Twenty seven named complainants
(represented by the Irish Nurses Organisation)
-v-
The Health Service Executive
(represented by the HSE - Employers Agency)
1. CLAIM
1.1 This case concerns a claim by twenty seven Directors of Public Health Nursing against the Health Service Executive that they are entitled to the same rate of pay as that paid to twenty three named Directors of Nursing (Mental Health) in accordance with section 19 of the Employment Equality Acts 1998 and 2004 on the gender ground. They claim that they both perform like work in accordance with section 7(1)(b) and (c) of the Acts.
2. BACKGROUND
2.1 The complainants allege that they are paid less than the named male comparators even though they perform 'like work' within the meaning of Section 7 of the Employment Equality Acts 1998 and 2004. It is the complainants' contention that the difference in pay is related to their gender. The respondent disputes like work and submits that there is no entitlement to equal pay.
2.2 The complainants referred a complaint under the Employment Equality Acts 1998 and 2004 to the Director of the Equality Tribunal on 23 February 2005. On 3 April 2006, in accordance with her powers under section 75 of the Acts, the Director delegated the case to Mary Rogerson, an Equality Officer, for investigation, hearing and decision and for the exercise of other relevant functions of the Director under Part VII of the Act. A submission was received from the complainant on 13 July 2006 and from the respondent on 14 July 2006 and 29 November 2006. Interviews with a representative sample of complainants and comparators were carried out and a joint hearing of the claim was held on 22 February 2007.
3. SUMMARY OF THE COMPLAINANTS' SUBMISSION
3.1 The INO alleges discrimination on the gender ground by the Health Service Executive against the 27 named female complainants, Directors of Public Health Nursing contrary to the provisions of the Employment Equality Acts 1998 and 2004. The INO claims the same rate of pay as that paid to 23 named male comparators, Directors of Nursing, Mental Health, in terms of sections 7(1)(b) and (c) of the Acts. The complainants and the comparators are employed by the Health Service Executive.
Work of a similar nature
3.2 In terms of section 7(1)(b) of the Acts, the INO submits that the job descriptions reveal that the work performed by the complainants and comparators is similar in many respects and any differences that may exist are not significant and are of small importance in relation to the work as a whole. It submits that a comparison and analysis of the job descriptions for the two posts supports this contention, revealing the almost identical nature of the two jobs. The comparison shows that the roles and responsibilities are categorised under almost identical headings as follows:
Leadership and Accountability
Planning
Operations
Personnel Management
Finance
Education
Quality Assurance
Key Performance Criteria
There are also two further categories of the job description of Director of Public Health Nursing, i.e. Liaison and Miscellaneous.
3.3 Furthermore, the job descriptions define the roles of both the Director of Public Health Nursing and the Director of Nursing, Mental Health Services as "working in collaboration with other professionals and service managers to achieve service goals". In addition, both positions require a "strategic approach to the development of services and structures, embracing continuous quality improvement and the management of changes necessary to achieve organisational objectives" in their respective settings.
3.4 Even within the above categories, the wording and language used to describe their respective roles and responsibilities is almost identical and where it is not, it is suggested that it is of little significance and reflects a stereotypical attitude to women's and men's work rather than any real difference in the level of responsibility or difference in the nature of the work as a whole. Each has responsibility for the development, management and delivery of nursing services within their respective health care settings, however, while the Director of Nursing, Mental Health Services operates on an institutional basis with some community based elements, the Director of Public Health Nursing operates on a geographic basis which makes the service more difficult to operate and manage. Further similarities arise in relation to reporting relationships and the management of staff. Both the Director of Public Health Nursing and the Director of Nursing: Mental Health Services each report to the Local Health Office Manager (formerly Assistant Chief Executive Officer). They each have responsibility for the management of a wide range of staff within their respective health care settings.
Work of equal value
3.5 In relation to section 7(1)(c) of the Acts, the INO submits that notwithstanding the claim under section 7(1)(b), the work performed by the Directors of Public Health Nursing is equal in value to the work performed by the Directors of Nursing: Mental Health Services in terms of skill, physical or mental requirements, responsibility and working conditions.
