Nurses call for health system based on social solidarity not private profit

national | worker & community struggles and protests | feature Wednesday May 10, 2006 17:18 by Annie Winters

INO Conference

The anger was palpable at last weekend’s INO conference in Cavan as nurses from around the country took to the floor to speak out about the woeful state of the health service and to demand better conditions for themselves and their patients. As professionals working at the coalface of the health care service, nurses witness the effects of under-funding, bad management and creeping privatisation in terms of their own working conditions and the level of care they can provide to their patients every day. As the government pushes for privatisation of our health service with incentives for construction of private hospitals nurses witness the erosion of our public health services. Motions brought to the conference by union delegates highlighted the many concerns held by nurses. Motions addressing privatisation, pay, severe understaffing, inadequate support, lack of respect and censorship of nurses were all put to the floor
Read on for a report on the conference and an interview with an INO delegate...

Harney & Privatisation
Nurses' total mistrust of the current PD minister for health Mary Harney and her neo-liberal politics was underlined by a vote of no confidence based on her “failure …to ease accident and emergency overcrowding, lack of clarity over how to address problems facing the public health care service,” and “her negative and antagonistic attitude” towards nurses. Harney’s privatisation plan for the health service was dammed in a motion passed in which the conference “condem[ed], and call[ed] for the immediate reversal of any and all strategies which move to introduce privatised health care.” The devastating effect of the privatisation of health care for both patients and staff in terms of access to and provision of care, pay and workers' rights was underlined by guest speaker Professor Alyson Pollock who spoke about the gradual privatisation of the British NHS, profit-driven health care and the campaign against this. Pollock reiterated the sentiments of many of the INO delegates calling for a health care system based on social solidarity not private profit.

Harney who had been scheduled to address the delegate’s conference failed to show citing a “diary issue” but, perhaps, the recent jeering of British Health Secretary Patricia Hewett at the Royal College of Nurses annual conference in Bournemouth was playing on her mind. Brian Lenihan, minister of state for health, attending in Harney’s stead, received a similar treatment. Irish nurses, like their British sisters, booing and jeering as Lenihan spoke of government plans for privatisation of the health service. INO President Madeline Spears accused the PDs of privatisation policy of “destroying our communities and our health service.” Her resolve to “wipe the PDs off the face of the planet” was met with rapturous applause from delegates.

Pay and conditions
The key demands articulated by nurses in relation to pay and conditions pertain to relative pay and hours of work. The struggle for parity of pay with other health-care workers has been an ongoing battle for nurses. The issue of ‘pay anomalies’ was highlted - i.e., nurses being paid less than other health care workers who are less qualified and hold less responsibility (such as social care workers). They are also demanding a thirty-five hour week in line with other health care professionals.

A presentation about the ‘pay campaign’ was made by INO deputy secretary Dave Hughes. Hughes outlined the INO pay campaign’s demands and proposed methods. He stressed that the union was not ‘threatening anybody’ with strike action and that demands could be won through ‘procedure’ and political means, urging delegates to ‘use your vote not your feet’. A ‘pay rally’ at Croke Park is planned for the 14th June at 3pm.

The aptness and political significance (or lack thereof) of the rally’s proposed venue was questioned by one delegate who recommended instead, marching on the Dáil. This suggestion was dismissed by Hughes who said the time might come for such actions but that it was not now. He encouraged nurses to put their faith in procedure, lobby at local level, use their vote and pack the busses for June 14th. Scepticism at the effectiveness of Hughes’ plan was vocalised by some of the nurses I spoke to. It is apparent that while the INO rank and file are fed up, pissed off and hungry for change, their union leaders do not want to rock the boat. As a body that has been demanding better pay and hours for over twenty years, one would question the merits of “not threatening anybody.”

Understaffing
A central theme at the conference was the severe understaffing that is prevalent in the Irish health service. A blue banner reading “safe staffing saves lives” hung at the top of the conference hall. Several motions brought the issue of understaffing to the floor. In terms of the negative consequences for patients, nurses spoke about how current inadequate nurse-patient ratios prevent nurses from “delivering the care we want to deliver.” In terms of working conditions “unacceptable levels of stress and occupational injury,” resulting from understaffing was highlighted. Connected to the issue of understaffing is that of overcrowding - the chronic A& E overcrowding and lack of hospital beds, which face already stretched nurses. A resolution calling for “the formulation of a capital building program” was passed - delegates stressing the need for more public not private hospital beds.

Lack of respect, lack of consultation and censorship
Many delegates spoke out at what they see as the disrespect for the nursing profession. One delegate commenting that, “we are ignored and treated differently because we are a workforce made up largely of women.” In terms of policy nurses complained that those working at the grassroots are not consulted about decisions that affect them. Concerns about the ‘hierarchical’ and ‘top down’ organisation of nursing were also raised in specific motions.

