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SIPTU says National Ambulance Service crisis has paramedics at ‘breaking point’
SIPTU representatives have raised concerns about the challenges facing its members employed in the National Ambulance Service (NAS) due to an increase in demand for its services that has pushed many paramedics to “breaking point”.
SIPTU Sector Organiser, Ted Kenny, said: “The upsurge in demand on the NAS is pushing many of its paramedics to breaking point. The increased numbers attending Accident and Emergency Departments across the country has severely impacted turn-around times, with crews having to wait hours on end to hand over their patients.
“Some paramedics have reported working several hours beyond the end of their 12-hour shifts which is leading to burnout. In addition to this, they are now being requested to work additional hours to assist with the current upsurge of activity being reported across the health service.
“SIPTU representatives have been engaging with the management of the NAS on a number of outstanding issues at the organisation including the implementation of an Independent Review of Roles and Responsibilities Report, staffing concerns and the appropriate funding of the service.
“The NAS has been under funded for years and needs at least an extra 2000 staff along with 120 new ambulances to provide the level of service that is now needed.
“The Independent Review of Roles and Responsibilities Report was jointly commissioned by the NAS, SIPTU and the HSE in 2018. The report made several recommendations to address recruitment and retention issues within the service, to identify career pathways for staff and to update the roles and responsibilities of all grades within the service. To date, the recommendations of the report has not been implemented.”
He added: “An appropriately staffed and funded NAS that can retain its dedicated workforce, would be of huge benefit to the communities it serves as well as the acute hospital sector which has seen a huge increase in activity in recent weeks.
“We are calling on the Minister of Health, Stephen Donnelly, to intervene to ensure the recommendations of the Independent Review of Roles and Responsibilities Report are implemented as a matter of urgency.”
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Update: Health Service Upsurge in Activity January 2023
SIPTU met with HSE Management this week to further discuss the situation regarding the increase in activity in the country’s acute hospitals. Below is a summary of that meeting.
The HSE provided the following update to the meeting:
• Attendance at ED is considerably higher than the same timeframe in 2022. (10,500 additional presentations)
• Highest ever recorded attendance of 75+ years patients.
• Influenza cases continue to rise
• RSV cases are evidencing a decrease
• COVID cases are steady
• The HSE acknowledged the work being undertaken by staff in all grades of the health service during this difficult period.
• The meeting was advised the National Crisis Management Team is meeting every week and local reviews are ongoing daily.
• The HSE accepted additional capacity is required in the private sector & community care.
• They advised they are engaging on a national agreement with private hospital representatives, but this has not been concluded. They stated funding has been made available.
• The meeting was informed of transfers being undertaken of medical patients to private healthcare.
• Site visits are ongoing across the country.
• They are seeking to increase resourcing over 24hrs and weekend service is being looked at.
In response, SIPTU and fellow health unions outlined the following:
• We stated it was unacceptable that many sites had failed to have any local engagement with union representatives on proposed changes to service provision.
• We advised we could not accept forced outcomes which sought to dismantle existing terms and conditions of employment of our members.
• Any proposal should come from local consultation and agreement with our membership & their representatives.
• We had sought a document from the HSE outlining the challenges and the perceived solutions. This was still awaited.
• We sought clarity what supports would be put in place for healthcare workers during this crisis, both those in work and those who have taken ill due to a workplace sourced infection.
• We asked for clarity on the arrangement with the private sector. What level of additional bed capacity, and where, is expected to come from that agreement? What level of additional support has been sought for the National Ambulance Service and diagnostic services?
The HSE confirmed:
• They are seeking to develop a document which will be shared with the unions.
• A management meeting was happening this evening to respond to the union call for supports for healthcare workers during this crisis. Further clarification would issue on this shortly we were advised.
• There would be no ‘ripping up’ of existing agreements with unions. Any proposal would have to recognise existing agreements. Local dialogue was key and would be supported at national level by the HSE.
• Agreement with private sector is not finalised. Local sites are required to identify what they need.
• Management accepted demands could not be made of staff. While a request may be made, subject to the agreed terms, acceptance would be on a voluntary basis only.
• Management also accepted any proposal for change to provide weekend cover could not simply be achieved by moving existing 5 day staff across a 7 day pattern.
• Management stated they had not received a request internally for additional capacity from the private sector for diagnostics.
The meeting adjourned and management agreed to revert on several key points asap. This includes:
• Provision of a composite document
• Clarity on the supports which will be provided to staff during this phase.
A further meeting was proposed for early next week. The date and time for this meeting is to be confirmed.
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SIPTU to meet with HSE to discuss difficulties faced by the acute sector
SIPTU and ICTU Health unions are to meet the HSE later this week to discuss the upsurge in activity faced by the acute sector. It follows a a meeting which took place on December 30th to discuss the situation.
At that meeting, management advised of the following:
• Different issues and pressures are presenting on sites across the country.
