INDUSTRIAL RELATIONS ACTS, 1946 TO 1990
SECTION 26(1), INDUSTRIAL RELATIONS ACT, 1990
DEPARTMENT OF HEALTH & VOLUNTARY HOSPITALS
DEPARTMENT OF HEALTH & CHILDREN
DEPARTMENT OF FINANCE
(REPRESENTED BY THE HEALTH SERVICE EMPLOYERS' ASSOCIATION,
IRISH BUSINESS AND EMPLOYERS' CONFEDERATION)
- AND -
IRISH NURSES' ORGANISATION
SERVICES INDUSTRIAL PROFESSIONAL TECHNICAL UNION
PSYCHIATRIC NURSES' ASSOCIATION
Chairman: Mr Flood
Employer Member: Mr Pierce
Worker Member: Mr Rorke
1. Claims referred from the Commission on Nursing:- (1) Recognition for long service in the staff nurse grade, (2) Review of differentials for Ward Sisters and other promotional nursing grades.
2. In March, 1997 the Labour Court issued LCR15450 in which it recommended that a Commission on Nursing be set-up within one month of the recommendation being issued. The report of the Commission on Nursing (the Report) issued on the 31st of July, 1998. The Report contained the following two recommendations:-
"The Commission recommends that the question of
additional recognition of long service for staff nurses
be examined through the established structures."
"The Commission recommends that differentials and
incremental annual leave in promotional grades be
examined as a matter of urgency, before December,
1998, through the established structures. To this
examination should be added the effect of the enhanced
role for ward sisters and higher grades which has been
recommended by the Commission earlier in this chapter."
On the 21st of September, 1998, the Unions referred the matter to the Labour Relations Commission. A conciliation conference took place on the 22nd of October, 1998. As agreement could not be reached the matter was referred to the Labour Court on the 4th of November, 1998 under Section 26(1) of the Industrial Relations Act, 1990. A Labour Court hearing took place on the 3rd of December, 1998.
CLAIM 1 - SUMMARY
3. The Unions are seeking for the staff nurse grade the introduction of long service increments, each of 6% of basic pay, payable after 16, 19, and 22 years service. It is also seeking that annual leave entitlements be increased from 24 days to 26 days for the first five years of service, 28 days after 5 years and 30 days after 10 years.
1. The Nursing Alliance represents nurses from all areas of nursing and within all specialities of nursing. Notwithstanding the structural changes recommended by the Commission on Nursing, it is a simple fact that in excess of 75% of all nurses will remain in the staff nurse grade for the duration of their working life.
2. The claim seeks to extend the staff nurse pay ladder, so that it spans a twenty-two year period, resulting in a closer alignment with the twenty-five year scale presently applicable to the teaching profession.
3. The pay changes sought would bring into line, in terms of the hourly rate of pay, the levels of remuneration of the staff nurse to that already applicable to the Grade 5 clerical officer, with whom the staff nurse has sought parity over the years.
4. Throughout this change process, which has been accepted by the staff side, the keystone of the system will be the staff nurse grade. S/he will be extremely challenged by the changes which are about to occur in nursing. This will occur through the advent of the entry level degree programme, the increased focus on best practice and in-service education, the ever increasing levels of technology within the health care system, the never ending and indeed increasing pressure on resources.
5. The anomalies with regard to the annual leave entitlements are well known and accepted by management.
6. The staff side is acutely aware of the cost of this claim. However, these additional costs will be significantly minimised by the extension of the scale by nine years. Furthermore, it is recognised that the changes sought could be linked with the structural and workplace changes proposed by the Commission, which are expected to be introduced over the next two years.
CLAIM 2 - SUMMARY
4. The Unions' claim that differentials arising from promotion within nursing are less than those applying in other professions and that this is a disincentive to promotion. The Unions argue that the claim is a long-standing claim which was tabled in 1993 in relation to a promised review of the gradings and differentials for nursing grades and that the employer side never sought to address the merits of the claim but has hidden behind the threat of consequential relativity and leapfrogging claims which might arise should further pay adjustments be conceded to nursing grades.
