INMO president Claire Mahon in her address sets out the INMO agenda on ratios at the ADC. Alison Moore reports

Nurses and midwives have experienced the toughest two years in the history of their professions. Pay cuts, pressure to increase productivity, workplace stress and generally having to ‘do more with less’ have made life on the front line of the Irish health service in recent years a challenge to say the least.

It is against this backdrop that the INMO launched its new safe staffing campaign that calls for minimum nurse to patient rations to be observed.

“We are no longer just advocates for our patients. We are now the advocates for our professions because if we do not stand firm, and fight for what we believe in, then no one will,” INMO president Claire Mahon told delegates in Kilkenny.

“Currently, as nurses and midwives, we are working in environments that are not conducive to safe care. We have, unfortunately, seen the evidence of this both here in Ireland, and in the UK.

“In our workplaces, we are overwhelmed with the negative impact on standards of care. We have, along with our colleagues, through hard work and determination, managed to maintain the health service despite the uncontrolled, and unmanaged moratorium of the past five years. We have lost over 5,000 nurses and midwives from the frontline. This has, is, and continues to, damage patient care,” she said.

Ms Mahon told delegates that in early 2013, the Organisation presented its survey on comparative staffing levels to the Oireachtas Health Committee. This survey was completed by Dr Keith Hurst, an independent analyst from the UK.

“Our staffing ratios campaign will be one of the key goals of this Organisation into the future. We launched our midwifery staffing levels campaign at a press conference in March when we highlighted that the internationally accepted ratio of one registered midwife to 29.5 births does not exist in any midwifery unit in Ireland. The worst staffed unit is Portlaoise at one to 55 and the average being one to 40.

“We have seen over the past 12 months, tragic events in our maternity services. These have been the subject of a number of enquiries, resulting in detailed reports, which have, in turn, seen the establishment of a National Maternity Services Review and a Maternity Workforce Forum. We welcome both of these initiatives and will actively participate in order to ensure that the necessary improvements are made,” said Ms Mahon.

She went on to urge delegates to say ‘enough is enough’.

“We can no longer continue to work in unsafe conditions. We can no longer put our patients, our families, our friends at risk. We can no longer put our registration at risk. We deserve better, patients deserve better. We do not want to be the subject of further inquiries. We know it is dangerous. International studies have clearly identified this. In February the Lancet reported the results of a study in nine European Countries – The RN4Cast, the results of which show ‘that the assumption that hospital nurse staffing can be reduced to save money without adversely affecting patient outcomes may be misguided at least and fatal at worst’.”

Ms Mahon likened the campaign to a battle; “we have a war to win and win it we will”.

“This will not happen overnight. It will be arduous. It will be demanding. It will take time and commitment. I hope you are ready, because I am. As the saying goes ‘if it is worth having, it is worth fighting for’. We have had enough. We will take it no longer so let 1:4 become our mantra,” she said.

“We want to deliver high quality care and, as dedicated professionals, we cannot accept anything less; because we do care, and we will always care. Go back to your workplaces and encourage, inspire and motivate your colleagues as we must take up this challenge. The evidence supporting our campaign is mounting. We must now push on never settling for anything less than a safe working, in a properly staffed, environment,” she urged those at the ADC.

Ms Mahon told delegates that when travelling around the country and meeting members she had developed an even greater admiration for the work of nurses and midwives.

“Although I thought it would not be possible, I now have an even greater respect for you. I am truly privileged to know you, and prouder now than ever before, to be one of you,” she said.

Haddington Road
The Haddington Road Agreement is not a deal that the INMO would have chosen according to Ms Mahon. She explained that the Executive Council truly believed that it had achieved the best possible outcome.

“We were the last union to leave the negotiating table. We had to be realistic and accept that rejection would have seen us isolated and alone in a dispute, a ‘strike’ situation. To have led you there would have been disingenuous.

“Colleagues, we have yet again been bruised and battered along with our public service colleagues. This saddens me greatly. The country’s problems were not of our making. We have paid a very large price. A price that has been felt in my house and I know it has been felt in all of yours,” she said.

Although the INMO secured some improvements in the graduate initiative, by having the payment increased to 85% in the first year and 90% in the second with the education component being provided by the RCSI, the Organisation believes that it remains unfair and unsatisfactory.

“We must ensure that the graduate programme is only used, under its limited terms, and that normal vacancies are filled through the standard means of open competition with the correct salary scale. There are employment opportunities appearing, and it is up to each and every one of us to monitor these positions and ensure our new graduates are aware of them and encourage them to seek opportunities as they arise,” she said.

Ms Mahon explained that the INMO would continue efforts to have this two-tier entry system eradicated. She observed that the Minister for Education recently acknowledged that anomaly in pay for new entrants is unacceptable for the teaching profession and demanded that the Minister for Health follow his lead.

The centenary of the 1916 Rising is around the corner and according to Ms Mahon, the celebrations must acknowledge the role nurses and midwives played in “rescuing this country”.

“Lest we forget, the end of the Haddington Road Agreement is 2016. This must be the date we take back what they took from us. We must make the future our own and not one made by politicians as many of them do not understand the pressures on families and households today.”