Indirect discrimination
3.6 The INO submits that the complainants and comparators perform like work but that the salaries of the Directors of Public Health Nursing are artificially depressed because of the predominantly female composition in their grade. The complainants refer to Flynn v. Primark (1) and Enderby (2) in relation to establishing a prima facie case of discrimination.
3.7 The INO further contends that the significant difference between the complainants' and the comparators' remuneration prejudices significantly more women than it does men and gives rise to an inference of discrimination which requires the employer to show that the difference in pay is not related to sex but is based on objectively justified factors. The INO submits that the HSE cannot offer objective justification for the difference in pay. The INO refers to Enderby in support of its claim.
4. SUMMARY OF THE RESPONDENT'S SUBMISSION
4.1 The dispute concerns a claim by 27 named Directors of Public Health Nursing for equal pay with 23 named Directors of Mental Health Services on the basis that they perform like work as defined by Section 7(1)(b) and (c) of the Employment Equality Acts 1998 and 2004.
4.2 Mental health services are currently managed within a catchment area by a management team consisting of a Hospital Manager, a Clinical Director and a Director of Nursing who report into the Local Health Office Manager (LHO). This management team has complete responsibility for the maintenance, development and organisation of the mental health service in the catchment area which is approximately the size of a county. The Director of Mental Health Nursing within this area has direct responsibility for the staff (nursing, care and household grades) and shares management responsibilities equally with the Clinical Director and the Hospital Area Manager for the delivery of the service. They are also responsible for policy matters, the co-ordination of activities and for the training of nursing staff.
4.3 The Public Health Nursing Service is delivered by a skill mix of Public Health Nurses, Community Registered General Nurses and Health Care Attendants who are based in health centres within a community health service area. These staff usually work in assigned geographical areas and provide a range of services in schools, health care centres, day-care, other community centres and in people's homes. The Director of Public Health Nursing together with the Assistant Directors is responsible for the planning and delivery of the overall service and staff working in the service are usually based at the Headquarters of the Community Health Service.
4.4 The salary scale applicable to Directors of Mental Health Nursing was negotiated on a national basis between the trade unions representing psychiatric nurses and the HSE Employers Agency/Department of Health. These salary scales apply regardless of the gender of the Director of Mental Health Nursing. The salary scales applicable to Directors of Public Health Nursing were negotiated on a national basis between the trade unions and the HSE Employers Agency/Department of Health. These salary scales apply regardless of the gender of the Director of Public Health Nursing.
4.5 The HSE contends that the Directors of Public Health Nursing do not perform "like work" with the Directors of Mental Health Nursing within the meaning of section 7(1)(b) and (c) of the Employment Equality Acts in that the work performed by the Directors of Public Health Nursing is not of similar nature to that performed by the Directors of Mental Health Nursing nor is the work performed by the Directors of Public Health Nursing of equal value to the work performed by the Directors of Mental Health Nursing.
4.6 The HSE contends that there is a significantly greater amount of responsibility and mental effort attaching to the role of the Director of Mental Health Nursing. Directors of Mental Health are responsible for a considerably larger workforce across a range of disciplines and are responsible for the delivery of nursing care both in community/residential settings and hospital settings whereas the complainants' responsibility lies solely in the community. Directors of Mental Health Nursing are responsible for patients with a diverse range of complex mental health conditions and they have particularly onerous responsibilities under the Mental Health Act, 2001 and the Criminal Law Insanity Act, 2006.
4.7 The HSE contends that the complainants have not established a prima facie case of discrimination on the grounds of gender as both male and female nurses occupy the post of Director of Mental Health Nursing. There are currently 33 Directors of Mental Health Nursing, 10 of which are female and 23 of which are male.
4.8 In relation to indirect discrimination, the respondent submits that none of the qualifications or requirements to hold the post of Director of Mental Health Nursing have a disproportionate disadvantageous effect on female psychiatric nurses because of their gender. Similarly, none of the requirements to hold the job of Director of Mental Health Nursing are such that they would be capable of being complied with by a significantly higher proportion of males than females. The HSE contends that the designated essential qualifications are necessary to the successful undertaking of the post of Director of Mental Health Nursing and therefore, objective grounds exist for requiring such qualifications. The HSE disputes that it indirectly discriminates against females regarding access to the post of Director of Mental Health Nursing.