The issue of censorship of nurses who speak out about substandard conditions by the HSE was raised. A resolution was passed that nurses who “present to the media…a truthful reflection of the state of their working environment” do not face obstructions, threats or other sanctions from the HSE. The delegates warmly supported this motion, Liam Doran union secretary exclaiming that nurses “cannot be silenced by bureaucrats sitting in ivory towers.” A motion calling for the support of whistleblowers was also passed.

Nurses, funding the health service & giving away our resources
Nurses working in the frontline of the health service witness daily the under-funding and inadequate input of resources, preventing them providing the care they want to deliver. In its heyday, nursing was seen as a vocation. Nurses were called to care; while they are now seen as skilled professionals, that vocational spirit applies to a degree. Nurses are not only advocates for themselves (demanding the pay and conditions they deserve), but also advocates for the patients they treat and care for. As one delegate commented, “When patients are suffering we have to stand up for them.” The current mismanagement of the health service in Mary Harney’s PD hands, is resulting in both, inadequate services for patients (overcrowding, hundreds of patients waiting on trolleys, understaffing, waiting lists), and well as poor pay for nurses. Instead of investing in the health service it is purposely degraded as privatise hospitals are subsidised and the neo-liberal agenda is pushed.

As Harney claims there is not enough money for decent service or to pay nurses the amount they demand and deserve, the state has given away billions of euros worth of our natural resources in the form of the Corrib gas field to private oil companies. As well as 100% ownership of the gas field thanks to Ray Burke’s scrapping of a state stake, the consortium of oil companies in control of Corrib, will pay no royalties. A slashed rate of 25% tax courtesy of Bertie Ahern (in his capacity as minister for finance in 1992), and a tax write-off for production, development and exploration costs back-dated 25 years ensure that they will pay either low or potentially no tax at all. The billions from Corrib should be paying nurses the wages they demand and deserve. It should be paying for a free accessible public health service for us all.

Interview with INO delegate.
‘Rose’ is a public health nurse and has been nursing for over forty years.

IMC: As a nurse how would you describe the current state of the health care system in Ireland?
Well I’m a public health nurse and in that area I see, you know, lots of shortages and lots of shortcomings. And while the aspirations are very good and noble and high-minded, there doesn’t seem to be the commitment to putting in resources and putting in the services on the ground. In theory, big advances have been made in supporting people at home but, when it comes to the reality, I just find that the resources are not on the ground. So there’s a lot of frustration, both in terms of families receiving services and, you know, people on the ground such as pubic health nurses trying to man the services. I see lots of shortcomings in terms of areas not covered fully, half cover, no cover for days off - issues that would have arisen from the commission of nurses that haven’t been fully implemented.

IMC:Have you seen changes in your time as a nurse, have there always been frustrations or is this a recent phenomenon?
It would be fair to say that there’s always been some level of frustration but it’s very pressing at the moment.

IMC:What are the most important concerns facing nurses at the moment?
Well I’m thinking of the young graduates now coming out with their honours degrees and I’m sure they will be expecting to be heard and remuneration for the effort and the work they put in to attaining their degrees. So I suppose the pay anomalies are still very much an issue, and I suppose nursing is still very much hierarchical and its kind of from the top down and that people should be given more autonomy on the ground. The shortages of staff, that’s a big issue. It’s a big issues because it’s so difficult to retain people. The system is being bled of highly qualified nurses because there are better terms and conditions abroad and just retaining nurses in the system is difficult because of the poor conditions and because how overstretched and how stressful the situation is. And then because the remuneration too is not as it should be.

IMC:Do you feel nurses have a voice to speak out about these issues?
I think there’s a huge potential for nurses to speak out and yet we don’t seem to the culture seems to be ‘just get on with it’ and that I suppose that will change slowly.

IMC:What’s your response to the proposed rally in June?
Well I see it as a move in the right direction and I’m glad that the pay issue is being addressed and that the people at the top will be made aware at the frustrations and the shortcomings that there are for nurses. Whether the venue (Croke Park) is appropriate is debatable but at least it will be a step in the right direction and we’ll take it from there.

IMC:Whats your opinion of the INO?
Well we’re told that our union is doing most for nurses, that’s its very instrumental in getting things done and yet you wonder, as I sit back here now I ponder over what’s been done over the last number of years? why are the frustrations there that are there? And you know are they really being heard and is there more that could be done? Because just coming from conference I’m just wondering why are terms and conditions for nurses so appalling and why have we left ourselves in such a vulnerable position?

I suppose one has to exercise a degree of scepticism and I you would hope that our union officials and those at the top are genuine and have the best interests of nurses at heart. It concerns me greatly that because were a body of women, you know is this something to do with it. Are we just easily put off, easily appeased are we easily satisfied? And I couldn’t see for the life of me if it was the same, if this was a male run service that we would have the conditions that we have. Were just being seen as handmaidens and easily satisfied and given token gestures.