WARD SISTERS/NURSING OFFICERS
- The removal of the first two points of the current ten point scale.
An increase of 25% to be applied to each of the remaining eight points.
The introduction of two long service increments both equal to 6% of salary applied after three and six years respectively.
Annual leave allowance of 30 working days.
1. Where premium earnings are a normal part of income i.e., staff nurse, the maximum of the next grade i.e., ward sister, must be greater than the actual earnings of the staff nurse so as to make the promotion financially viable. The difference should be a minimum of 15% of total earnings.
2. In addition to addressing the existing shortcomings in terms of the differentials and comparable pay levels applicable to ward sister/nursing officer, the claim must also reflect the pay structure that should accompany the enhanced role envisaged for front line managers arising from the Commission's Report. It is clear that the newly retitled clinical nurse/midwife managers grades will have greater degrees of accountability and responsibility in the areas of clinical competence, managerial functions, budgetary management and information technology.
3. The pay adjustments sought are required both to redress current shortcomings and also reflect the proposed changes detailed by the Commission on Nursing. Some of the pay adjustments sought should be applied in parallel with the introduction of the work practices and other changes required arising from the Commission on Nursing's final report. This is consistent with the view that this is the final stage of the restructuring process, envisaged for nursing grades arising out of the PCW agreement.
4. In relation to junior ward sisters, the claim is for the removal of the first two points of the scale and an increase of 25% to be applied to each of the remaining points. This would reflect the enhanced role envisaged for this grade as it effectively becomes a more integrated part of the front line management structure operational in all wards/departments.
- The Unions are seeking parity in terms of pay and conditions of employment for nurse teachers with college lecturers in universities/third level colleges.
- UNIONS' ARGUMENTS:
1. The minimal differential which currently exists between grades of nurse teacher and staff nurse must be addressed in order to ensure a continuing supply of nurse teachers.
2. The terms of pay and conditions of employment must reflect the work currently undertaken by nurse teachers and management must recognise the enhanced role envisaged arising from the many and varied changes in nurse education recommended by the Report.
SENIOR NURSE MANAGERS
As part of the interim agreement, contained in the Blue Book and LCR15450 a significant restructuring of senior nurse manager grades and salaries took place. This essentially involved the creation of five bands of Director of Nursing which would replace the previous arrangement which involved thirteen separate grades of matron. The claim seeks significant increases in pay across all bands.
1. The newly introduced five band system, although now broadly acceptable in structure to the staff side, has a number of anomalies which need to be addressed if a proper and appropriate pay structure is to be introduced for nurse managers.
2. The proposed new rates would create meaningful differentials between senior nurse managers and the staff nurse and ward sister grades and bring senior nurse manager salaries into line with that existing for comparable senior grades and recognise the enhanced roles envisaged by the Report.
CHIEF NURSING OFFICERS - PSYCHIATRIC SERVICE
The Unions are seeking maintenance of the current pay relationship with the Director of Nursing (Band 1).
1. This post warrants parity with the director of nursing (Band 1). The chief nursing officer reports directly to the Programme Manager and is the senior post within the clinical services. The appropriate salary for the post is £44,000 - £48,000.
SENIOR NURSE MANAGERS - MENTAL HANDICAP SERVICES In any realignment nurse managers in the Mental Handicap Services wish to maintain their relative pay position within nurse management. The current pay structure is as follows:-
- 1. Centres with Schools of Nursing with budgets in excess of £5 million - £29,346 - £32,490 x 7.
2. All other centres band 5 - £23,724 - £26,902 x 7.
The Unions are seeking:-
- 1. School of nursing and large centres - £38,000 - £43,000.
- 2. All other centres as band 5.
In addition the staff side is seeking an increase in the annual leave allowance to a minimum of 32 days.
1. Salary increases are required to ensure that promotion to senior nurse manager positions have a meaningful impact upon income.
