FULL RECOMMENDATION
INDUSTRIAL RELATIONS ACTS, 1946 TO 1990 SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990 PARTIES : DEPARTMENT OF HEALTH AND CHILDREN HEALTH SERVICE EMPLOYERS AGENCY DEPARTMENT OF FINANCE (REPRESENTED BY THE HEALTH SERVICE EMPLOYERS' AGENCY AND THE IRISH BUSINESS AND EMPLOYERS' CONFEDERATION) - AND - IRISH NURSES' ORGANISATION SERVICES INDUSTRIAL PROFESSIONAL TECHNICAL UNION PSYCHIATRIC NURSES' ASSOCIATION IRISH MUNICIPAL, PUBLIC AND CIVIL TRADE UNION DIVISION : Chairman: Mr Flood Employer Member: Mr Pierce Worker Member: Mr Rorke |
1. Hearing arising from Labour Court Recommendation LCR16084.
BACKGROUND:
2. LCR16084 dealt with claims lodged by the Nursing Alliance as a result of two recommendations contained in the Report of the Commission on Nursing.
The two recommendations were:
"The Commission recommends that differentials and
incremental annual leave in promotional grades be
examined as a matter of urgency, before the end of
December, 1998, through the established structures. To this
examination should be added the effect of the enhanced
role for ward sisters and higher grades which has been
recommended by the Commission earlier in this chapter."
and
"The Commission recommends that the question of
additional recognition of long service for staff nurses
be examined through the established structures."
In LCR16084, the Court indicated it was not in a position to make a definitive recommendation on the issues before it, given that no negotiations had taken place between the parties. The Court recommended "that the parties enter into discussion immediately on the implementation of the Report on Nursing".
The parties met on the 25th of February, 1999, but difficulties emerged immediately. Following intervention by the Court, a chairman was appointed to assist the parties and to report back to the Labour Court.
While progress was made, the parties failed to reach agreement on a number of issues. Labour Court hearings were held on the 29th and 30th of April, 1999, at which comprehensive written and oral submissions on a range of issues were made by both parties, and the Court subsequently met separately with each side.
RECOMMENDATION
RECOMMENDATION:
The changes in the role of nurses over several years were first proposed for referral to a special commission as far back as 1990, with a view to assessing the extent of up-skilling that had taken place in their work, to consider the effect of these changes on the position of nurses' pay relative to other groups of employees in the general work force.These issues finally came under discussion in 1996, and have since been the subject of proposals of an Adjudication Tribunal and three Labour Court Recommendations.Following the rejection of the Adjudication Board's proposals, the matter came before the Labour Court in February, 1997. The Court issued LCR15450, dealing with the five claims raised by the Unions at the time, which included the pay scales for staff nurses.
As a result of the implementation of the Adjudication Board's proposals (Blue Book), as extended by LCR15450, significant pay increases were awarded to all nursing grades.
However, the Court, in its recommendation in 1997, was critical of the failure to put in place a Commission to carry out a thorough investigation of the nurses' role in the community and in the Health Service, although this had been proposed regularly since 1990. The Court recommended that a Commission be set up immediately to address such items as structure and work changes, grading, training and educational requirements, promotional opportunities and related difficulties, and to undertake a general assessment of the evolving role of nurses.The Commission on Nursing was subsequently set up and produced a comprehensive report containing 200 recommendations. This report is seen as the blue print for the future of nursing. The recommendations included the following:-
1. The Commission recommends that differentials and incremental annual leave in promotional grades be examined as a matter of urgency before the end of December, 1998, through the established structures. To this examination should be added the effect of the enhanced role for ward sisters and higher grades recommended by the Commission,
and
2. The Commission recommends that the question of additional
recognition of long service of staff nurses be examined through the
established structures.
The parties entered into discussions but in February, 1999, the negotiations ran into difficulties and, following a re-call of the parties to the Court, a chairman was appointed to assist the parties in their deliberations. As a result, discussions took place over eleven days during the following weeks, and agreement was reached on a number of issues including revised job specifications.The parties, however, failed to reach agreement on aspects of the following substantive issues:-Salary levels and incremental leave for management grades
Grading issues
Reporting Relationships
Banding
Ratios
Nurse Teachers
Psychiatry - CNM3 Posts
Allowances
Staff Nurse - Recognition for Long Service
The employers' arguments at the Labour Court hearings included claims that some of the issues raised had wider implications for National Agreements, that significant increases had already been received by nurses, and that the job changes proposed for management grades would be evolving over the next two years.
