FULL RECOMMENDATION
INDUSTRIAL RELATIONS ACTS, 1946 TO 1990 SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990 PARTIES : CORK UNIVERSITY HOSPITAL - HSE SOUTH - AND - IRISH NURSES' AND MIDWIVES' ORGANISATION DIVISION : Chairman: Ms Jenkinson Employer Member: Mr Murphy Worker Member: Mr Shanahan |
1. Comprehensive staffing review on nurse/patient ratios and undertaking on implementation of outcome.
BACKGROUND:
2. The Union claims that the ratio of nursing staff to patients is unacceptably low at Cork University Hospital (CUH) and is seeking a review to address the issue with an undertaking from the Employer on implementation of the outcome of such a review. At present nursing has lost over 200 positions at CUH since 2007 and there are more to follow in 2012 through retirement. A staffing review is unacceptable to the Employer who reiterated their unwillingness to engage in the proscess.
The dispute could not be resolved at local level and was the subject of a Conciliation Conference under the auspices of the Labour Relations Commission. As agreement was not reached, the dispute was referred to the Labour Court on the 24th March, 2010, in accordance with Section 26(1) of the Industrial Relations Act, 1990. A Labour Court hearing took place on the 2nd December, 2011.
UNION'S ARGUMENTS:
3. 1. Additional nursing staff are required in order to provide safe standards of care for the patients at CUH. A comprehensive staffing review is required immediately and a guaranteed implementation of findings in order to ensure patient care and safety.
2. CUH is a University Hospital, it trains students in undergraduate and post graduate activity and is a centre of excellence for multiple specialities. There are now insufficient nurses on the ground to deliverclinical care and guarantee the safety of patients.
EMPLOYER'S ARGUMENTS:
4. 1. HSE South wish to formally advise the Court that there is no capacity to increase current staffing levels in CUH having regard to the allocated budget and the approved ceiling for 2011.
2. Management is satisfied that the current staffing level in CUH is comprehensive and ensures the delivery of a safe and quality service to patients.
RECOMMENDATION:
The Union’s claim before the Court seeks HSE South to commission a comprehensive patient/staffing review in Cork University Hospital and furthermore it seeks implementation of the results of such a review. The Union maintained that the staffing ratio to patients is unacceptably low in the Hospital.
HSE South on behalf of the Hospital stated that nurse management continuously monitor and adjust staffing levels to include a skill-mix which is reflective of service needs and activity within the Hospital and moreover it stated that it was satisfied that the current nurse staffing levels are comprehensive and ensure the delivery of a safe and quality service to patients. Furthermore, it held that there was no capacity to increase current staffing levels in the Hospital having regard to allocated budgets and the approved staffing levels for 2011. Finally, it stated that it must operate within the constraints of the moratorium on recruitment and promotion in the public sector.
Having considered the submissions of both sides the Court is of the view that a staffing review at this point would not be effectual in the light of the current restrictions on the public sector and accordingly does not recommend in favour of the Union’s claim.
The Court notes that in October 2009 under the auspices of the LRC it was agreed between the parties to set up a pilot initiative in identified clinical areas/wards to examine existing nursing staffing levels and work practices/workloads within existing resources in an integrated skill-mix approach to patient care management together with a review Group. The pilot initiative ran for three months which was then subsumed into the resulting review Group.
The commitment to consult with trade unions in implementation of the Agreement is central to the Public Service Agreement 2010-2014. Clause 2.4 provides that unions and employers should take a collaborative approach to the challenges facing them within the health sector to deliver significant cost efficiencies while at the same time protecting the quality and effectiveness of services provided to the public. At Clause 2.7 the Agreement provides for robust consultation with the trade unions, which takes account of staff concerns and rights, where organisational and service changes are required in the health sector on the scale outlined by the Agreement. Furthermore, it states that the health service's information and consultation mechanism will be used to assist implementation of the required change in an atmosphere of industrial peace.
The Court recommends that consistent with the pilot initiative and subsequent review Group undertaken in 2009 and under the auspices of the requisite provisions of the Public Service Agreement the parties should engage in a collaborative approach to examine nursing staffing levels and work practices/workloads to ensure appropriate patient care within existing resources while at the same time protecting the quality and effectiveness of the services.
The Court so recommends.
Signed on behalf of the Labour Court
Caroline Jenkinson
22nd December 2011______________________
JFDeputy Chairman
NOTE
Enquiries concerning this Recommendation should be addressed to John Foley, Court Secretary.