5. CONCLUSIONS OF THE EQUALITY OFFICER
5.1 The issue for decision in this claim is whether or not each of the complainants is entitled to equal pay with each of the named male comparators in terms of Sections 19 of the Employment Equality Acts 1998 and 2004 on the basis that they perform like work within the meaning of section 7 of the Acts. In making the decision in this claim, I have taken into account all of the submissions, both written and oral, made to me by the parties. It was agreed that I would evaluate the work undertaken by three complainants as representative of all of the complainants on the basis that the complainants perform like work with each other. Similarly, it was agreed that I would evaluate the work of three comparators as representative of the comparators on the basis that the comparators perform like work with each other. The names of the complainants and the comparators whose work I evaluated are recorded at Appendix 4. In this regard, I have taken into account the interviews I conducted with a representative sample of complainants and comparators and generic job descriptions for the complainants and the comparators are set out at Appendices 5 and 6 respectively.
Gender Discrimination Claim
5.2 Each of the complainants is seeking equal pay with each of the named male comparators on the grounds of gender in terms of Section 19(1) of the Employment Equality Acts 1998 and 2004. They allege that they perform 'like work' with the named male comparators in terms of Sections 7(1)(b) and (c) of the Acts. The Labour Court in the case of Dowdall O' Mahoney & Co. Limited v. The Irish Transport and General Workers Union (3) which dealt with a claim in relation to general operative factory work, considered the three subsections of Section 3 of the Anti-Discrimination (Pay) Act, 1974 which were substantially the same as the like work provisions of the Equality Acts. The Court found in that case that the work of the claimants and comparators was similar. It stated that:
It is the intention of section 3(b) to cover claims from persons employed in such situations as opposed to persons employed on the same work which is covered by Section 3(a), e.g. two bus conductors or work that is not the same or similar which is covered by Section 3(c), e.g. a clerical worker and a general operative worker.
The High Court has stated in relation to section 3(c) and 'equal in value':
No doubt, the words should not be used so as to require a mathematical exactitude of equality, having regard to the statutory context in which they are used (4).
The Supreme Court stated subsequently in relation to Section 3(c) that:
No doubt that condition extends to cases where the work performed by the two persons or groups is dissimilar in nature, and perhaps radically so, ..... (5)
I will proceed to consider the complainants' claim under section 7(1)(b) and (c) of the Acts.
Section 7(1)(b)
5.3 Section 7(1)(b) of the Employment Equality Acts 1998 and 2004 provides in relation to work which one person is employed to do, another person shall be regarded as employed to do like work if -
(b) the work performed by one is of a similar nature to that performed by the other and any differences between the work performed or the conditions under which it is performed by each either are of small importance in relation to the work as a whole or occur with such irregularity as not to be significant to the work as a whole".
The primary function of the complainants is to manage the provision of the community nursing service in their geographical area whereas the primary function of the comparators is to manage the mental health service in their geographical area. The work performed by the complainants and the comparators is primarily to manage the provision of a particular health service. However, each manages the service in conditions where they are qualified and have experience in their respective disciplines. The conditions under which their work is performed are not of small importance to the work as a whole and do not occur with such irregularity as not to be significant to the work as a whole. I therefore find that the complainants and the comparators do not perform like work within the meaning of section 7(1)(b) of the Acts.
Section 7(1)(c) - Work of equal value
5.4 Section 7(1)(c) provides that:
The work performed by one is equal in value to the work performed by the other, having regard to such matters as skill, physical or mental requirements, and responsibility and working conditions.
In relation to this particular criterion, the Labour Court has stated :
"..., in deciding whether or not the work of the comparator is of equal value to that of the complainant it is the actual duties performed which are relevant and not the qualifications held by the respective parties." (6)
I have considered the work of the complainants and comparators in terms of skill, physical requirements, mental requirements, responsibility and working conditions in accordance with section 7(1)(c) of the Acts.
5.5 My findings are as follows:
Skill
The complainants as Directors of Public Health Nursing provide leadership and direction for community health related services and manage the overall delivery of the service to patients. The performance of their role requires a high level of the following skills:
Management and Leadership, Teamworking, Communication, Interpersonal, Decision Making, Networking/Influencing, Planning, Financial Planning and Management, Negotiation and Analytical.