2. A staff nurse in a band 5 hospital earns essentially the same income as the director of nursing when actual earnings are taken into account. In the circumstances there is no incentive for promotion to senior management posts.
3. The differentials issue as it pertains to senior nurse managers is serious and regressive. The present situation militates against the maximum number of people applying for these senior posts. This has been acknowledged by the employer side.
In referring to the overall function of middle nursing and midwifery management, the staff side seek to include the following grades Night Sister/Night Superintendent, Assistant Director of Nursing, Assistant Chief Nursing Officer, Divisional Nurse Manager, Assistant Matron.
In restructuring the senior nurse management grades, it is the view of the staff side that all of these grades should have a pay relationship with the director of nursing post in their hospital. This relationship should give them a salary of 80% of the rate granted to the director of nursing.
1. The Commission recommends that middle nursing and midwifery management should have a defined management role and not merely retain a "gatekeeping" administrative function.
2. The Commission is recommending the empowerment of middle management, in nursing and midwifery, to become operational managers and to assume more autonomous roles and functions. Linked with the change must be an appropriate salary.
3. The staff side cannot over emphasise the significant issues that lie behind its claims for enhanced differentials for middle and senior management The present structure is a source of great unrest, and frustration for the 500 people approximately who currently occupy these grades.
COMMUNITY NURSING GRADES
In relation to this particular area the claim refers to the following three grades:-
Public Health Nurse
The unions are seeking a direct analogue with the senior social worker grade (current salary £27,890 - £32,548 x 5). In addition two long service increments of 6% of salary to be applied after three and six years at the new maximum.
Senior Public Health Nurse
A minimum differential of 15% at all points of the scale between the public health nurse and the senior public health nurse.
Superintendent Public Health Nurse
The retention of the current arrangement which involves alignment for pay purposes with Director of Nursing (Band 3). In addition, the Unions are seeking an increase in annual leave entitlements to 30 working days for public health nurse, 31 days for the senior public health nurse and 32 days for the superintendent public health nurse.
1. The public health nurse is the focal point of all community health services and essentially provides the main alternative to in-patient hospital admission.
2. The current pay scale clearly undervalues the current role and function of the public health nurse. The differential between the public health nurse and the staff nurse grade was worsened by the "Blue Book" agreement and LCR15450. Significant changes have taken place with regard to the role and function which have not been properly reflected in the pay applied to the grade.
3. The pay determination system, where the nurse is being treated as one grade, has failed to recognise and deal with this complete change in the working life of the public health nurse. This has resulted in the pay level, applicable to this grade, being significantly below that warranted by the contribution made to the community health service.
4. The senior public health nurse is the first promotional grade within the community nursing structures. The differential between the public health nurse is inadequate to attract the maximum people to apply for promotional posts.
5. The Commission recommended that the future role of the superintendent public health nurse should be concentrated on a number of specific issues. Against this background the maintenance of the current pay alignment is reasonable and logical.
COMMUNITY REGISTERED PSYCHIATRIC NURSE
The grade of community registered psychiatric nurse is now well established within the overall mental health services available. The grade currently has a broad pay relationship with the nursing officer grade. The Unions are seeking that the pay relationship be maintained.
1. The Commission on Nursing has recommended substantial changes to the existing role with much closer integration with other community based health professionals. This will impact upon the role of the community registered psychiatric nurse, in terms of the education levels required, the reporting relationships and volume of work. While this is welcomed by the staff side, it must be followed by appropriate increases in salary.
- 1. Centres with Schools of Nursing with budgets in excess of £5 million - £29,346 - £32,490 x 7.
5. 1. The Minister for Health and Children has already indicated that the Government is accepting the broad thrust of the Commission's Report, including the pay dimensions of various important recommendations in the Report (such as the introduction of a clinical career path involving new higher grade specialist posts). The Minister has said that he wishes to talk to the nursing unions about a partnership approach to the implementation of the Report.