• The current challenge is not only prevalent to emergency departments and is being experienced across all areas of the acute system.
• There is significant absence of healthcare workers being recorded due to illness.
• The current level of activity within the acute system has not been experienced since the beginning of the pandemic in early 2020.
• The level of flu symptoms presenting have not spiked and are continuing to climb. This is causing a significant level of concern.
• The meeting was told members of the National Crisis Management Team (NCMT) are visiting all acute sites across the country. This is an ongoing situation.
• NCMT is engaging with all sites and advising them to use whatever means are deemed necessary to address the upsurge.
• Solutions are being identified locally as they will be different depending on the challenges arising.
• Management stated they have been planning for winter 2022/2023 for a considerable period but the current patterns are presenting a sudden surge with no ending in sight.
• Discharges are being prioritised.
• This is an exceptional influenza season. Due to post covid, flu was very low in the last two years. The season normally peaks at week 4. This is now week 7 and is still climbing.
• Cases of RSV (in children of 5 years and younger) appear to be falling.
• No new COVID variant has been identified.
In response, SIPTU requested the following:
1) A composite document from the HSE which outlines all the challenges presenting across the country, the local solutions identified to address them and confirmation they will be supported with necessary funding. The HSE stated they would seek to have a document prepared for the unions and this would be shared at the next meeting.
2) Confirmation from the HSE of what protections and supports they will put in place for healthcare workers themselves who are striving to provide care to their patients in this extremely difficult period. The HSE stated this would be considered and they would seek to respond next week.
3) Clarification regarding the use of additional capacity within private hospitals. We were advised additional capacity within private hospitals has been secured across the country. Th Union understands this includes additional capacity within the private hospitals we organise within. The meeting was advised the specific use of additional capacity within private hospitals will depend on what is available and the local needs arising. The exact arrangements will be agreed at local level.
4) Clarification if additional capacity is being utilised by the National Ambulance Service (NAS). The meeting was advised NAS already has arrangements for the use of private or voluntary ambulance services. SIPTU requested specific information relating to what additional capacity is currently being used by the NAS to address the upsurge in activity. The Union was advised this would be sought from the NAS and presented at a further meeting.
5) Management stated additional capacity within diagnostics is a central element of the plan to address the current challenge arising. SIPTU requested clarification of what specific provisions are being made available for additional diagnostics capacity.
SIPTU will endeavour to keep members updated on the outcome of the next meeting.
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SIPTU Nursing and Midwifery Sector Welcomes Government approval of additional supports for Student Nurses and Midwives
SIPTU’s Nursing and Midwifery Sector has today (December 13th 2022) welcomed an announcement from Minister for Health, Stephen Donnelly, that it is his intention to provide additional supports for student nurses and midwives to the value of €9m.
In November 2021, the Minister published the Longer-Term Review of Matters Relating to Student Nurses and Midwives (McHugh Report). The review, carried out by Mr. Seán McHugh, made a number of recommendations that would enhance the pay and conditions of student nurses and midwives. Today, Minister Donnelly announced government approval for funding the following, in line with the recommendations in the McHugh report:
1) An enhanced Travel and Subsistence Scheme for student nurses and midwives in years 1 to 3 of their studies will see each receive €500 per year as a targeted measure to contribute towards meeting the extra costs of meals associated with practice placements outside the student’s core placement site.
2) A new rate of €80 for overnight accommodation is being introduced, along with an increased weekly cap of €300, for those students who require accommodation away from their normal place of residence while attending practice placements. This weekly cap is three times the cap introduced on 1st January 2022, and almost six times the previous cap.
3) Student nurses and midwives can also avail of, on a vouched basis, the reasonable cost of uniform laundry services during periods of overnight accommodation.
4) Pay will be re-instated at 80% of first year staff nurse/midwife pay scale, for internship students.
5) Two additional uniforms for student nurses and midwives at the start of their internship.
Speaking after the announcement, SIPTU Sector Organiser, John McCamley said “The announcement of government approval for funding to implement these elements of the McHugh report is welcomed. It follows a long-fought campaign by our members to address some of the financial hardships faced by student nurses and midwives during their placements; and we are hopeful that it will go some way towards encouraging people into the profession.”
“The Union will now be engaging with the Department of Health to ensure that these measures will be implemented without delay, now funding has been approved.”
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SIPTU says employment permits do not resolve retention issues of home care workers
A recent government announcement that 1,000 General Employment permits will be made available for home care workers from January 2023 will not address the core issues of recruitment and retention of carers in the home care sector, according to SIPTU Organiser, Pat Flannery.
He said: “SIPTU members have previously raised concerns following publication of the ‘Report of the Strategic Workforce Advisory Group on Home Carers and Nursing Home Healthcare Assistants’ in September 2022 that the recommendations did not go far enough to address the crisis of staffing within the sector.