The comparators as Directors of Nursing, Mental Health provide leadership and direction for mental health nursing and related services and manage the overall delivery of the service to patients. The performance of their role requires a high level of the following skills:
Management and Leadership, Teamworking, Communication, Interpersonal, Decision Making, Networking/Influencing, Planning, Financial Planning and Management, Negotiation and Analytical.
I find that the demands made on the complainants and comparators in terms of skills are equal.
Physical Requirements
The complainants and the comparators did not have any physical demands in their positions over and above what would be normal for a person primarily carrying out office work. It is sometimes necessary for both the complainants and the comparators to travel to other locations of work within their geographical area and it is also necessary for both to travel generally to various locations within the country for the purposes of meetings.
I find that the demands made on the complainants and comparators in terms of physical requirements are equal.
Mental Requirements:
The complainants need to have knowledge of the service being provided and of the Irish Health Service in general and a good knowledge of the legislative framework in which the service is provided and they must work within the confines of the legislation. The complainants may have to attend Court, for example, in relation to proceedings under the Nursing Home legislation but this aspect of the work is an irregular occurrence.
The comparators need to have knowledge of the service being provided and of the Irish Health Service in general and a good knowledge of the legislative framework in which the service is provided and they must work within the confines of the legislation. The comparators may have to co-operate and act in an advisory role in relation to Tribunals reviewing involuntary detentions and attend Court as necessary but this aspect of the work is an irregular occurrence.
I find that demands made on both the complainants and comparators in terms of mental requirements are equal.
Responsibility
The complainants, as Managers of the Public Health Service are responsible for the management, planning and delivery of the public health service to patients with diverse medical conditions at various locations both in terms of the location of staff and the actual delivery of the service within a geographical area. This includes responsibility for the management of a considerable staffing allocation of nursing and non nursing staff, i.e. Homecare Attendants. (Some Directors of Public Health Nursing also have ultimate responsibility for the management of the Home Help Service). The Directors of Public Health are also responsible for financial matters particularly in terms of monitoring expenditure and staying within their budget allocation. The complainants have considerable responsibility for the safety of staff in terms of a one to one service in homes being provided.
The comparators as Managers of the Mental Health Service are responsible for the management, planning and delivery of the mental health service to patients with diverse medical conditions at various locations both in terms of the location of staff and the actual delivery of the service within their geographical area. This includes responsibility for the management of a considerable staffing allocation of nursing and ancillary staff (i.e. Domestic Staff and Care Assistants). The Directors of Nursing, Mental Health are also responsible for financial matters particularly in terms of monitoring expenditure and staying within their budget allocation. The comparators have considerable responsibility for the safety of staff in terms of the nature of the service being provided.
I find that the demands made on both the complainants and comparators in terms of responsibility are equal.
Working Conditions:
The complainants work a 39 hour five day week in an office environment but have to be available to deal with emergency situations on a 24/7 basis.
The comparators work a 39 hour five day week in an office environment but have to be available to deal with emergency situations on a 24/7 basis. (Some of the Directors also participate in a formal on-call arrangement whereby they are formally on call one week in every six week period but during this time, they are not in attendance at the workplace and may be paid an allowance.)
I find that the demands on both the complainants and comparators in terms of working conditions are equal.
5.6 It is to be noted that there was considerable divergence between the parties in relation to the numbers of staff that some of the Directors of Public Health Nursing were responsible for. In summary, based on the foregoing, I find that the demands made on each of the named complainants in terms of skill, physical or mental requirements, responsibility and working conditions are equal to the demands made on each of the comparators. I, therefore, find that each of the complainants perform 'like work' with each of the named comparators in terms of Section 7(1)(c) of the Employment Equality Acts 1998 and 2004.
Grounds other than gender
5.7 Section 19(5) of the Acts provides that:
.... nothing in this Part shall prevent an employer from paying, on grounds other than the gender ground, different rates of remuneration to different employees."