2. The nursing unions are seeking to use the Commission's Report as a pretext for re-opening their PCW local bargaining claim. It is clear from the terms of LCR15450 and the terms of reference of the Commission that, while the establishment of a Commission was an essential element in resolving the nurses' claim under the PCW, a re-opening of PCW pay issues was never envisaged.
3. The Government statement of the 25th of September, 1998 made it clear that nurses' pay cannot be divorced from public service pay policy generally and that to attempt to deal with it in any other context would run the substantial risk of leading towards a destabilising return of leapfrogging 'special' increases to restore traditional relativities.
4. The Unions' claims were not raised with the Labour Court in 1997 when it issued its recommendations on revised pay and conditions for nursing grades under the PCW. They are new claims.
5. The terms of reference of the Commission on Nursing, based on LCR15450, do not include any reference to long-service increments for the staff nurse grade, nor does the Report make any reference in relation to increased annual leave for the staff nurse grade.
6. The rationale for premium earnings is to compensate staff for the inconvenience of working 'unsociable' hours. It would be unprecedented to continue to compensate for unsocial hours when such hours are not being worked or to pay compensation on an on-going basis. In all sectors of the economy staff cease to benefit from shift premia or other unsocial hours payments when they take up promotional posts which do not require them to work unsocial hours. Percentage differentials, therefore, should only be evaluated by reference to basic salary.
7. It is management's view that the Commission on Nursing Report, a document welcomed by all sides, sets out a blueprint for the future development of nursing. Management recognises that implementation of the Commission's recommendation will have significant cost implications.
8. Unions and management must begin detailed discussions on the implementation of the measures recommended in respect of nurse management grades. It needs to be recognised that, having achieved very significant special pay increases under PCW further pay developments for grades above staff nurse level come within the new framework recommended by the Commission and accepted by management and within the context of overall public sector pay policy.
9. In its recommendation LCR15450 the Labour Court recommended a completely new 10 point salary for the staff nurse grade with a long service increment after 3 years service on the maximum scale. In summarising its recommendation the Court stated:-
"On the evidence presented the Court is satisfied that the
nurses have fallen behind other grades and the Court has
attempted to remedy that position. The terms outlined above
are the maximum which could be recommended."
10. An overriding concern of the management side is the need to ensure that any further developments in relation to the pay of nurses is addressed in a way which does not spark off a further spiral of public service pay claims with all the implications this would have for the overall management of the economy. The February, 1997 settlement with nurses cost about 14.5% and over £80 million, involving increases ranging form 6% to 17% for staff nurses, and 12% to 16% for ward sisters.
The Labour Court as part of Recommendation No. 15450 recommended the setting up of a Commission on Nursing to examine such items as structural and work changes, segmentation of the grade, training and educational requirements, promotional opportunities and related difficulties and a general assessment of the evolving role of nurses.
The Commission was set up following acceptance by the parties of the Labour Court Recommendation and it subsequently produced a comprehensive report including 200 recommendations. The Commission Report contained the following two recommendations:
1. The Commission recommends that the question of additional recognition of long service for staff nurses be examined through the established structures.
2. The Commission recommends that differentials and incremental annual leave for promotional grades be examined as a matter of urgency before the end of December, 1998 through the established structures. To this examination should be added the effect of enhanced role for ward sisters and higher grades which has been recommended by the Commission earlier in this chapter.
These issues were the subject of conciliation at the Labour Relations Commission on the 29th of October, 1997 at which no common ground could be found and they were subsequently referred to the Labour Court. A Court hearing was held to deal with these issues on the 3rd of December, 1998.
At the hearing the Nursing Alliance argued that the claims made were long standing ones that had been unresolved over many years. They stated that they “form the very core of any dedicated effort to restructure nursing in a manner which maximises the individual nurses contribution to efficiency and effectiveness through high productivity and enhanced flexibility, while genuinely recognising their financial worth.”
They indicated that there was a very serious crisis in nursing, that nurses were angry and frustrated, that there was an acute shortage of nurses resulting in curtailment of services and that school leavers were unwilling to consider nursing as a career. They argued that the annual leave allowance for nursing grades was significantly lower than that applicable to other grades within the service. They stressed that differentials arising from promotion within nursing are less than those applying in other professions and are a major disincentive to people to take on promotion.
