The role of the Health Service Employers' Agency is misunderstood, writesGerard Barry
Recent commentaries on the Irish health service demonstrate serious confusion about the role of the major organisations within it and indeed the history of major recent industrial disputes.
The Health Service Employers' Agency (HSEA) is the employer representative body for all publicly funded health service employers, i.e. health boards, public voluntary hospitals and voluntary bodies within the intellectual disability sector. These organisations employ some 96,000 people and have a €5 billion plus annual pay bill.
The HSEA conducts pay negotiations on behalf of these employers with the health service unions who represent the workforce and leads the way in the development of the best human resource practices.
Much public debate, of which the recent Irish Times editorial "Threats to our Health" of March 25th, 2003, is an example, highlights some of the misconceptions and confusion regarding the HSEA's precise role and responsibilities, particularly with regard to the conduct of industrial relations in the health service. As the representative body of Exchequer-funded health agencies, the HSEA's primary responsibility is to represent the employers' interest and to protect the Exchequer, i.e. the taxpayer.
The charge by The Irish Times editorial writer that the HSEA "has failed to prevent a number of industrial disputes involving doctors and nurses in the public service" ignores a number of realities in these disputes.
Firstly, successive pay agreements have contained "industrial peace clauses" which outlaw the threat or the taking of any form of industrial action by trade unions (or employers) in pursuit of demands for pay terms in excess of the provisions of these agreements. Yet it is a matter of record that the health service unions have engaged in a number of serious industrial disputes in recent years in pursuit of pay increases well in excess of the standard pay terms previously agreed by the social partners.
The HSEA has striven hard over the years to resolve disputes in a fair and consistent manner and where agreement has not proved possible in direct negotiations with the trade unions we have always utilised the State's industrial relations machinery i.e. the Labour Relations Commission and/or the Labour Court. We have always honoured recommendations from these institutions.
In contrast, the unions have adopted an a la carte approach to these institutions, accepting or rejecting verdicts as they see fit. For example, the nurses' strike in October 1999 followed one of the most comprehensive and detailed Labour Court investigations in the court's history, which awarded one of the biggest pay increases ever to any large group of public service workers. Yet the nursing unions rejected the court's recommendations and embarked on strike action.
The Non-Consultant Hospital Doctors (junior doctors) took strike action in some hospitals last summer to prevent hospital managers commencing a gradual reduction in NCHD working hours so as to ensure compliance with the EU working time directive for a 58-hour working week by August 1st, 2004.
This action was taken against the background of years of public protests by NCHDs about their long working hours and the successful lobbying by the Irish Medical Organisation in Brussels to have the protection of the working time directive extended to NCHDs.
In the current dispute involving the public health doctors the IMO has embarked on a "work to rule" and is threatening strike action before it has fully utilised the State's industrial relations machinery in the search for a solution to their grievances.
While it is acknowledged that the Public Health Review Group did take considerably longer to report than originally envisaged, it is important to understand that the IMO was an equal partner and co-owner of the review process and as such must accept collective responsibility for its outcome.
The HSEA, for its part, has confirmed to the IMO that it is willing to make good any pay increases its public health doctors may have lost out on because of the delay in completing the review, in addition to the pay increases recommended for them by the Public Service Benchmarking Body.
While the HSEA readily acknowledges that the state of industrial relations in the health service in recent years is a cause of legitimate concern to both Government and the public at large, a stable industrial relations environment requires a commitment on the part of all involved to dispute resolution through the use of due process and honouring agreements.
I take encouragement from the recent pay agreement, Sustaining Progress 2003-2005, and the recognition on the part of all of the health service unions and employers of the paramount importance of a better industrial relations climate and partnership in the health service.
Where disputes or differences arise they must be resolved in a manner that insulates the health service from the damaging effects of industrial action and the consequent hardship and distress to hospital patients and other users of the health service. It is the least that the community can expect from us.
Gerard Barry is the chief executive of the Health Service Employers' Agency (HSEA)