Nurses, doctors clash with Government over staffing and contracts

INMO says its continued cooperation over winter ‘should not be taken for granted’

Nurses and midwives have warned the Government that their continued co-operation in the health service over the winter “should not be taken for granted”.

The Irish Nurses and Midwives Organisation (INMO) said its members' safety was facing a triple threat from understaffing, the winter surge in demand for care and the Covid-19 pandemic.

Separately public health doctors expressed “extreme disappointment” over a lack of progress in talks with Government and health service officials on Wednesday on moves to place specialists in this area on contracts on a par with those of hospital consultants.

The Irish Medical Organisation (IMO) said public health doctors were getting just "lip service" for their efforts in the fight against Covid-19. It said it was the essential work of public health doctors that was "allowing society and schools to re-open through their management of outbreaks, clusters and surges of Covid".


The IMO is seeking that the public health becomes a consultant-led service and that public health specialists be awarded consultant contracts “to reflect their expertise and specialist skills”.

Public health specialists earn €113,822 at present. Hospital consultants with a type-A contract - which permits them to treat only public patients - have a pay scale that ranges from €141,026 to €195,653.

IMO chief executive Susan Clyne said on Wednesday following the talks: "It is a matter of extreme disappointment that we were advised that the Department of Public Expenditure and Reform (DPER) had no timelines for the required legislative reform to enable progress and have yet to sanction the terms of the new consultant contract and its implementation.

"The argument for public health specialists to be awarded consultant posts has long been accepted in many Government- commissioned reports including Crowe Howarth and Dr Gabriel Scally's report on cervical check yet little or no progress has been made to date. It is all the more concerning that even in the context of Covid there is no urgency on the part of Government to deal with this matter."

The IMO said the Government was prepared to rush through legislation to facilitate pay increases for super junior Ministers “but the same urgency is not there when it comes to delivering a consultant-led, well resourced and appropriately staffed public health system”.

“It is all the more frustrating and disrespectful to our public health specialists in circumstances where it is their essential work that is allowing society and schools to reopen through their management of outbreaks, clusters and surges of Covid and they receive little more than lip service for their efforts.”

‘Triple threat’

The INMO said its executive was “urgently seeking talks to establish how many extra nursing and midwifery posts will be funded over the coming year - particularly in winter”.

INMO president and Sligo-based nurse, Martina Harkin-Kelly, said following a meeting of the union’s executive on Wednesday that the health service was facing a triple threat from understaffing, winter and Covid.

“The three make for a bruising combination, pushing nurses and midwives to breaking point.”

“We are not simply attending work: we taking serious risks to provide care, often in exceptionally uncomfortable environments.

“The INMO executive council today had a very clear message: the HSE must engage with the union on its workforce plans urgently. We cannot go into winter without a plan that’s agreed with frontline workers. Nurses and midwives cannot be taken for granted.”

INMO general secretary, Phil Ní Sheaghdha said HSE needed to set out how and where the health service would find additional nursing and midwifery staff this winter.

“That should naturally be done in consultation with the INMO, yet we have still had no engagement, with winter fast approaching.”

The Department of Health said the Minister for Health and the HSE were committed to the early introduction of a new model for public health care which would incorporate consultant status for public health specialists.

It said engagement with the IMO on the twin issues of consultant status and remuneration for public health specialists had been ongoing since January 2019.

“The Department and the HSE have consistently indicated their support for consultant status and significantly enhanced levels of remuneration (a type ‘A’ consultant contract) in this engagement.

“It is envisaged that sanction will be sought from the Department of Public Expenditure and Reform for consultant status and remuneration as soon as the model is finalised.”

The Department of Health said it had been engaging with DPER “on the need to prioritise the amending legislation in the autumn session to enable implementation”.

Martin Wall

Martin Wall

Martin Wall is Washington Correspondent of The Irish Times. He was previously industry correspondent