Mary Harney (Dublin Mid West, Progressive Democrats)

The fundamental question we have to ask ourselves, as a Parliament, a Government and a society, is what does fairness demand in this situation?

First, and more important than anything else, is what fairness demands for patients. More than 1 million patients are seen in our hospitals each year. Fairness demands that we put patients first, avoiding at all costs inconvenience, distress, disturbance and delays for patients and their families. It is up to those who are strong and healthy in Government, administration, management and trade unions to do this. Fairness demands that disputes are fully explored and settled without distress to patients. There is no point arguing in theory over what type of industrial action affects patients and their families. The test is a simple one: what do patients and their families experience? What do they say? On that basis it is clear already. I deeply regret that the current industrial action is simply not fair to patients, even before any escalation.

Fairness demands that we should take account of 300,000 other public sector workers who have agreed to a fair and collective way to address their pay concerns through benchmarking and Towards 2016. We cannot allow one dispute effectively to dishonour that agreement with them. I believe they rightly expect the Government to hold the line. Fairness demands that we take account of 1.7 million private sector workers, for many of whom pay and conditions are also set or influenced through partnership and whose taxes pay for the salaries of the public sector. These workers include nurses in the private sector. For most of these workers, pay increases amounting to 32%, as per the INO-PNA claims, are unimaginable, and, if paid to others from their taxes, are unacceptable.

Fairness demands that we take account of all taxpayers who together will pay more than €14 billion for health services and investment this year and who rightly can ask for the reasons upwards of €1 billion more would be required from them to meet the demands in this dispute. Fairness also demands that we engage reasonably with the issues raised by the two nurses' organisations in this dispute, that we make available all the industrial relations machinery of the State to address their claims and that we engage in good faith in those processes. We have done all this and we stand ready to continue to do so. In short, fairness demands that a judgment is made taking into account the needs of all groups, starting with patients, and reaching a balance between all. It is not just about fairness to nurses; it is about fairness to all.

The public will rightly want to decide whether their Government is balancing all the needs of all people in its response to this dispute. To make up their mind, the public deserve to know some of the facts. The INO-PNA lodged eight cost increasing claims in December 2005. The dispute centres on two claims for a reduction in the working week from 39 to 35 hours and a pay increase of 10.6% for more than 43,000 nurses of all grades to address a pay anomaly in the intellectual disability sector, which affects 50 staff nurses. A four-hour reduction in the working hours of nurses would take 7.7 million nursing hours out of the public health system and would represent a pay increase of 11.4% on the hourly rate for nurses. The two claims translate into a claim for a 22% pay increase, which, when combined with the 10% available under Towards 2016, amounts to a 32% increase. The four-hour reduction in working hours per week amounts to 30 more days off a year.

A total of 70% of the workforce in the health sector is contracted to work a 39-hour week and nurses account for only half of that figure. Nursing support staff such as health care assistants, attendants and porters, as well as NCHDs and ambulance personnel, also work a 39-hour week. The two nurses organisations are seeking a Dublin weighting allowance. The estimated cost of granting an allowance of €3,800 to Dublin-based nurses would be in excess of €52 million per annum. All other public servants in Dublin would seek a similar allowance. If an allowance were granted to all public servants, the annual cost would be in excess of €252 million.

The claims were heard by the Labour Court in June 2006 and a recommendation issued on 9 November 2006. The court did not recommend concession of the major claims, nor the Dublin weighting allowance, but, instead, urged the unions to reconsider their position on benchmarking so as to have their pay claims dealt with though this process. On the claim for reduced hours the Labour Court stated concession of the claim at this time would have profound consequences for both health care delivery and costs unless effective countervailing measures could be put in place. The court recommended that the parties should jointly explore the possibility of initiating an appropriate process aimed at achieving major reorganisation of working arrangements and practices within the health service generally. Health service employers have confirmed their acceptance of the Labour Court recommendation and their willingness to hold discussions on the claim for reduced working hours as recommended by the court. The national implementation body was made available to the INO and PNA to take up these issues and engaged in good faith to chart a way forward without industrial action. Unfortunately, this outcome of this process, like that of the Labour Court, was not accepted by the INO and PNA.

Public sector nurses pay amounts to €2.2 billlion. The last national agreement, Sustaining Progress, gave cumulative pay increases to nurses of 13.16%, in addition to benchmarking increases of between 8% for staff nurses and 16% for directors of nursing. Nurses' pay has increased by between 75% and 103% across grades since 1997. The basic pay of a newly-qualified staff nurses, before premium shift pay, is €31,233, which compares to the average industrial wage of €31,360 last September. The average annual salary of a nurse in 2005 was €56,000. The number of nurses in whole time equivalent terms has increased by more than 11,100 since 1997 to 36,730 whole-time equivalents or 43,000 individual nurses in the public sector alone. The number of promotional posts in nursing is almost 9,500, an increase of almost 4,000. We have created over 1,900 new clinical nurse specialist and advanced nurse practitioner posts. As a strong supporter of expanding the role of nurses, I have given approval for nurse prescribing to start.

Like most people, the Government and I value and support the profession of nursing and the work of thousands of nurses. Many people rightly say that no price or payment can be put on compassionate care by a top class nurse. No price can be put on a top class teacher or the skill of doctors, no amount can be paid for the bravery of a garda facing criminals and no price can be put on the courage of air-sea rescue staff and many other public servants. Yet we must to settle on a payment and that is why we have to use sophisticated industrial relations methods in a way that is fair to all. I want to see nursing and nurses continue to be held in high esteem by our society. No one wants to see the standing of nurses diminished in the eyes of patients. It would be a tragic mistake if an industrial relations dispute were to have that result and, unfortunately, this dispute runs the serious risk of doing just that.

So what is the way out? There is one way out, one way forward, and it is the same way that hundreds of thousands of other public service workers have taken without special preconditions. It is a way that holds no threat, no dangers, no hidden pitfalls for nurses. It is easy to take, it is available and it is not a long and arduous path. It is the benchmarking route.

Less than nine months are left in this year for the benchmarking process to be completed. In that context, can this disruption to patients and their families be worth it? Surely it cannot.

I urge all involved to reconsider. The Government remains ready to deal with all these issues in a way that is fair to patients and their families, to public servants, workers, taxpayers and the public.

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