The European Court of Justice has stated in a case brought by a speech therapist who belonged to a group who were predominantly female and were receiving less pay compared to a group of pharmacists who were predominantly male:
., if the pay of speech therapists is significantly lower than that of pharmacists and if the former are exclusively women while the latter are predominantly men, there is a prima facie case of sex discrimination, at least where the two jobs in question are of equal value and the statistics describing that situation are valid." (7)
5.8 The Court went on to hold that:
....., where significant statistics disclose an appreciable difference in pay between two jobs of equal value, one of which is carried out almost exclusively by women and the other predominantly by men, Article 119 of the Treaty requires the employer to show that the difference is based on objectively justified factors unrelated to any discrimination on sex.
In that case, the employer sought to rely as sufficient justification for the difference in pay upon the fact that the rates of pay for the jobs in question were decided by collective bargaining processes. The Court held:
.... the fact that the respective rates of pay of two jobs of equal value, one carried out almost exclusively by women and the other predominantly by men, were arrived at by collective bargaining processes which, although carried out by the same parties, are distinct, and, taken separately, have in themselves no discriminatory effect, is not sufficient objective justification for the difference in pay between those two jobs.
5.9 In the case before me, I have found that the complainants and the comparators are engaged in like work within the meaning of the Equality Acts. The complainant grade is now exclusively female and has been almost exclusively female (during 2000-2005, there have been one or two males in the Director of Public Health Nursing grade) whereas the comparator grade is predominantly male. In the circumstances and in accordance with the principles established in Enderby, the complainants have established a prima facie case of discrimination on the gender ground. It therefore falls to the respondent to show that the difference in pay is objectively justified. The respondent submitted that the rates of pay for the different positions were negotiated on a national basis with the Unions representing the two grades and that gender is not a factor in agreeing rates of pay. However, in the light of the European Court of Justice finding in the Enderby case, the respondent cannot rely on the collective bargaining process as objective justification for the difference in pay. Furthermore, the Court noted in that case that if the employer could rely on the absence of discrimination within the collective bargaining process (or in that case separate bargaining processes) as sufficient justification for the difference in pay, he could "easily circumvent the principle of equal pay .......". I, therefore, find that the respondent cannot rely on the collective bargaining of pay rates as valid justification for the difference in pay between the complainants and the comparators.
Transparency in pay systems:
5.10 The European Court of Justice in a case concerning occupational pension schemes which established that pensions are pay within the meaning of Article 119, stated that:
Article 119 prohibits any discrimination with regard to pay as between men and women, whatever the system which gives rise to such inequality. (8)
The Court continued:
With regard to the means of verifying compliance with the principle of equal pay, it must be stated that if the national courts were under an obligation to make an assessment and a comparison of all the various types of consideration granted, according to the circumstances, to men and women, judicial review would be difficult and the effectiveness of Article 119 would be diminished as a result. It follows that genuine transparency, permitting an effective review is assured only if the principle of equal pay applies to each of the elements of remuneration granted to men or women.
5.11 The European Court of Justice has also considered whether an inconvenient hours supplement paid to midwives and not paid to clinical technicians should be taken into account in calculating the salary which serves as the basis of a pay comparison. It ruled that:
..... the inconvenient hours supplement is not to be taken into account in calculating the salary which serves as the basis for a pay comparison for the purposes of Article 119 of the Treaty and Directive 75/117. (9)
The Court went on to hold that in order to ensure greater transparency and guarantee compliance with the requirement of effectiveness underlying Directive 75/117, the midwives' monthly basic salary should be compared with the like salary of clinical technicians.
Subsequently in Brunnhofer v. Bank der osterreichischen (10) the Court stated:
... equal pay must be ensured not only on the basis of an overall assessment of all the consideration granted to employees but also in the light of each aspect of pay in isolation.
In the case in issue, whilst the comparators in some instances may have a formal on call duty one week in every six working weeks for which they may be remunerated separately, it should not form part of the comparison for equal pay purposes.
6. DECISION
6.1 In view of the foregoing I find that each of the complainants perform 'like work' with the named comparators in terms of Section 7(1)(c) of the Employment Equality Acts 1998 and 2004. I find that there are no objective grounds other than gender for the difference in pay in accordance with section 19(5) of the Acts and I, therefore, find that the complainants have been discriminated against by the respondent.
6.2 I hereby order that the respondent pay to each of the twenty five named complainants referred to in Appendix 1:
(i) arrears of pay with effect from 23 February 2002 (if in employment on that date) or arrears in respect of so much of their employment as begins not more than 3 years before 23 February 2005 whichever is appropriate;
(ii) equal pay with effect from 23 February 2005.
