FAQ - Pay and Numbers Strategy Ballot

It is unacceptable to the INMO Executive Council that vital frontline nursing and midwifery posts have been left vacant or have been essentially abolished by the HSE.  Significant risks, now arise associated with, unsafe staffing levels, have been made worse by the HSE Pay and Numbers Strategy which replaced the recruitment embargo. There was no consultation with trade unions  ahead of the Strategy’s publication. The Pay and Numbers Strategy has meant that derogations that were in place no longer exist, forcing many departments and wards to work short continuously.

We have many examples of unfilled posts, lack of authority for Directors of Nursing or Midwifery to recruit, and breaches of industrial relations agreements on staffing, which are all leading to unsafe working environments for members.

The HSE census figures that are relied  upon to determine the whole-time equivalent (WTE) numbers and growth in various grades are disputed by the INMO.

The Pay and Numbers Strategy cannot be allowed to be a ‘done deal’. HSE employees through their unions were not consulted and that must change. Staff deserve transparency and a voice in the decision-making process.

The simple point is the Irish population has grown by 21% between 2006 and 2022 while the WTE population only grew by 12% during the same period. Since 2019 alone, there has been an 8.5% increase in population (421,800), and between April 2023 and April 2024 the population rose by 98,700 – the largest 12 month increase since 2008. Currently, those over the age of 65 have increased to 15% of the population.  

The nursing and midwifery workforce was just recovering from the 2007 embargo which took 12 years to regain the losses and in 2020 was only just recovering when Covid hit and many new services were required overnight. We now have a higher population, an older population, and new services – recruitment is not keeping pace with these growing demands on the public health service.

Regularly political commentators state that we have never had as many nurses and midwives, however, nurses and midwives working on the frontline know for the reasons set out above that we still do not have sufficient nurses and midwives to provide safe care.  We simply must continue to recruit to meet the growing demands and provide sufficient numbers to deliver safe care and meet the safety levels required.

The country's needs are increasing, and we require realistic and agreed workforce planning to allocate resources effectively. Direct hires should be prioritised over relying heavily on agency staffing. The HSE's arbitrary downsizing decisions, particularly regarding safety critical frontline positions, must stop. We need a patient-centred health service that supports both patients and staff.

The INMO’s immediate priority is to end this recruitment moratorium so that Directors of Nursing and Midwifery have appropriate authority to recruit and fill posts as necessary to ensure safety and to meet service demand.  This will ensure that there is safe staffing at the bedside.  A longer-term solution sought by INMO is the introduction of legislation to underpin safe staffing – so that the measured safety staffing levels are enforced by law.

You will be asked to vote for industrial action up to and including the withdrawal of labour.

This will provide for different stages of industrial action including a work-to-rule and work stoppages if required. Members are advising us that they are working over their contracted requirements in terms of hours and attendance on an increasingly regular basis.  This cannot continue as it leads to increased ill health and burn out. 

The INMO Executive Council feels very strongly that this action is now necessary as the unsafe staffing levels and restrictions on recruitment must be addressed.   They are asking that you vote in favour of industrial action.

The INMO is organising this ballot in workplaces - firstly members who are employed in public community and long-term care facilities, followed by members working in the acute hospitals, including maternity and children's hospitals.

There is a separate process for non-HSE disability services which are now governed by the Department of Children, Equality, Disability, Integration and Youth  and balloting will not take place in these locations as part of this phase.

Those working in the private sector, student nurses and midwives,  agency nurses and midwives, and section 39 organisations will not be balloted.

We intend to run the ballot over 5 weeks and have the count completed during the week of 25th^h November.

The decision about when the industrial action will commence will be taken by the INMO Executive Council and they will, of course, consider all options to ensure members can be assured that the effective nature of any industrial action is maximised. On this occasion, we will also co-ordinate the action with the other trade unions balloting their members so that all those voting for industrial action are in dispute at the same time.

All options will be discussed at our information meetings so please do attend and have the up-to-date information.

It is extremely important that you vote and have your voice heard. Nurses and midwives have always stood with their patients when it comes to safety issues, and this is now a watershed moment in the context of patient safety which is directly linked to nurse/midwife staffing levels. We cannot be expected to provide safe and timely care, which the public deserves, with an unsafe level of staffing.

The more members who vote the more powerful you all are. This is why this campaign involves more than the INMO e.g. FORSA trade union representing your colleagues in the allied health professions e.g.  physiotherapists, speech and language therapists, social workers, and clerical and administrative staff are also balloting their members.

Joining now means that you can vote. Joining also means that you can avail of all the other services and support we offer, but we cannot support you with issues before you join – so don’t wait until its too late!