The first national nurses’ strike in almost 20 years is posing a major challenge for a health service already under strain. The timing of the initial in a planned series of six 24-hour work stoppages yesterday could not have been worse from the perspective of the Health Service Executive (HSE), given the traditional pressures exerted on services during the peak winter season.
More than 2,000 planned operations were cancelled, along with 13,000 outpatient appointments. Further disruption included long waits for those services that were operating. More seriously, the HSE acknowledged that its ability to deliver safe services would be “compromised” during the industrial action. This is a matter of deep concern; patient safety must be a priority and any threat to it must be minimised.
Although hospital emergency departments (EDs) continued to operate, just a skeleton staff of nurses was deployed and they did not provide a triage service. About 3,500 patients attend EDs daily and those who did turn up needed to be prioritised and treated. The closure of local injury units because of the strike and the impact of bad weather further complicated the situation.
The HSE and the Irish Nurses and Midwives Organisation worked hard in advance to agree contingency arrangements for the strike, and these contacts resulted in derogations being agreed by the nurses to allow specific services to operate. It is vital as the dispute continues that discussions between hospital and local strike committees result in a dynamic response to conditions, so that surges in demand or major incidents can be dealt with promptly.
More than innovative thinking will be needed to resolve the growing unrest among health staff
Further one-day strikes are planned by the INMO on Tuesday and Thursday of next week, and industrial action is also being taken by psychiatric nurses. The cumulative effect of these disputes will see tens of thousands of patients waiting longer for medical attention, effectively reversing what little progress has been made in reducing waiting lists over recent months.
For now, the prospect of a resolution to the nurses' strike seems distant. The Labour Court has decided not to make a formal intervention at this point. A wide gap separates the INMO's call for an across-the-board pay rise for its members and the Government's contention that the €300m cost of this claim cannot be afforded, would breach public service pay agreements and would trigger knock-on claims.
More than innovative thinking will be needed to resolve the growing unrest among health staff. The Government, public service management and the nursing unions must now use the opportunity provided by the gap before next week’s scheduled strikes to get back around the table.
Instead, further entrenchment on all sides appears more likely.