The Unions' arguments included claims that nurses had fallen behind other groups on pay and conditions, that the profession had difficulty in attracting enough suitable people, and that nurses were not prepared to accept promotion under the current conditions. They also argued strenuously that their claims should not be rejected because of the numbers involved, and the fact that any increase for nurses, however small, would represent a significant increase in Government expenditure.
The Court, while noting all the arguments made, has considered the issues before it, and is making this recommendation on the basis of what it considers to be justified, taking into account the history of these negotiations over many years.
It is important for the parties to understand that, while a wide range of issues were put before the Court during the recent hearings, the Court is clear that pay increase claims were dealt with by the Blue Book and LCR15450, and that the issues now to be considered are those arising for nurses from the implementation of the Nursing Commission Report. In particular it is conscious that it is the new work roles and responsibilities now being introduced that form the basis for the consequential increases in pay and conditions now being recommended for promotional grades.The Court, in making its recommendations, has addressed as many of the issues before it as possible. However, the Court does not consider itself to be in a position to decide the relative grading of particular posts in dispute. Such issues should be dealt with by an appeal mechanism to be set up by the parties.Similarly, disagreement on banding and ratios between jobs cannot be addressed by the Court at this stage. These issues are best addressed by discussions between the parties as the new roles develop.
The Court recommends as follows on the other issues before it:-
1.Salary Structures and Incremental leave for promotional grades
In any job regrading exercise arising from restructuring, some individuals will be upgraded, others will stay as they are, and some may feel that they have suffered a loss of status.
The problems arising are exacerbated when individuals appear to lose differentials they enjoyed against other posts, and others may believe that their posts should be in a higher grade. While an objective of the regrading may be to meet the changing requirements, a pragmatic approach has to be taken to the human difficulties that can arise as a consequence.
In order to deal with the apparent loss of differentials, where significant, the Court recommends that the following three areas should carry an allowance, payable on a red-circle basis to current staff. These allowances to be as follows:-
Deputy Nursing Officer - �750 p.a.
Theatre/Night Nurse - �450 p.a.
Public Health Nurse - �900 p.a.
These allowances to be discontinued once an individual gains promotion, or if these posts are upgraded, either by appeal or restructuring.
This arrangement deals with the perceived loss of significant current differentials, arising from the new grading structure.
Conscious that the new roles agreed for management grades in most cases greatly expand their current roles, and of the arguments made in relation to the lack of incentive for people to take promotion, the Court amends the employers' offer on salary scales as outlined in Appendix 1.
Given that the Court could have issued its recommendation earlier, but by agreement with the parties held it over to August, the Court recommends that the 1st phase of the new scales should apply from the 1st of July, 1999.
Having, as recommended by the Commission, examined the issue of incremental annual leave in the higher grades, the Court recommends that the following leave entitlements should apply in CNM1 grade and above.
0 - 5 years 25 days
5 - 10 years 26 days
10 years + 28 days
2.Nurse Teachers
The Court is conscious that the Nursing Education Forum will review the proposed new educational process for nursing and is expected to report by September, 2000. While management argues with some justification that it cannot put proposals until then, the Court believes that the nurse teachers should have some guidelines as to the likely options open to them following from the Commission's recommendations.
The Court, therefore, recommends for this group that 3 options be made available, given the radical nature of the proposed changes.
Option 1 - University Teaching
Option 2 - Remain in Hospital Roles
Option 3 - Early Retirement
Given the impact that the proposed radical changes could have for some individuals, the Court believes it is essential to provide a voluntary early retirement package for this group, and so recommends.
Pay and conditions for nurse teachers should be finalised by September, 2000, when the Forum report will be available. In the meantime, this group should be paid 4% from the 1st of July, 1999, on account, to be subsumed into any payincreases negotiated after the Forum report, clarifying their new roles, is available.
The conditions currently in place on a temporary basis for the group seconded to the University from the Department of Health should continue to apply to this group in the meantime.
3.Psychiatry - CNM3 Grade
Management's failure to identify CNM3 posts in psychiatry at the outset has caused major problems. While statements have been made that some posts will be graded CNM3 in the future, the lack of any clear commitment has caused serious alienation.
The Court, in order to address the concerns expressed, recommends that management commit to at least 25 CNM3 posts being created in psychiatry over the two year implementation period.
4.Reporting Relationships
The proposal to have Directors of Nursing report to the General Manager rather than the Programme Manager is seen as contentious in some areas. However, it is clear that in many areas these reporting arrangements currently operate. The main concerns centre around the General Managers' ability to deliver on key nursing issues, and also the fact that people may be prevented from contacting the Programme Manager directly on specific issues.