6.3 I hereby order that the respondent pay to each of the complainants referred to in Appendix 2:
(i) arrears of pay with effect from 29 November 2003 (if in employment on that date) or arrears in respect of so much of their employment as begins not more than 3 years before 29 November 2006 whichever is appropriate;
(ii) equal pay with effect from 29 November 2006.
__________________
Mary Rogerson
Equality Officer
23 March 2007
APPENDIX 1
Complainants named on the original referral form (25)
1. Kathleen Malee
2. Dolores O' Neill
3. Eleanor Dowling
4. Virginia Pye
5. Mary Curran
6. Anna Kelly
7. Mary Fanning
8. Margaret Daly
9. Phil O' Regan
10. Eileen Weir
11. Marie Faughey
12. Mary Mc Dermot
13. Stasis Cody
14. Elizabeth Doyle
15. Geraldine Mc Goldrick
16. Grace Fraher
17. Margaret Hennessy
18. Mary Liston
19. Helen Harris
20. Cathleen Curry
21. Marie Dooley
22. Kathleen Cusack
23. Rosa Gardiner
24. Geraldine Tabb
25. Mary Finn-Gilbride
APPENDIX 2
Additional Complainants named on second referral form (2)
1. Mary Byrne
2. Jennifer Bollard
APPENDIX 3
Comparators named in relation to the claim (23)
1. Andrew Callinan
2. Jimmy Finnegan
3. Ray Sweeney
4. Pierce Finnegan
5. PJ Lawlor
6. Larry Ward
7. John Meehan
8. Michael Cotterell
9. Michael Bambrick
10. Pat Byrne
11. Dominic Smith
12. Sean Tone
13. Joe Mc Fadden
14. Michael Hughes
15. John Flagherty
16. Denis Creedon
17. Padraig Gilligan
18. Gerard Hoey
19. Damien Murray
20. Brendan Byrnes
21. Michael Kirwan
22. Bill Frewn
23. Kevin Plunkett
APPENDIX 4
Names of complainants and comparators interviewed
Complainants Comparators
Virginia Pye Joe Mc Fadden
Jennifer Bollard Larry Ward
Geraldine Tabb (by phone) Bill Frewn (by phone)
APPENDIX 5
Job Description for Director of Public Health Nursing
Purpose of position:
- To provide strategic and clinical leadership and direction for public health nursing and related services.
- To ensure the overall delivery and management of efficient and effective community nursing services.
Reports to: Local Health Manager of the HSE Region.
Location: Office in Health Centre
Location of Service Provision: Health Centres, Homes, Nursing Homes, Schools and Pre Schools
Hours of Work: 39 hours per week
The functions of the Director of Public Health Nursing:
1. General duties:
a. To manage the overall team responsible for the provision of public health at regional centres catering for geographical regions. This includes managing various grades of staff including nursing and public health nursing staff and non nursing staff such as Home Care Attendants.
b. To provide the public health service within a legislative framework adhering and referring to the relevant pieces of legislation particular to the provision of that service, for example, the Health Act, 1970, the Misuse of Drugs Acts, Health (Nursing Homes) Act, 1990, the Child Care Act, 1991 and the Child Care (Pre School Regulations) 1996.
c. To carry out audits of the services being provided including quality audits and implement change as necessary in relation to staff, skill mix and other resources.
d. To ensure that statutory audits take place for example, the audit of all private nursing homes in their region biannually.
e. To deal with complaints regarding nursing homes, liaise with legal teams, prepare reports and attend court as necessary in relation to any prosecution.
f. To provide monthly statistics in respect of posts numbers and types, number of clients and care packages.
g. To deal with general complaints within the context of complaints procedures, writing reports and recommending improved processes.
h. To provide information and reports including statistics for parliamentary questions and representations.
i. To prepare and develop business case proposals for the funding of special initiatives.
j. To participate in relevant meetings, i.e. team meetings, staff meetings, and other heads of disciplines
k. To prepare reports, policies and procedures as appropriate including incident reports, best practice guidelines and insure implementation of operational policies and personnel policies.
l. To be available at all times to deal with urgent situations.
