In the weeks ahead nurses and midwives will have to decide on whether to bank about €20 million in pay improvements suggested by the report of the Public Service Pay Commission, or press for a better deal, potentially on foot of industrial action.
Nurses had wanted the commission to recommend across-the-board pay rises as a means of tackling recruitment and retention problems.
However, the report found there was no generalised recruitment and retention problem and pay was not the key factor in staff shortages.
The commission recommended increases of 20 per cent in some nursing allowances and improved access to promotional posts.
But not all nurses would benefit from these measures.
The Government estimates that about 18,000 nurses – out of a workforce of close to 40,000 – would receive a pay boost under these changes to allowances. On average, the proposed initiatives could be worth about €400 more annually.
The Commission held out the potential for a further review to examine “the adequacy of current pay arrangements” down the road.
However, the language was somewhat vague. It suggested the Government and unions could consider putting such an arrangement in place “at an appropriate time and without compromising the stability of the public service pay bill”.
The Government will now begin talks on foot of the commission report.
The Minister for Public Expenditure, Paschal Donohoe, is anxious that any such improvement in allowance payments be "quarantined" and do not lead to knock-on claims elsewhere.
Whether the suggested general pay review for nurses would be acceptable to other public service groups would be questionable.
In reality, any such review may have to be linked to the implementation of the Sláintecare health reforms and any work practice changes this would involve.
The Irish Nurses and Midwives Organisation (INMO) on Tuesday called for direct negotiations with Ministers on pay in advance of a special conference it is holding at the end of the month.
Talk to nurses and midwives anywhere in Ireland, and they'll tell you pay is the number one cause of understaffing
The union’s general secretary Phil Ní Sheaghdha said: “It’s up to the Ministers for Health and Finance to engage with us seriously before our special delegate conference in September. Our deadline stands. Without progress, our members will be forced to examine other alternatives.
"Nursing and midwifery are professions in crisis, with only one application for every four vacancies. Talk to nurses and midwives anywhere in Ireland, and they'll tell you pay is the number one cause of understaffing.
“Ireland simply can’t hire enough nurses and midwives on these wages.”
It is unclear whether any such Government engagement will be directly with nurses and doctors or with the broader public service trade union movement.
The governing council of the Irish Medical Organisation is expected to respond fully to the Commission following a meeting on Thursday.
“There are almost 500 vacant consultant posts at present, and more NCHDs [non-consultant hospital doctors] are emigrating to work and live abroad than ever before. The challenge now is for the Government to devise a realistic response to this crisis which will address the critical shortage of doctors now and in the years ahead,” it said.
The president of the Irish Hospital Consultants Association, Dr Donal O'Hanlon, said the recruitment and retention crisis needed to be urgently addressed in order to provide timely and quality care to patients.