FULL RECOMMENDATION
INDUSTRIAL RELATIONS ACTS, 1946 TO 2001 SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990 PARTIES : TALLAGHT HOSPITAL - AND - IRISH NURSES ORGANISATION DIVISION : Chairman: Mr Flood Employer Member: Mr Pierce Worker Member: Mr O'Neill |
1. Breach of Escalation Procedure
BACKGROUND:
2. AMNCH Tallaght Hospital is a merger of three hospitals in Tallaght, Co. Dublin which occurred in 1998. Though the hospital is a modern acute care facility, there is an acute shortage of in-patient beds. It was agreed between the Hospital Management and the Nursing Alliance group of unions (INO, SIPTU and IMPACT) that an Escalation Procedure be put in place. This procedure allows for the use of the day surgical unit (day ward) to accommodate up to 12 patients who require admission but for whom no beds are available in the wards. This requirement was necessary to alleviate overcrowding in the A&E Department.
Industrial action in the form of a 'work to rule' had been taken by INO members in the day surgical unit (now suspended until after the outcome of the Court hearing). This action was, in the Union's view as a result of that unit being used on a daily basis and as a norm for inpatient services. This is in breach of the spirit of the Escalation Procedure.
The dispute could not be resolved at local level and was the subject of a number of conciliation conferences under the auspices of the Labour Relations Commission. As agreement was not reached, the dispute was referred to the Labour Court on the 31st March, 2003, in accordance with Section 26(1) of the Industrial Relations Act, 1990. A Labour Court hearing took place on the 30th April, 2003.
UNION'S ARGUMENTS:
3. 1. The Union claims that AMNCH Tallaght have constantly breached their own escalation policy on a daily basis. They are using the escalation policy to reduce day ward surgical activity as a cost cutting exercise.
2. The Union further claim AMNCH Tallaght have ignored the concerns of the Day Care Nursing staff with regard to the impact of the escalation policy on health and safety grounds, support services grounds and operational grounds. The concerns mentioned were completely ignored by Management, to the extent that day ward staff were previously not allowed to be part of the Admissions and Discharge Steering Group.
3. The Union claim AMNCH Tallaght have failed to implement properly the escalation procedure as part of the admissions and discharge policy. As a result, they have failed to provide a safe working environment for nursing staff and patients of the day care ward.
MANAGEMENT'S ARGUMENTS:
4. 1. The escalation policy for AMNCH Tallaght was agreed with the Nursing Unions, the Medical Profession and Hospital Management.
2. Management are not in breach of the escalation policy.
3. The escalation policy is due for review by the Admission and Discharge Monitoring Committee in May of this year. This fact has been conveyed to the Union. This review mechanism is the appropriate forum to raise issues associated with the operation of the policy.
RECOMMENDATION:
The Court having considered the comprehensive oral and written submissions made by the parties is of the view that the audit proposed by management should be undertaken in the month of May and that all the relevant parties should participate.
However, the Court would also recommend that the surveys carried out for the earlier months of the year be included in subsequent considerations, in order to give a more balanced and comprehensive assessment of the problems being encountered within the hospital.
The Court is conscious of the view expressed by the Union that management has not done all in its power to reduce the pressures being imposed as a result of difficulties in the A & E area.
There is a perception on the Union side that not everything possible is being done on the management side to facilitate the smooth implementation of the escalation policy. However, the Court notes that the situation has changed and that admissions have increased significantly since the escalation policy was put in place.
These issues should form part of the review by the Admission and Discharge Monitoring Committee, which is due to take place in May.
The Court is conscious of management's desire to have as much information as possible in order to make meaningful progress in addressing the difficulties arising. However, the Court is conscious that individuals within the system are under stress and recommends that a time scale be put on both the audit and the considerations of the result.
The Court, therefore, recommends that the audit as proposed in May take place, but that priority be given to bringing forward proposals by the end of June, to improve the situation.
Signed on behalf of the Labour Court
Finbarr Flood
7th_May, 2003______________________
JB/MB.Finbarr Flood
NOTE
Enquiries concerning this Recommendation should be addressed to Jackie Byrne, Court Secretary.