The Court believes this issue should not cause problems, if handled sensitively. It is essential, however, that the General Manager is seen to deliver on requirements, and that it is agreed that individuals can have access to programme managers if dissatisfied, or on specific defined matters.
5.Long Service Recognition
The Court, in LCR15450, subsumed the two Long Service Increments proposed in the 'Blue Book' scales into the Court's adjusted pay scales, and added a further Long Service Increment, when deciding the pay structures for staff nurses.
However, the Commission has suggested that the question of long service recognition should be considered, given that some nurses may not be promoted, or want to be promoted, thus staying as staff nurses for many years.
In response to this, the Court recommends that long service should be recognised by 3 additional leave days to be given at staff nurse level, 1 day after 5 years and 2 additional days after 10 years. This recommendation takes account of the fact that nurses, uniquely among the professional grades in the Health Services, work a 39 hour week.
6.Special Allowances
The Court did state in LCR16083 that the Unions could raise other issues in their discussions with management, and the Court understands that concessions in the area of overtime and two extra psychiatry qualification allowances have been made. The Court does not recommend any further concessions as part of this negotiation.
However, the Court accepts that situations can arise where certain nurses can find that their particular role requires an inordinate amount of availability for on-call. The Court recommends in this situation that discussions should take place to agree some adjustment in allowances where on-call times exceed accepted levels.
7.Management/Empowerment of Nurses
The Court is aware of considerable discontent and low morale in the profession due to the perception that nurses lack any real medical involvement, or recognition and appreciation from their superiors, including some doctors and consultants.
The Court is also concerned at the reference by the Commission to the level of bullying which has been recognised as a serious problem by all parties.
The Court strongly recommends that these issues be taken seriously by management and special education and training programmes on management and leadership skills be put in place immediately, in addition to the formal and informal control procedures recommended by the Commission.
8.Advanced Training
In the course of the hearings, the Court has become aware of anomalies in the way in which different hospitals treat leave for nurses attending outside courses relevant to their work, and leave for study and examinations. In some cases, nurses are given reasonable time off to meet such needs, while at the other extreme nurses are required to take such time as part of their holiday entitlements. Similarly, some hospitals pay in full the fees for such courses on satisfactory completion, while others do not.
The Court is of the view that this lack of consistency is inappropriate in such situations, and recommends that the parties agree a uniform approach on these matters.
9.Lump Sum
The Recommendations of the Nursing Commission represents major changes in nursing. While the amount of change required from individuals and groups will vary considerably, some having significant change, others minor, the change in structures, training and culture will affect all elements and levels of nursing. Without these changes in organisation and culture over the next few years the proposals, as outlined by the Commission, will fail. The changes embrace the totality of nursing from selection, training and responsibility to the quality of service provided. The process of change will require teamwork, as well as leadership from all involved.
Taking into account the fundamental nature of the changes proposed for nursing, the Court recommends that a buy-in lump sum of �1,250 be paid to all nurses, conditional on acceptance of this Labour Court Recommendation. This should be paid one month after acceptance.
Summary
This Recommendation is the culmination of many years of discussions and negotiations on nurses' pay and conditions. The Court believes that the package now proposed, in addition to the concessions already achieved on pay, conditions, and allowances represents significant improvements in the financial package for nurses. However, a financial package alone is not enough to address the issue of low morale in the profession.The lack of appreciation and involvement felt by nurses, coupled with serious incidents of bullying, have to be addressed urgently. The Court strongly recommends that management take these problems seriously and set up a mechanism to ensure that nurses’ skills and ability are utilised by involving them much more in the decision making process and that formal and informal procedures are put in place to deal with bullying in the workplace.
The issue of nurses’ pay and conditions has taken up more of the Court's time in recent years than any other issue. Much of this is due to the failure to deal with the issues as promised several years earlier. The Court believes that over the last two years the nurses have justifiably improved their position, not just financially, but in terms of gaining recognition for the enhanced role of the profession.
During these lengthy discussions, the Court has been extremely impressed by the professionalism, patience and courtesy shown by all the parties in very difficult situations. The Court would like to express its gratitude towards all concerned for the manner in which they conducted the discussions during the many long and difficult hearings over extended time periods.
Signed on behalf of the Labour Court
Finbarr Flood
31st August, 1999______________________
C.O'N./D.T.Chairman
NOTE
Enquiries concerning this Recommendation should be addressed to Ciaran O'Neill, Court Secretary.
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