This situation was worsened with LCR15450, as it actually reduced the differentials which existed between the staff nurse maximum and the maximum of ward sister and other higher grade pay scales.
Management, for its part, argued that these were new claims and could not be taken in isolation from public sector pay policy. While they had accepted the broad thrust of the Report of the Commission on Nursing and accepted that there would be significant costs involved, they believed that the Alliance was using this as a pretext to re-open the PCW negotiations. They were prepared to discuss issues that would arise from the implementation of the Report but they could not accept the Alliance claim, which they saw as an attempt to re-open the negotiations for all nursing grades.
The Commission, in its Report, dealt in some detail with the issue of nurses who would remain primarily responsible for the delivery of high quality care to patients and clients within the health service but might not move on to higher grades. It also dealt with the differential situation and indicated that it considered the existing differentials constituted a difficulty in relation to promotion. They went on to say the current pay structures seriously mitigate against the current staff nurses availing of promotional opportunities. On the question of incremental leave it highlighted that, unlike every other occupation in the health service, nursing does not have a system of incremental leave.
The Court is satisfied that the issues referred by the Commission and now being addressed were not before the Court in 1997 but are based on the consequences of implementation of the Nursing Commission Report.
The Court accepts that pay scales must be improved to reflect the enhanced roles proposed in the Report for ward sisters and higher grades. The pay scales for staff nurses were addressed in Labour Court Recommendation No. 15450.
The Court also believes that the morale problems outlined in Court, that appear to be caused by the attitude to and treatment of nurses by some superiors, doctors, and consultants, must be addressed.
However, the Court while accepting that there are grounds for salary increases in promotional grades, believes that these must be based on negotiation and implementation of the Nursing Report which has not yet been discussed by the parties. The Court finds it inappropriate to make a recommendation at present without having knowledge of what is likely to be agreed. There has been no discussions between the parties and no attempt at conciliation at the Labour Relations Commission.
The Court believes that Labour Court Recommendation No. 15450 was the culmination of lengthy negotiations resulting in substantial improvements for nurses and that the Commission Report forms the basis for progressing further the nurses aspirations and for enhancing the nursing profession.
The Court notes that the Commission has indicated that:
(a) it considers that existing differentials constitute the main difficulty in relation to promotion,
(b) current pay structures seriously mitigate against encouraging nurses to avail of promotional opportunities,
(c) another factor which must be taken into account in relation to promotion is that, unlike almost all other occupations in the health service, nursing does not have an incremental leave arrangement.
The Court also notes that management has, for its part, accepted:
(a) the broad thrust of the Commission's Report including the pay dimensions of various important recommendations in the Report,
(b) that there will be significant cost implications in relation to ward sisters and higher grades,
(c) the need to address the issue of lack of involvement and empowerment of nurses.
However, the Court is not in a position to make a definitive recommendation on the issues before it, given the fact that no negotiations have taken place between the parties, and consequently it is unable to assess the effects on personnel and the financial implications of the implementation of the Report.
The Court, therefore, recommends that the parties enter into discussion immediately on the implementation of the Report on Nursing. These discussions should include the financial implications of implementation, and the effect on individuals and groups within the nursing profession.
The Court in making such a recommendation is conscious of the lack of trust between nurses and management based on perceived delays in completing negotiations in the past and failure to set up a Commission despite commitments given. The Court is also conscious that the Nursing Alliance has made a number of decisions pre-empting the outcome of the Labour Court hearings.
The Court is, therefore, setting a deadline for these discussions to be completed by May 1st, 1999 at which stage the parties will report back to the Court. The Court will then make definitive recommendations on the substantive issues on which parties have failed to reach agreement.
Signed on behalf of the Labour Court
9th February, 1999______________________
Enquiries concerning this Recommendation should be addressed to Fran Brennan, Court Secretary.