outstanding issues.
Signed on behalf of the Labour Court
Finbarr Flood
13th August, 1999______________________
M.K./D.T.Chairman
NOTE
Enquiries concerning this Recommendation should be addressed to Michael Keegan, Court Secretary.