10th May 2024
Irish Nurses and Midwives Organisation Annual Delegate Conference
Minister,
Thank you for joining us here in Croke Park.
Minister, thank you for attending our conference and addressing our delegates, before I respond and set out the very pressing issues that are impacting each and every working nurse and midwife in this room and in each healthcare setting across the country, I want to offer condolences to the families of all our colleagues who we have lost since last year’s conference and also to our colleagues who have lost loved ones and friends during the year.
We of course all remember the patients and their families we have interacted with and cared for and helped through difficult times in this past year.
It is with great pride that I as President of the INMO maintain and guard our voice for colleagues but also by extension for our patients in the everyday activities of this professional trade union.
Our thoughts are with our healthcare colleagues and people who are the innocent victims of war in Palestine. We were delighted to welcome Dr Jilan Wahba Abdalmajid the Palestinian Ambassador to Ireland to our conference yesterday and hear her first-hand account of the situation in her homeland.
The conflict in Gaza demonstrates the violation of the most sacred of safe spaces, hospitals and ambulances.
The death toll of women, children and men has now reached over 35,000 in Gaza alone and many more have been exposed to life-changing trauma.
We applaud and offer our solidarity to the heroic efforts of health care workers who are striving to save lives, bring new life into this world without any semblance of normality under incredibly dangerous and unpredictable circumstances.
We are proud in the INMO of our strong ties with our colleagues in Palestine, In June 2023, our General Secretary as part of a 4 member ICTU delegation, travelled to the West Bank in Palestine and witnessed, at that time, the impact of occupation on the normal delivery of essential healthcare.
Much lobbying has taken place which the INMO has been part of, to seek stronger European Union opposition to the complete violation of human rights, the opposition to the systemic targeting of healthcare facilities and we are now seeking support from the Department of Foreign Affairs in joining us and Healthcare Workers for Gaza who want to do more and provide on the ground essential recover services.
We call on the international community to exercise all powers to ensure it becomes a lasting peace, we need the powers that have influence to now concentrate on rebuilding the shatters lives and futures of so many in this region
We welcome the announcement by the Taoiseach that Ireland will formally recognise Palestine as a State.
I want to thank the outgoing INMO Executive Council who have been a brilliant team to work with over the past two years and have been steadfast in their support for nurses and midwives across the country over the past two years.
I was first elected President of the INMO in October 2020, when the health service and indeed the country was going through a state of flux.
We were dealing with a global pandemic and a virus that we didn’t know would manifest in the manner in which it did. I don’t want to dwell on COVID too much in my final speech to conference but Minister, for many of our members, particularly those with Long COVID who have been sent on many unnecessary emotional rollercoasters because of a hands off approach to their future by Government, they want you and the Taoiseach to protect them now when they need it, they answered Ireland’s Call and cannot be forgotten.
They also want a specific scheme to provide certainty for those who go to work not expecting to be injured but unfortunately that can happen as we have seen so many times, and they want to be viewed the same as many of their frontline public servant colleagues who have broad and encompassing injury at work schemes.
Healthcare provision is and will continue to be very hazardous occupation and this must be acknowledged by Government through protections and supports put in place for those who risk their future health for the good of others.
Government has announced the establishment of a COVID Inquiry, we welcomed that and now ask that you name a date for the Inquiry. Our members want their union to be able to speak candidly on their behalf. Our experience is important and should be listened to.
We are still bearing the marks of that extremely bruising time, colleagues who had a huge amount of experience are now leaving the profession before their time, young nurses who should be the future of the Irish healthcare system are now the future of health systems in Australia and the NHS and we all know that the pandemic didn’t help. Having a moratorium and offers of three month contracts actively work against encouraging people to stay.
As INMO President, I was very proud of our own internal campaigns on public sector pay – it was great to meet members in their workplaces around the country as part of two separate campaigns, hear their issues and take the lead from our members on what we should focus on keeping forward.
We engaged with government officials as part of ICTU Public Services Committee and Minister it is with absolute regret and annoyance we again bring to your attention the HSE’s slow pace of implementation- when a pay deal is struck both sides have to comply with the speedy implementation - civil servants, teachers, gardaí and others have now correctly been paid the cost of living increases negotiated and agreed – why is it that the healthcare workforce is still waiting?
