Ms Phil Ní Sheaghdha:

I will deal with the final point first. Theatre time is not being utilised largely because hospitals are admitting a large number of medical patients to beds through the emergency department. The majority of patients admitted through emergency departments are medical patients. Therefore, the post-operative beds are simply not available. One will often hear stories from patients who are taken directly from the emergency department to theatre and then to the recovery room in some instances for two or three nights because no ward bed is available for them. That is impacting on patients booked in for elective procedures. If no bed is identified, obviously they cannot be asked to come. Many patients talk about elective operations being cancelled repeatedly because of the lack of availability of beds.

Theatre nurses are highly trained and skilled and in short supply. While we have managed to keep numbers sufficiently above the threshold, the requirement to provide an on-call service impacts significantly on them. As well as working a 39-hour week, they also need to provide an on-call service which in many instances takes them out of the service. We need to staff theatres inclusive of the on-call commitment. Basing it on a 39-hour week is not helping to determine the correct number because every single night of the week an on-call team needs to be available and in some instances two, depending on the specialty involved. In some hospitals where maternity services are also a feature, if there is an emergency, the hospital might only have one on-call team to deal with an emergency and it might have an emergency obstetrics case. It has become a significant risk in some hospitals, particularly those outside the maternity specialism. Some hospitals cater for general admissions, maternity services and paediatrics all under the one roof and have one theatre on-call team, which is not safe.

With regard to the pay differential, the settlement of the dispute, which was delayed but has now started to be implemented, will see a big difference in salary at staff nurse grade. The second part of this is the expert group on the management grades. We are disappointed in the length of time it has taken the Department of Health to revert to us on the terms of reference and the parties to conduct it. The Labour Court has instructed that it has to be concluded by next May in order to feed into the next round of public service pay talks. Despite numerous requests, we have not received the terms of reference. We have submitted our draft terms of reference and the parties to conduct the expert review. We are awaiting this from the Department and it is well overdue.