Nurses on a picket line mean lives on the line

WHAT makes the nurses' dispute so potentially serious is the fact that health services to the public will be endangered, and thus patients' lives. Health services, and especially those in major acute hospitals, run on a knife edge at the best of times.

In January and February the knife's edge is particularly keen and there have already been stories of people waiting up to three days on trolleys in accident and emergency wards. How long will those trolley sojourns become when A&E departments become the focus of all attempts by patients and GPs to get hospital treatment?

On Tuesday, the Labour Court began its efforts toe salvage a settlement. Its intervention, under the chairmanship of Ms Evelyn Owens, has averted many major disputes. The most recent was the Aer Lingus pilots' dispute, which was settled last September, less than five hours before it was due to begin.

There are severe time constraints on this occasion as well. But there is an even more fundamental problem and that is the lack of success of the general secretary, Mr P.J. Madden, as well as the other leaders of the Irish Nurses' Organisation (by far the largest union) in selling a deal to their members.

The Labour Court can engage in its time honoured practice of wearing down the negotiators, on both sides, through hours of discussions and extracting the last ounce of concession they are prepared to make to each other. But the court cannot do that to 26,000 nurses. That process can only take place on the picket lines.

The social partners who engineered the type of national agreements we have in this State hoped pickets and the serious disruption they bring would be banished to the industrial relations past. But national agreements are based on the assumption that everyone is more or less happy with their place in the trade union pecking order.

It is no coincidence that four of the major groups of workers involved in major disputes over the past two years have been comparatively low paid and overwhelmingly female: Dunnes Stores shopworkers, civil service clerical workers, Aer Lingus cabin crew, and nurses.

Of these groups nurses are undoubtedly the best paid. But nurses don't compare themselves any longer with other women workers, including health professionals, because other women health workers, such as speech therapists, are just as badly paid. They look at the predominantly male health professionals and they look at outside professional groups.

The days when women looked on a job as something to tide them over until marriage, or for pin money, are long gone. Today they take a long, hard economic look at issues like pay, pensions and career structures. Unfortunately, national agreements reflect the bad old days, as far as these women are concerned.

If they are to redefine their status as workers, by definition they have to do so outside the terms of national agreements. That is why they are so unconcerned about breaching the industrial peace clauses of Partnership 2000 or the Programme for Competitiveness and Work.

Unions like SIPTU, IMPACT and the Psychiatric Nurses' Association of Ireland may find it hard to square issuing strike pay to members when they have signed up to the deal. For the INO the matter is academic - there is no strike pay.

Instead, that union has ploughed its limited resources into a publicity campaign to carry its message to the public. It may be as well, for the unions have difficult task if the strike is to go ahead.

On the one hand they have to keep the immense public sympathy they have on the other they have to make sure the industrial action is effective enough to force a substantially better offer from the Government before they are starved back to work.

Many staff nurses seem happy to adopt a confrontational, high risk strategy because they are convinced of the justice of their cause, and because they have little previous experience of industrial conflict. During the past few months INO membership has soared from 14,000 to over 21,000.

Lack of experience in conducting disputes has been reflected in some local strike committees trying to reduce the levels of emergency cover below those agreed by the nursing unions and health managers at national level.

It is hard to see how this dispute can be easily resolved. The cost of conceding the main demands tabled by the INO is, according to the Minister for Health, Mr Noonan, an additional £150 million, if early retirement is included.

In many ways early retirement, estimated to cost £50 million, is the most justifiable demand of general nurses. Psychiatric nurses, gardai, firefighters and prison officers, all overwhelmingly male occupations, have it. Research also suggests that nurses who remain full time in the profession have a significantly shorter life expectancy than other women in comparable occupations where women predominate, such as teaching and social work.

IT may be that nurses could win early retirement by taking an anti discrimination case to the EU Court of Justice. Some observers wonder why that course was not pursued years ago. But EU justice is very slow. For the moment nurses must rely on the Labour Court.

The court may find it possible to bend the framework of the PCW or Partnership 2000 to accommodate extra pay for nurses, but the frame could crack if early retirement is added to the agenda. If nurses really want a revolution in the workplace it is hard to see how they can achieve it without taking to the barricades, or in their case the picket lines, on Monday.

Part of the price may be paid in patients' health, or even lives. Pail may be paid in changing for ever the way the public perceives nurses in our society. Nurses may feel it is worth the risk.