There can be no surprise that the Minister for Health, Mr Cowen, received muted applause and some derisory laughter when he addressed the annual meeting of the Irish Nurses' Organisation in Letterkenny at the weekend. He told the nurses, now three-and-a-half years into a still unresolved dispute about their pay, their career structures, their responsibilities and the very future of their profession, that it had proved impossible to isolate their Labour Court settlement in 1997 from other levels of public service pay. Part of that settlement was the establishment of an independent commission, chaired by Miss Justice Mella Carroll. This made it quite clear that there had been massive change in nursing over recent decades which needed to be addressed both monetarily and structurally. Yet Mr Cowen's immediate reaction was to say that the pay elements had to be addressed in the context of public service pay generally.
The Labour Court had recognised that there had been extensive changes in the requirements placed on nurses in both training and delivery of health care. The independent commission confirmed such change. Would-be nurses have recognised the radical changes that have taken place in their chosen profession and have turned to other tasks to fulfil whatever other vocational ambitions they may have held. There is now a critical shortage of skilled nurses in the hospital services because of this. Many nurses have left the profession because there was so little recognition of the burden of skills and responsibilities which they had to carry. Yet Mr Cowen and, it has to be said, certain other unions in the public service - now trying to leapfrog on a nurses' settlement that still has not been resolved finally - do not appear to have recognised any of this.
The nurses are a special case. It cannot be said too often. They and this State (if it is to maintain a health care service of high quality) need a special settlement which is outside the traditional norms and relativities of others in the public service. The minister needs to act and to speak as if this was his ambition too, but he has shown no sign of commitment to, or understanding of, the nurses' situation. Instead of lecturing the nurses at their meeting about how their threats of industrial action are not helpful to the resolution of their long-standing dispute, he would do better to engage actively in their cause with some evidence of sympathy for their case. The health-service paymasters at the latest round of discussions have steadfastly resisted claims involving pay. The minister and the Cabinet should remind themselves that they, on behalf of the citizens of the State, are the ultimate paymasters.
The public services unions, too, must give the nursing alliance of the INO and other nurses' unions, some leeway to make special amends for the deplorable lack of care demonstrated by the State for nurses in recent decades. Even as their jobs were becoming more demanding and more arduous, and as report after report on their profession was left ignored and unimplemented, the nurses' jobs were becoming more difficult as their pay levels declined relative to their duties. It is long past time that some amends were made to nurses. If none can be made without breaking the Exchequer, then neither the Government nor the people can complain when wards are closed because there are no nurses to care for the patients that might be admitted to those closed wards. Is this the legacy that Mr Cowen wishes to leave behind him when he departs the Department of Health?