Nicky McFadden (Fine Gael)
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I am asking that the Minister for Health and Children, Deputy Harney, intervene in the serious dispute at Portiuncula Hospital, Ballinasloe, County Galway, ongoing since September 2008. I raise the issue because much is at stake for the health of the people of the midlands and Galway area. The hospital is integral to the health services for the area because Athlone, with a population of more than 20,000, does not have its own hospital. A press release from the Health Service Executive last month stated wards might close and surgical services could be cancelled at the hospital owing to the dispute. The hospital has 200 beds with 700 health staff. It would have serious consequences if there were any cancellations of surgical procedures.

Five nurse managers, who have given stalwart service to the health service over the years, had concerns over health and safety issues for staff and patients. There have been several peaceful lunchtime protests where auxiliary and nursing staff have shown their support for their colleagues in the dispute. A stalemate has emerged between the hospital's senior management and these nurse managers.

There is a possibility the Labour Relations Commission will mediate between both parties. There appears to be reluctance on the part of the senior management at Portiuncula Hospital to engage in discussions that might allow those on both sides to air their grievances. This matter is not beyond resolution. I am of the view that there has been a lack of communication. I know members of the senior management at the hospital and also the five nursing managers who are absent from work on sick leave as a result of stress. I am aware that the latter want to care for the patients at the hospital and I cannot understand why this matter has reached a stalemate. The Minister for Health and Children must intervene.

Last year, staff at Portiuncula Hospital discharged more than 11,000 patients and dealt with 6,300 day cases. In addition, 39,000 people attended the hospital through the outpatients department. I do not wish to be political about this issue, that is not why I am raising it, but the Hanly report is being implemented behind closed doors and I am concerned that the HSE will use what is happening as an insidious means by which to downgrade services at Portiuncula Hospital. It has already been stated that there will be ward closures, that surgical procedures will be curtailed and so forth.

I ask the Minister of State to ensure that all the services currently on offer at the hospital will be retained and that the dispute will be resolved so that the five nurse managers, who are dedicated and have a vocation to their work and who really care about people, will be able to return to work.

Martin Mansergh (Tipperary South, Fianna Fail)
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I thank Senator McFadden for raising this matter, which I am taking on behalf of the Minister for Health and Children, Deputy Harney. I do not doubt what the Senator said with regard to the value and importance of the services on offer at Portiuncula Hospital and people's concerns in respect of possible reconfigurations. I am familiar with these matters as a result of events in the area I represent.

The issue raised by the Senator relates to an internal operational matter at Portiuncula Hospital, which is managed by the HSE. However, the Department of Health and Children has been informed by the HSE that concerns were raised by senior nurse management in respect of communication, morale and working relations. Hospital management engaged a third party to undertake a review that would include recommendations, as appropriate. This approach was agreed with the Irish Nurses Organisation, INO, which advised its members to participate in the process.

The HSE also informed the Department that failure to comply with an instruction from the general manager to two assistant directors of nursing to participate in the review resulted in the disciplinary procedure being invoked. On appeal to the director of the National Hospitals Office, the complaint of insubordination was upheld with a lesser sanction and the staff were asked to return to work on 10 November 2008. On that date, the staff in question informed management that they were on sick leave. Industrial action by the INO commenced on 17 November and was lifted on 24 November following agreement by the INO and the HSE on two matters, namely, an independent review of the HSE disciplinary procedure in this case, with recommendations for future situations, and the appointment of an agreed mediator to manage an orderly return to work for those assistant directors of nursing involved. Mediation hearings were held on 9 December 2008 and 12 January 2009. These were organised by the Health Service Executive employers agency but they have not proven successful to date.

The return to work of the assistant directors of nursing has been hindered by the insistence of the INO that all records of disciplinary sanction be removed from the files of the assistant directors of nursing and that no disciplinary action should be taken against three other assistant directors of nursing who had also refused to attend a meeting as instructed and who also went on sick leave in November 2008. Management's position is that this request is outside the terms of the November agreement. HSE management has contacted the INO and confirmed its intention to attend conciliation with a view to securing an acceptable accommodation which will allow for the orderly return to work of the five assistant directors of nursing.

Nicky McFadden (Fine Gael)
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I thank the Minister of State for outlining the position. However, I am already familiar with the complexities of the situation. His reply did not really provide much comfort, particularly as I asked that the Minister for Health and Children should become involved. The toing and froing involving the HSE and the INO has been taking place since September last and a satisfactory resolution has not been reached. I am of the view that it will be necessary for the Minister to bring the five nursing managers and the various other parties involved together to discuss this matter. If this happens, the authoritarian attitude that has marked the reaction to the dispute will be absent. A peace process is required in this instance. I accept that what I am seeking is out of the ordinary but that is what must be done.

Martin Mansergh (Tipperary South, Fianna Fail)
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There are ample conciliation procedures available in the health service and elsewhere. In general, Ministers are advised not to intervene in disputes of this nature. If they did intervene, we would rapidly reach a position where no dispute could be resolved without the personal involvement of the relevant Minister, and that would simply not be practical. I share the Senator's desire to see this matter resolved through a display of goodwill, flexibility and pragmatism on the part of the various parties involved. Those parties must be willing to accept mediation and arbitration.

Nicky McFadden (Fine Gael)
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I wish to——

Paddy Burke (Fine Gael)
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There is no provision for the Senator to make a further intervention.

Nicky McFadden (Fine Gael)
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The question of health and safety is one of the issues of contention in this dispute, but the Minister of State did not refer to it. Perhaps he will bring that aspect of the matter to the attention of the HSE.