A deal between the Health Service Executives and the Irish Nurses and Midwives Organisation, which has averted planned strike action, involves cash bursaries to attract nurses, promotions, extra annual leave and a review to establish appropriate staffing in emergency departments.
The strike, which was scheduled for seven hospital emergency departments today, was called off last night pending a ballot of INMO members on a new set of proposals agreed at talks at the Workplace Relations Commission.
INMO General Secretary Liam Doran said the ballot will be carried out by 5 January.
He said the agreement will try to reduce overcrowding in hospitals and will result in the reduction of elective surgeries.
However, the HSE's National Director of Human Resources, Rosarii Mannion, said she does not accept that the deal would mean reducing the number of elective surgeries.
Mr Doran acknowledged that all nurses are over worked, but said this dispute was centred on emergency staff problems and finding a better deal for them.
Emergency nurses will get two additional days of annual leave in 2016 and 2017 in lieu of missed meal breaks.
This will apply to those currently employed and those recruited before December 2016.
Among the recruitment initiatives, there will be a €1,500 relocation payment for nurses recruited from abroad.
In addition, recruits in all nursing disciplines, not just emergency departments, will be entitled to a €1,500 educational bursary payable one year after they join.
A review of staffing levels in emergency departments must be completed by the end of March 2016.
There will also be an accelerated report on pay for student and newly-graduated nurses to be completed by 22 December.
Extra grade one clinical nurse managers will be promoted to aid with patient flow.
In addition, in departments with high numbers of admitted patients for whom beds are not yet available, there will be dedicated grade two clinical nurse managers to oversee their care.
Hospital escalation policies to deal with overcrowding will be standardised across the country.
As yet two things remain unclear: the cost of the proposals, and the extent to which they may trigger knock-on claims from other grades.
The INMO has confirmed that further industrial action in emergency departments scheduled for January will remain in place until members decide whether the proposals negotiated with the HSE are good enough.
Asked whether the additional leave to compensate for missed breaks could realistically be contained to emergency nurses, Mr Doran said this related distinctly to health and safety and to pressure in emergency departments.
He also welcomed new promotional structures, as well as the promise of a new emergency department staffing report to be completed within three months.
Asked about the cost of the measures, Mr Doran said that was a matter for the employer.
Ms Mannion said the HSE was in the process of costing the final details, but expected funding to come from existing resources.
She acknowledged that the educational bursary would apply to all new nursing recruits, not just those in emergency departments, but said there was competitive market with a global shortage of nurses, and it was hoped this initiative would help with recruitment on a broader scale.
She said the two extra days annual leave in 2016 and 2017 was to compensate individuals working in very difficult environments in emergency departments.
Asked about the potential for knock on claims, she said the annual leave claim was related to emergency department nurses, and she was confident it can be contained, as the HSE made the concession on the basis that the issues are specific to the emergency sector.
She said the proposals absolutely did not breach the Lansdowne Road Agreement, as that was not within the HSE's discretion.
Speaking on RTÉ's Today with Sean O'Rourke she said if the deal is accepted it will result in much better conditions for staff.
Ms Mannion added that other staff members in the health service worked extremely hard but she was not aware of other departments in the health service that were under the same pressure as emergency departments.
She said the €1,500 bursary would not be given in payment to nurses who qualify for it but would be granted to employers to spend on training.
Ms Mannion said there would be an increased recruitment drive over the Christmas period and hoped the new incentivised deal would encourage nurses to return to the public service and appealed to anyone currently working in the private sector to apply to the HSE.
Fianna Fáil's Health Spokesman Billy Kelleher has said while the agreement between the INMO and HSE might go towards addressing some of nurses' concerns, "the fundamental principals of a proper health service" had not been addressed.
Speaking to RTÉ News, Mr Kelleher said Government needed to address what he described as the "underfunding and the under capacity in our health services".
Mr Kellher said this had to be done quickly or we would see a continued escalation of the number of people both on trolleys and awaiting appointments.
He also said he expected the HSE service plan, which went before Cabinet today, would be published tomorrow and he wanted to see a strong commitment from the Government to address these problems.
SIPTU awaiting details of deal
SIPTU's Health Divisional Organiser has said the union is waiting to see the detail of the deal agreed between the INMO and the HSE.
Mr Bell said SIPTU may submit its own claim, depending on the detail of the agreement reached between the HSE and the INMO.
Paul Bell said the devil is in the detail and SIPTU nurses had taken the approach that there was a need to increase staffing levels but there was no indication yet as to whether there would be an increase in the number of nurses or other staff in the emergency department.
Mr Bell questioned the judgement of confining the deal to nurses in emergency departments and said there are many other members of emergency staff, including doctors, ambulance staff and porters, who are caught up in the current crisis.
Speaking on RTÉ’s Today with Sean O'Rourke, Mr Bell said that other grades of staff in the health service have had their work conditions changed over the past number of years and they will want to know how the deal will affect them.
Mr Bell added that SIPTU would like to know how the HSE can afford to pay the extra hours and supplements out of its budget given it has already had to apply for a supplementary budget this year.
He said the Lansdowne Road Agreement determines conditions and pay and it will be a challenge for the HSE to ringfence this agreement for emergency nurses.
Mr Bell said that this dispute began over concern for patients at emergency departments but it has yet to be learnt whether additional resources to ensure their well-being have been achieved under this deal.