“The announcement made on 30th November last by junior minister, Damien English, that work permits will be made available for home care workers from January 2023 shows a lack of imagination in how the Department intends to deal with the shortage of Health Care Assistants in the home care sector.
“Our members are concerned that the disparity in basic pay and in terms and conditions of employment will continue to exist between workers in public and private employments within the home care sector. As a consequence, workers will continue to vote with their feet and go to work in public employments.
“We note that Damien English has said that the permits being made available will be for full-time positions with a minimum salary of €27,000. A Health Care Support Assistant in the HSE can earn up to €38, 290 and has access to far more favourable terms and conditions of employment including premium payments, travel and mileage payments, as well as access to a pension scheme, which is not available to their private sector counterparts in many instances.
“SIPTU is calling on the minister to prioritise addressing poorer working conditions within the private home care sector and for the Union to be represented on the ‘Implementation Group for the Report of the Strategic Workforce Advisory Group’ which has been established by the Department of Health.”
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First meeting of National Radiation Therapist Review Group takes place
SIPTU have welcomed the first meeting of the National Radiation Therapist Review Group which took place today, December 1st.
This first meeting takes place at a crucial time for cancer treatment services. Radiation therapy is used in the treatment of around half of all cancer cases. This treatment is delivered by radiation therapists who, as part of a multi-disciplinary team, have the legal authority to carry out this role. SIPTU has continuously raised the crisis that exists in the recruitment and retention of radiation therapists; and the knock-on effect it is having in delayed treatment for patients. Currently there is approximately a 15% shortage of Radiation Therapists nationally.
Following the meeting Sector Organiser, John McCamley, said “The National Radiation Therapist Review Group will investigate and make recommendations on a range of matters which could alleviate the recruitment and retention crisis among radiation therapists. This will involve exploring areas around safe staffing, career progression, advanced practice, managerial structures and role development for the radiation therapist.”
It is hoped that the Review will contribute to the continued professionalisation of the service to the benefit of staff and patients.
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INMO and SIPTU prepare for industrial action over Clifden District Hospital Failures
Members of SIPTU and INMO are preparing to ballot for industrial action due to the failure of the HSE in St. Anne’s CNU and Clifden District Hospital, Clifden, Co. Galway to engage with the trade unions under the auspices of the Workplace Relations Commission, following the unilateral imposition of rosters and failure to be transparent in the future of Clifden District Hospital.
Conciliation talks under the auspices of the WRC failed to progress due to management’s refusal to comply with the provisions of the Public Service Agreement as it pertains to roster changes and service reconfiguration of the service delivered from Clifden District Hospital.
It is the belief of our members that management have orchestrated a situation whereby there is critical shortage of nurses leading to an inability to maintain services on both sites. The blatant lack of workforce planning has resulted in this situation occurring.
Management proceeded to unilaterally impose rosters and have failed to provide any cogent information regarding the future of Clifden District Hospital.
Staff and the community are very concerned regarding the future of Clifden District Hospital.
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Sláintecare essential to reform of dysfunctional healthcare system says Shortall
Full implementation of the Sláintecare policy is essential for the effective reform of our health and social care services, Social Democrats co-leader, Róisín Shortall, told the SIPTU Health Division Biennial Delegate Conference in Waterford on Wednesday, 26th October.
Shortall said: “Sláintecare is a 10-year roadmap for reform of our health and social care services, to get us from the current two-tier unfair and unequal and in many ways dysfunctional, health service to a universal single-tier health and social care service where people can access timely care on the basis of health need and not on their ability to pay.
“The Sláintecare report was published in May 2017 so we’re now coming to the end of year five, and the question is ‘What have we got to show for it?’ The first two years consisted of lip-service from the Fine Gael government where the Minister for Health talked the talk but didn’t actually walk the walk. The term Sláintecare became a convenient brand for him to wrap himself in.
“It seemed that most senior government politicians assumed that Sláintecare would go the way of those other health reports and be forgotten. However, when it came to the general election in early 2020, Sláintecare was adopted as official policy by all parties. No one had a Plan B.”
She added: “Like many things in life, the causes of the dysfunction and inequality of our health service are down to political choices, bad choices, which favour vested interest over the public interest.”
SIPTU Health Division Organiser, Kevin Figgis, said “Change is an integral part of working within the health service. Our members have demonstrated their ability to work in a changing environment over many, many years. They will not be found wanting when it comes to engaging with the implementation of Sláintecare.”
He added: “However, as we begin to grapple with what this entails, we will be doing so from the principled position that we will not be engaging with any programme that could be seen as eroding the hard-won terms and conditions that our members have fought for. SIPTU will not be engaging with any reform agenda that includes the outsourcing of our members’ roles to third parties.”
Róisín Shortall addressed the SIPTU Health Division Biennial Delegate Conference in the Tower Hotel, The Mall, Waterford City as a guest speaker on October 26th.
