Irish Medical Organisation

Health sector retirements - IMO IR Director on Newstalk

28th February 2012

The following is a transcript of extract from a Newstalk Lunchtime interview on public retirements in the health sector. IMO's IR Director Steve Tweed joined Liam Doran of the INMO to discuss the issue and the current visble lack of a HSE contingency plan for the health service given the departure of thousands due to retirement.
Newstalk Lunchtime with Jonathon Healy on Tuesday 28th February.
Presenter (Jonathan Healy):
I want to turn to the big day tomorrow for nine thousand members of the public sector because they’re availing of the Early Retirement Scheme. They will be gone by Thursday. Minister for Public Sector Reform Brendan Howlin was speaking a little bit earlier on Newstalk. He’s acknowledged that there will be problems on the frontline but the aim at the end of it is to have a better more efficient and cheaper sector. 

What does it mean if you or a family member needs hospital care on Thursday? We’ll try and tease that out now with Liam Doran of the Irish Nurses and Midwives Organisation and Steve Tweed, Director of Industrial Relations with the Irish Medical Organisation which represents doctors. Gentleman you’re both very welcome to the programme.
Liam first of all to you, I mean you’ve been trying to get to the bottom of this for some time as to what the contingency plan is. Are you satisfied there is a contingency plan in place for Thursday?
Liam Doran:
Well we’re not satisfied in the sense that, the contingency planning was left far too late and, but at the same time it has to be acknowledged it was very difficult and remains very difficult because this is a self selection retirement option and really you have to bring it down to the level of the individual hospital or the individual primary care area in order to try to work out who is leaving and how do you maintain services. I mean I wish I could share the Minister’s confidence about, you know no one’s going to oppose being efficient and effective, but the problems in the public health service is that we have had three successive years of financial cuts, four successive years of staffing cuts. We have increasing levels of demand. 
Staff are doing super human things everyday to keep the system afloat and you know the wall gets higher and you know we’re going to have to make it work but I think the only way it’ll be made work is by the health service becoming smaller in terms of capacity, in terms of available beds, in terms of available continuing care beds, in terms of primary care interventions. The health service will become smaller and primarily focus upon emergency essential work only.
Well we heard Brendan Howlin, well we would have heard Brendan Howlin there saying that they’re going for a more efficient and a cheaper sector but what about this suggestion that they’re going to change the rosters of nurses now, going to two six hour shifts as opposed to twelve hour shifts. Are nurses going to be willing to accept that change?
Liam Doran:
I mean it just drives me to despair Jonathan and listeners, to hear this been written by people from the central, sort of high echelons of the office of the health sector and so on and it’s so detached and so removed from what’s happening in the frontline. Rosters change everyday and have been changing everyday for the last two or three years in the health system. If people counted up the amount of unpaid hours that nurses do, that junior doctors do and that consultants do in fairness, and allied health professionals do to keep the ship afloat. So it’s only insulting people to suggest as this action plan did today that they’re concerned that they’re paying people for hours they don’t work. My concern is that they’re not paying our members for all the hours they do work trying to provide safe care. So the idea that there is some more juice to be squeezed out of nursing rosters is a pure fallacy. Our members are flexible, they’d have to be flexible, we’ve lost five thousand nurses in the last four and a half years and the only way the ship is being kept afloat is because of the flexibility of frontline staff.
Steve Tweed from the Irish Medical Organisation, we have been warned that there will be an impact on frontline services, but is there any kind of guarantee that your members are able to provide that should people turn up, particularly in the case of emergencies on Thursday that there’s going to be sufficient people on the ground to be able to deal with them.
Steve Tweed (IMO):
Well our members will always aim to provide the best possible service and they’ll do everything within their power to actually ensure that happens. Patient care and patient safety is actually a primary concern of the IMO and our members. I agree with Liam. It’s ok for most of Ireland to come out and say we want the more efficient and more effective health service. I think we could all agree with that. The difficulty here is the lack of foresight and the lack of planning to get to the position we’re in now. The IMO has been calling for some time now, that they have proper capacity planning put into the health service, not just for now but for the future and plans for the future, not just plan on a day by day basis.
