The failure of the Commission on Nursing to deal with pay and early retirement is likely to gravely disappoint the State's 30,000 nurses. The report, due to be ratified by commission members on Wednesday, is expected to add to unrest over Public Service pay and conditions.
Almost 200 recommendations are contained in the report, many relating to structural and educational changes in the profession, but the commission believed the outstanding industrial relations issues should be redirected to the Labour Court.
The Commission on Nursing was set up as part of the £87 million package which nurses accepted in a ballot completed in February 1997. Chaired by Miss Justice Mella Carroll, the commission met some 3,000 nurses from throughout the State as part of its consultation process.
It is understood there was a threatened split in recent weeks between the four unions in the Nursing Alliance - the Irish Nurses' Organisation, SIPTU, the Psychiatric Nurses' Association and IMPACT - because of the apparent failure of the commission to address these issues.
The group of unions met separately from the commission on two occasions at the end of last week and finally managed to come to an agreement on Thursday. It is believed some are still unhappy but hopeful the thrust of the report will be a strong back-up when they return to the Labour Court.
The report is to be sent to the Minister for Health, Mr Cowen, and is to be published in early September.
One union source said it was expected nurses would be very pleased with a number of the recommendations, including the establishment of a Nursing Council and new structures within the profession. However, much disquiet is expected because pay and early retirement issues had not been addressed and were deemed outside the group's terms of reference.
"Our understanding was that the terms of reference were broad enough to deal with the outstanding difficulties over the years, including industrial relations issues."
A number of issues are to be referred back to the Labour Court, including allowances for nurses.
Other matters relate to "acting up", where nurses fill the role of ward sister or matron at weekends and other times; salaries for ward sisters; incremental annual leave and additional long service increments.
As far as the commission is concerned, early retirement is being dealt with by the Commission on Public Service Pensions. Currently, the vast majority of nurses must work until aged 65, unlike psychiatric nurses, prison officers and gardai, who can retire eight to 10 years earlier.
It is expected there will also be unhappiness among about 2,000 ward sisters. The bulk of the money in the original pay deal was targeted at staff nurses, eroding the pay differentials between them and staff nurses. Now they will have to return to the Labour Court for their pay increase.
Among its other recommendations, the commission has called for the establishment, on a statutory basis, of a Nursing Council which would oversee post-graduate education and clinical specialism.
The report recommends new structures in the nursing profession to encourage nurses to specialise in certain areas and operate with a degree of autonomy. It also recommends new gradings within the ward sister structure and changes within the nursing management structure.