Statement by the National Implementation Body
Statement by the National Implementation Body
The National Implementation Body has continued to monitor developments in relation to the nurses’ dispute noting the positions outlined by the parties in public comment and documentation since the talks at the NIB were adjourned on 1st May last.
In its statement at that time the NIB indicated that it envisaged that a resolution to the issue of working hours might be found through a two phase approach in which a specific reduction in working hours would be followed by a second phase in which the Labour Court would have a key role.
Having regard to the seriousness of the dispute and the possible effects of further escalation, the NIB has decided to make recommendations to the parties to provide a basis for settlement. As indicated in its statement of 1st May the Body is established under Social Partnership Agreements and, accordingly, it is required to operate within the framework of such Agreements, including, in particular, the terms of pay agreements. These recommendations are framed in that context.
Phase One
In relation to a first phase, it is the Body’s view, in light of the positions of the Parties, that an initial reduction must be implemented on a cost neutral basis and without diminution of service to patients on the basis of:
(a) The parameters for change, especially in rosters, skill mix and other productivity measures, which have been discussed at national level;
(b) Individual service locations would use these parameters to draw up a package of local changes which would enable the initial reduction in working hours to be implemented on a cost neutral basis in a manner which reflected the nature of the service being delivered in that location;
(c) The Health Sector Performance Verification Group would provide an independent validation process to confirm that the changes planned for each location were sufficient to support the initial reduction and to verify delivery of these changes in advance of the target date for the reduction; and
(d) The initial reduction would be implemented in each location on foot of such verification.
On the basis of the foregoing, and that the changes sought and implemented will be proportionate to the specific reduction in hours and provided it is achieved on a cost neutral basis, the NIB recommends that a reduction of 1 hour 30 minutes to 37 hours 30 minutes net be implemented with effect from 1 June, 2008 with pro rata reductions for those working less than full time.
Phase 2
The legitimacy of the objective of the unions to achieve a 35 hour working week is acknowledged by the management. However, they state that they are unable, at this time, to agree that it is attainable or in what timescale, since this will require considerable engagement at national and local level, involving technical expertise and analysis of international best practice. The latter is being pursued by the HSE at present through a tendering process for appropriate consultancy support. Furthermore, the Labour Court noted that the 35 hour claim would require the implications for the duties, hours and work organisation of other grades and professions to be identified and managed appropriately, so as to attain optimum standards of safe and cost effective staffing levels and work practices.
The NIB believes that the flexibilities and changes in roles and duties which have been offered by the INO/PNA are highly significant and have the potential to make a significant contribution to the quality and effectiveness of the healthcare system including professional care by nurses, as well as to facilitating reduced hours of work within the framework of public pay policy. The NIB therefore recommends below a process to progress the changes which would be required to facilitate reduced hours and calls on the management and trade unions to work together in good faith towards the realisation of reduced hours for nurses within the earliest feasible timeframe, consistent with the wider context of this claim set out above.
The NIB recommends the establishment of a Commission to produce an independent assessment of how a 35 hour week for nurses can be achieved, having regard to the issues set out in Labour Court Recommendation No. 18763. The Government should appoint an eminent person, as independent Chair, two members with international expertise in the management of healthcare and specifically nurse management, and, following consultation with the HSE and the nurses, two additional members. This Commission would examine the international experience of best practice in the activities and deployment of nurses, and the type of flexibilities and change which would be necessary to achieve a 35 hour week. The Commission should take account of the submissions from the HSE management, based on the analysis which it is initiating, and the nursing unions who should elaborate to the Commission on the changes they believe would facilitate the 35 hour week.
The Commission should report within six months, having reviewed the evidence and engaged with nurses and management at national and local level.
The NIB recommends that the Labour Court should develop proposals as to how the second phase of hours reduction should be implemented in light of the Commission’s Report, including validation of the timeframe for implementation. The Court should be invited to recommend how the technical analysis, local engagement and impact on the roles and duties of other grades and professions should be managed to secure the highest standards of efficiency and confidence. The Court, in framing its recommendations, should have regard to;
i. Experience in implementing the Phase One reduction to 37 hours 30 minutes;
ii. The terms of public pay policy under Towards 2016;
iii. The role of the Forum on Health Service Modernisation, agreed between the Government and ICTU; and
iv. The role and potential of the Health Sector National Partnership Forum.
The NIB believes that the scale of the changes which will arise from this process will be challenging to all stakeholders in the delivery of healthcare, and will require sustained and creative engagement at all levels of the policy and delivery systems.
The Body noted in its statement of 1st May that the Labour Court had recommended that issues of nurses’ pay in excess of the basic terms of Towards 2016 should be dealt with through the Public Service Benchmarking Body. It remains open to the unions to put to the Benchmarking Body a case which reflects a very much expanded role for nurses and midwives in the context of enhanced duties, more cost effective and appropriate skill mixes and more efficient rosters, as have been proposed during discussions between the parties.
The NIB recommends that the Parties should confirm to the Benchmarking Body the scope and potential of such proposed changes and assist the Body by outlining the arrangements for verification and validation of such changes. These changes are consistent with the overall Transformation Programme which is underway in the HSE and would deliver significant added value to the Health Service.
One significant aspect of the position of the INO/PNA is that they have not accepted the terms of Towards 2016. The Agreement contains the procedures, including referral to the Labour Court, for dealing with any issues relating to the application of its terms. Issues arising regarding implementation, on foot of acceptance by INO/PNA, should be dealt with in line with those procedures.
Having engaged with this dispute extensively over many weeks, the NIB has put forward these proposals in the firm belief that they represent the only basis on which the current dispute can be brought to an end. The NIB urges the Parties to accept these proposals in order to avoid further planned stoppages, the ongoing work to rule and proposed salary deductions, and in the interest of patient care.
ENDS
15th May, 2007.