2. Operations:
a. To ensure the maintenance of proper standards in private nursing homes and boarding out homes according to the legislation and regulations.
b. To ensure the discharge of all professional and statutory responsibilities in the area of childcare. This includes being a member of the Child Protection Notification System.
c. Assist in the development of HSE policies and services in relation to domiciliary births and ensure that domiciliary community midwives are qualified to practice and adequately trained.
d. Assign the management and monitoring of the Home Care Attendants and Home Help Service (the latter in some cases only).
e. To work with community nursing personnel, general practitioners, practice nurses, other Directors of Nursing and Consultants to develop the most effective procedures for the referral of patients to the community services, for the treatment and for the discharge of transfer to other services and ensure the development of the concept of care planning with other professionals and to ensure effective liaison with other health professionals, voluntary groups and groups representing the general public.
3. Leadership:
a. To provide strategic and clinical leadership and direction for community health nursing and related services.
b. To ensure that staff are committed to and participate in the changing ways in which nursing services are being provided to ensure that the health needs of patients are met.
c. To develop, maintain and review the community nursing organisational structure within the context of overall organisation objectives including decisions to develop key posts.
d. To be responsible for strategy, policy and practice development, education and professional duties imposed by statute or determination.
4. Planning:
a. To prepare, cost, manage and ensure implementation of service plans for the community nursing service including reviewing performance indicators, preparing yearly business plans and reports on outputs.
b. To participate in care group planning in co-operation with the multi-disciplinary team.
c. To participate on regional and national strategic, advisory and implementation committees for various groups.
5. Quality Assurance:
a. To ensure that modern standards of clinical nursing care are in operation and regular monitoring of nursing care is undertaken through audit.
b. To maintain good collaborative working relationships and communications with appropriate statutory, professional and voluntary organisations and to ensure adherence to all codes and guidelines relating to professional nursing practice and behaviour.
c. To measure the quality and standard of community nursing care through service plans and examination of activity levels.
d. To ensure best practice in the management of direct patient care and ensure the development of the concept of care planning with other professionals.
6. Managing Staff
a. To manage and assign responsibility to the Assistant Directors of Public Health Nursing.
b. To manage the personnel function including managing the mix of various posts under their responsibility, participating in relation to recruitment, managing the roster and the deployment of staff, reviewing and monitoring work performance, implementing HSE personnel policies and procedures, dealing with IR issues for staff including attendance at redress fora as necessary and promoting and maintaining a safe environment for staff.
7. Financial
a. To participate in overall financial planning of the service including preparing annual financial estimates of nursing and related manpower needs including education and training needs, assessment of priorities in pay and non pay expenditure and managing the finances ensuring that expenditure stays within budget and that the expenditure is controlled and efficient and that any savings are identified.
b. To delegate as appropriate, budgetary control and implement monthly expenditure audit systems.
8. Training
a. To ensure that ongoing training needs of staff are met whether by in-house trainers or external companies and personally delivering training where appropriate.
b. To ensure that the training needs of student nurses and student public health nurses are met and liaise with the appropriate third level institutions.
c. To maintain awareness of relevant nursing research and new developments and to initiate and facilitate relevant nursing research and promote awareness of ongoing research into issues affecting nursing and patient care.
APPENDIX 6
Job Description for Director of Nursing, Mental Health
Purpose of position:
- To provide strategic and clinical leadership and direction for mental health nursing and related services
- To ensure the overall delivery and management of efficient and effective mental health nursing services.
Reports to: the Local Health Manager of the HSE Region.
Location of Postholder: Office in Hospital
Location of Service Provision: Acute Mental Health Unit, Day Hospitals, Day Centres, Hostels, Sheltered Workshops and Homes.