Ms Mahon said that the German government recently announced pay increases of 3% for their public servants and demanded the same for Irish workers.

“Well, if it is good enough for them, it is good enough for us! We have worked hard, we have taken the pain and now we want relief and the last thing we need is a further €2 billion taken from our economy in 2014.

“Friends, do not be fooled by the promise of tax cuts, as tax cuts will ultimately mean service cuts, which will impact on us as service providers. We want to have our pay reinstated. The tax burden must be spread so those who have wealth are made pay and not just ordinary workers. I will make no apologies for saying we deserve it. It is due to us, especially when those who caused our economy to collapse have walked away scot free,” she said.

Safe Practice and education
Outside of campaigning, Ms Mahon reminded members of the Organisation’s role in educational support for members. The safe practice campaign is ongoing around the country and, to date, more than 5,000 members across the country have availed of it, free of charge.

“We will continue these workshops, into the future, in order to support and assist our members in their day-to-day practice,” Ms Mahon told delegates.

She also reflected on the success of the workshop held for CN/MMs in the Gresham Hotel late last year, which was attended by more than 300 delegates. The speakers included Siobhan O’Halloran, the chief nursing officer, Peter Carter from the RCN and representatives from the HSE and the NMBI.

“It is by doing sessions like this that we remain relevant to all members. I have attended many safe practice sessions and find the information invaluable when conveying your concerns to the relevant parties in the HSE and the CNO. This is something I hope to continue, next year, as protecting our practice is of paramount importance to all of us,” she said.

Richmond purchase
Ms Mahon continued, saying that the INMO is a progressive, and optimistic, organisation that seeks to anticipate, and prepare to meet, the needs and expectations of its members, and it was in this context that the former Richmond Hospital was purchased with the aim of housing the INMO’s expanded education requirements.

“It is adjacent to our existing head office, the Whitworth, and will fully complement the Organisation’s activities. As the Organisation’s new Education and Event Centre, its purchase marks another major milestone in the history of the INMO. It heralds a new era with regard to our work in the areas of education and continuing professional development.

In reference to some speakers to motions at the ADC questioning the purchase of the building Ms Mahon said that she noted that delegates were “seeking to look at the strategic direction of the Organisation” and said that she welcomed this, stating “it is always good to look to the future”.

Social policy
The INMO is actively involved in efforts to shape social policy and has taken up a number of campaigns. It collaborated with the Immigrant Council in the ‘Turn Off The Red Light’ campaign. As a result of the ongoing campaign, Ms Mahon informed delegates that the Oireachtas Justice Committee has recommended that the purchase of sex be criminalised and that it was hoped that this legislation would be passed by government.

The INMO held its first LGBT conference last summer which was very successful and Ms Mahon told conference that the Organisation hoped to keep this initiative going.

The INMO has also been involved with the National Women’s Council for several years and this year at the Council’s conference in June, the Organisation’s motion will be on maternity staffing.

At the workplace
Ms Mahon updated delegates on INMO director of industrial relations, Phil Ni Sheaghdha’s work with the National College of Ireland preparing a survey for nurses and midwives in relation to bullying in the workplace.

“I think all of us will agree that this is a major issue in the workplace again reflected in a motion being put to conference,” she said.

Speaking on the general activities of the INMO in the past year, Ms Mahon said: “This Organisation has been active on issues, both local and national, on behalf of members. We have achieved many positive third-party findings which greatly benefit the members involved. We are currently at the Labour Relations Commission with our claim for the lifting of the moratorium on recruitment. This claim is linked to our staffing campaign and will be pursued until the government lifts this flawed, damaging, and corrosive and harmful recruitment ban.”

Looking to the future
Speaking on what the coming year might hold Ms Mahon said: “Looking to the future, the challenges ahead are great but so too is the strength, commitment and resilience of nurses and midwives. In the interests of patients, the wider community and ourselves we must fight to maintain and improve the quality, accessibility and volume of health services to meet the needs of our communities. Everybody deserves healthcare! But they also deserve safe healthcare, with motivated staff, who are highly trained professionals.

“ The past two years have been interesting, exciting, inspiring and thought - provoking. I have been immensely proud to represent you and I am honoured that I have had this opportunity. I wish to thank you all, those at work and at home, who placed their trust in me. Colleagues thank you for these exceptional two years”.

Ms Mahon also paid tribute to her colleagues on the Executive Council as well as the first and second vice-presidents of the Organisation, for their commitment throughout their term in office.

“I must add that the last two years has involved much additional commitment and it has been a difficult time. We have had to make hard decisions which were always made with the best interests of the members, in mind.

“I give my best wishes to the outgoing Executive Council members and thank them for the energy they brought to the Council. I welcome our new members and look forward to working with them,” she said.

Exhorting the delegates present, Ms Mahon concluded her delivery on a rousing note:

“Believe me when I say our time is coming. Let us shape the future, starting today, as we cannot, and will not, leave it to anyone else”.

ADC - Presidential address - Let ‘1 to 4’ become our mantra