Last week saw a planned work-to-rule suspended by health unions following an agreement reached with the HSE. Unions, including the INMO and Fórsa, initiated this industrial action due to the ongoing impact of the HSE’s ‘Pay and Numbers Strategy’. This previously saw the HSE initiate a ‘hiring freeze’ in the middle of a prolonged health service staffing crisis, and continues to restrict the recruitment of both patient and non-patient facing roles.
Leaving posts vacant for long periods of time means that healthcare staff are working unpaid overtime to keep services running. They are asked to ‘act up’ to fill more senior roles without increased pay or required training; and are forced to complete tasks outside of their role. This does not just leave workers burnt out but is highly dangerous in clinical settings. INMO General Secretary Phil Ní Sheaghdha stated that ‘Nurses and midwives on the frontline are crying out for support, and they feel ignored. Instead of additional staff, they are being faced with recruitment embargoes and needless administrative obstacles. Senior decision-makers in the HSE are clearly desensitised to the risks associated with continuing to leave posts vacant. Unsafe staffing is having a detrimental impact on the health and safety of our members who are experiencing high levels of exhaustion and are extremely demoralised by constant exposure to high clinical risks.’
Agency staff not the answer
Policies like these increase staff burnout, and blatantly compromise patient outcomes. This shifts the responsibility of managing the HSE’s fiscal responsibility problem onto frontline staff who are already tasked with providing a vital public service with little resources. We can also see clear hypocrisy when senior management were sanctioning the booking of agency staff over the period of the work-to-rule, leading to the planned escalation of industrial action to a full work stoppage in Our Lady of Lourdes Hospital Drogheda. The recruitment and retention of agency staff is more costly than permanent staff, and although the ‘Pay and Numbers Strategy’ aims to limit agency recruitment – this is not being seen in practice.
It is important to note that the planned work-to-rule was not suspended by the Psychiatric Nurses Association; mental health nurses completed only contracted duties until last Friday when the HSE agreed to complete a review on staffing levels in mental health services by the end of April. This demonstrates the even larger crisis in our mental health service with critically unsafe levels of staffing. The suspension by general nursing and healthcare staff unions has come following an agreement that maternity leave cover will be prioritised, more consultation with unions on future staffing decisions, and an increase in the conversion of agency posts to permanent HSE jobs.
Much more needed to end health staffing crisis
The proposals are yet to be reviewed, and it will be up to the union members on whether to go ahead with further industrial action. However, it is clear that this agreement won’t be the magic bullet to fix the crisis in our healthcare system. We can see that over the past few weeks even the threat of staff only performing contracted duties made HSE management engage and make some concessions. Health and social care staff need to now more than ever, join and be active in their unions, because, as this dispute has shown, together their voices can be heard.