Hours of Work: 39 hours per week
The functions of the Director of Nursing, Mental Health:
General duties:
a. To manage the overall team responsible for the provision of mental health at various types of centres within a defined geographical region.
b. To provide the mental health service within a legislative framework adhering and referring to the relevant pieces of legislation particular to the provision of that service, for example, the Mental Health Act, 2001 and the Criminal Law (Insanity) Act, 2006.
c. To co-operate with any tribunals which are established to review the detention of involuntary psychiatric patients, the role of the Director being to ensure staff are trained to assist and participate in Tribunals, that accurate patient records are maintained and that there is full compliance with the Act.
d. To co-operate with any inspections carried out by the Commission for the Prevention of Torture and Violence, for example, in terms of providing access, providing a profile of the Unit and answering questions.
e. To participate in any Court proceedings.
f. To carry out audits of the services being provided including clinical audits and implement change as necessary.
g. To be available at all times to deal with urgent situations. (In some instances, Directors of Nursing, Mental Health have to be available for formal on-call one week in every six and may be remunerated separately.)
h. To select, as appropriate, staff to accompany non national patients being repatriated.
i. To deal with complaints generally, for example, patient care, write reports and recommend improved processes.
j. To provide monthly statistics to the HSE, e.g. expenditure and sick leave.
k. To provide information and reports including statistics for parliamentary questions and representations.
l. To prepare and develop business case proposals for the funding of special initiatives i.e. as part of service planning.
m. To participate in relevant meetings, e.g. senior management team meetings, staff meetings, unit management meetings, heads of department meetings, sector headquarter meetings and committee meetings.
n. To prepare reports, policies and procedures as appropriate and ensure implementation.
2. Operations:
a. To participate in the management team with the Hospital Manager and the Clinical Director and report to the Local Health Manager.
b. To implement operational policies, protocols and guidelines for the utilisation of services including in-patient and day services, community services and conduct an audit of such usage.
c. To develop collaborative care planning for the patient in conjunction with other professionals such as Consultants, Clinical Psychologists, Social Workers, Occupational Therapists, Cognitive/Behavioural Therapists and Family Therapists.
d. To develop and implement a discharge and after care policy and ensure good liaison with community and other services i.e. patient's community addiction teams and mental health consumer/voluntary groups, patient advocacy groups, suicide resource officers and bereavement support groups.
3. Leadership:
a. To provide strategic and clinical leadership and direction for mental health nursing and related services.
b. To ensure that staff are committed to and participate in the changing ways in which nursing services are provided to ensure that the health needs of patients are met.
c. To be responsible for strategy and policy on practice development, education and professional duties imposed by statute or determination.
4. Planning:
a. To prepare monthly reports on nursing and related activities and expenditure.
b. To participate in the preparation of plans for services annually that define objectives and identify major action plans for each Division and Nursing Management and monitor and report on their implementation as required.
5. Quality Assurance
a. To ensure that modern standards of clinical nursing care are in operation.
b. To take responsibility for implementing the HSE policy on complaints and patient services.
c. To maintain good collaborative working relationships and communications with appropriate statutory bodies, i.e. Mental Health Commission, An Board Altranais and the National Council for Nursing and Midwifery professional and voluntary organisations.
d. To ensure adherence to all codes and guidelines relating to professional nursing practice and behaviour.
6. Managing Staff
a. To manage and assign responsibility to the Assistant Directors of Mental Health Nursing
b. To manage the personnel function in relation to their particular area including skill/grade mix planning, participating in relation to recruitment, managing the roster and the deployment of staff, reviewing and monitoring work performance, implementing HSE personnel policies and procedures, dealing with IR issues for staff including attendance at redress fora as necessary and promoting and maintaining a safe environment for staff.
7. Financial
a. To participate in overall financial planning of the service including preparing annual financial estimates of nursing and related manpower needs including education and training needs, assessment of priorities in pay and non pay expenditure, and managing the finances ensuring that expenditure stays within budget and that expenditure is controlled and efficient and that any savings are identified.
b. To delegate as appropriate, budgetry control and implement monthly expenditure audit systems.
8. Education and Training:
a. To ensure that the direction and coordination of nursing education and training is consistent with the overall HSE strategy and meets the national criteria set by the National Council for Nursing and Midwifery.
b. To ensure that the training needs of psychiatric nurses in training are met by arranging clinical placements and signing off on the students' learning during the placements and also arranging clinical placements for persons from other disciplines.
c. To ensure that in-service education programmes and ongoing learning needs of all staff are met including delivery of programmes where appropriate.
d. To take part in relevant nursing research and promote awareness of ongoing and current research into issues affecting patient care.
e. To develop knowledge of systems used by nurses in other agencies and/or countries, including staffing, personnel, financial and patient information systems.