Do you think that the HSE is pretty much epitomized by this idea that they’re constantly fire fighting, that they are going from day to day and not necessarily from month to month or year to year?
Steve Tweed:
They may be. However the IMO are saying very clearly that we can sit down, and we’re more than willing to sit down with the HSE, and talk about the service and how the service will likely be delivered in the future. You can’t do that without doing a full evaluation of the service that we have at the moment. Where we are with that in terms of the staffing and the professionals in the service and where we actually want that service to be in three, four, five years time. And we’re more than happy to sit down and have that discussion with the HSE. Unfortunately no matter how many times that I have written to the HSE and asked for the contingency plans and how they’re going to go over what’s going to happen tomorrow whenever people leave the service, I have yet to get a response from them.
Have you seen the contingency plan? Have the IMO actually seen what the plan is?
Steve Tweed:
No, we haven’t seen what the plan is. I have written to the HSE just within the matter of a few weeks again asking them for the contingency plan. It was quite interesting that on the Frontline a few weeks ago the Minister attended on behalf of the Government, talked about working groups being established, have been working hard to ensure the service will be maintained after people left. I wrote immediately after that meeting and I’m still waiting for any information around the contingency plan. I’m not so sure those contingency plans have been worked through in any detail.
Liam Doran can I ask have you seen the contingency plan?
Liam Doran:
No, I don’t think there is a master contingency plan. I think what the HSE stance has been that we have a budget, we have an action plan or a service plan for the year and it’s up to our four regions to try to drill down and live within that budget but I think what’s, you know I agree too with Steve, I mean what’s been underestimated in all of this rhetoric, and all of us you know saying things to each other by megaphone is that the Irish public health service is placing an unprecedented downsizing in terms of the last three years and the coming three years and I think that’s underestimated by the political system, it’s underestimated by higher senior civil servants and departments and underestimated by the HSE in so far as the level of contraction in terms of available for scheduled and unscheduled care, the level of primary care interventions, the loss of staff, the reduction in budgets, we are going to have, even with the most, you know twenty four seven flexibility from staff, whether that be a doctor, a nurse, an allied health professional, support staff. 
All these people are essential, but regardless the amount of flexibility the loss of posts has been so significant, the reduction in spend has been so great, and the demand continues to increase. Everyone underestimates the contraction of the services taking place.
And is the point that, even for your members who are on the ground, and the same for Steve’s members, that in the next twenty four hours or forty eight hours we’re going to have going away parties, we’ll have staff leaving the wards after whatever, thirty, twenty five years, however long they’ve been there, probably longer in many cases and that the true impact of this isn’t going to be felt by either the HSE or by your members until Thursday morning.
Liam Doran:
Oh I think to be honest with you Jonathan it’ll be Thursday morning and Friday and the next week and the next month. I mean the loss of experience and expertise that is taking place at the moment all at the one time, you couldn’t dream it up in terms of the wrong way to manage a system because we’re losing nurses who have twenty, twenty five, thirty, thirty five, I was speaking to a nurse yesterday, forty years experience and she retired last Friday. An experienced theatre nurse. So you can’t just replace that person. You know such is the person you replace, you’re replacing the experience as well. So I think the health service will be significantly the poorer, not just in terms of numbers or in terms of quantum of service but just in terms of brain power and that will take a long to make good and I think, you know it is a flawed approach and the challenge as Steve has said, is there’s more to come in terms of what the Government policy is about our health system and I still remain, make the point, I don’t think the Government understands the contraction that is going to take place and is taking place in the health system and how everything in terms of safe care has a potential to be compromised. 
Liam Doran of the INMO, Steve Tweed from the IMO, thank you both very much for talking to us this afternoon gentleman. 

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