As Minister for Health, I ask you to raise this with the CEO of the Health Service Executive and not tolerate any excuses.
Since we last met at annual conference, we celebrated 20 years of our internationally educated nurses and midwive’s section. We very much welcomed your commitment on the creation of an integration post for nursing and midwifery. We have continued to advocate for our members who have decided to make Ireland their home.
As an ugly anti migrant rhetoric begins to rear its head in Ireland, we want our internationally trained colleagues will be assured that they will be fully supported, and the integration post should only be the first of many such posts.
Wexford
We are thrilled to have Eleanor Carpenter here who is the Director of Nursing in Wexford General Hospital. She will speak later about how they so ably managed a safe evacuation when their hospital went on fire with no injuries. Eleanor and her team made us all so proud.
Stardust
It was a great moment of pride for the INMO to see that the Government gave a long-overdue State apology to our friends in the Stardust families after the verdict of unlawful killing was announced. Since becoming President of the INMO, I have been so privileged to get to know the families.
They know that they are always welcome to remember their loved ones on the grounds of the old Richmond Hospital, which is now the Richmond Event Centre, where we have a permanent reminder to the 48 victims.
Safety of our members
Minister, the safety of our members has never been more pressing.
While we absolutely welcome the establishment of the Health and Safety Authority’s advisory for the healthcare sector, which was speedily set up by your former colleague Simon Coveney after lobbying by this organisation, our expectations are extremely high.
At least twelve nurses and midwives are assaulted in their workplace every single day of the week. Those are only the cases we know about. Underreporting is high because the reporting process can be arduous, especially after a shift that you have worked has been relentless and the staffing below what it should be, finding the mental energy to write a report that often doesn’t receive the attention it should is difficult.
Accusations have been levelled at this organisation that we emphasise the issues arising too often – I must say as I set out earlier, we make no apology for continually highlighting the issues faced by our members as they strive to provide safe care which is increasingly impossible under the circumstances they are forced to work in.
It’s these overcrowded and understaffed conditions and lack of prioritisation of the employers legal obligation to provide a safe place of work that demands this reaction.
Think how the nurses and midwives who are working in hospitals where the spotlight is constantly on the conditions in which they are working.
Nurses and midwives are the healthcare workers with the most facetime with patients and their families, they are the ones who are bearing the brunt of public anger for conditions that are outside of their control. They are also the ones subjected to many repeated inquiry procedures, internal and external to account for their actions.
Minister, we want to see a public inquiry into how the lack of multi-annual funding, implementation of safe staffing and skill mix has affected patient outcomes.
We cannot continue to be the subject of inquiries when those that make the decisions to curtail services or freeze recruitment are not.
We will make no apologies for sounding the alarm on our conditions and making it clear to anyone who has a say in the implementation of the roll out of the Safe Staffing Framework that the conditions are unsafe and dismantling our ability to carry out our work safely.
Overcrowding and Staffing
Our safety and our ability to do our jobs in a safe and timely manner cannot come secondary to fiscal and budgetary requirements.
The recruitment embargo as a whole sends a message that safe staffing is no longer a priority. It’s not enough to tell us that safe staffing is fully funded if it is not being rolled out.
We are telling you today, loud and clear, that the recruitment moratorium is making it impossible for us to carry out our jobs safely and it is time for you as Minister for Health to sanction a clinical review into how this is impacting patient care.
We are working in a healthcare system that is dealing with huge population growth, complex co-morbidities, worrying levels of acuity and the system response from the State has been to stop hiring much needed healthcare staff at the time it needs it the most.
You only have to look at the HSE’s Service Plan for the level of the lack of ambition around nurse and midwife safety, the focus on provision of services, which is correct, ignores the reality of the workforce wellbeing – there is not one mention of the health and safety measures needed to keep staff in overcrowded, increasingly dangerous workplaces safe.
Women’s Health
Minister, you know I am passionate about women’s health. We acknowledge the positive changes you have introduced as Minister in this area. As an ANP in Gynae, I very much welcome the investment in women’s health. I would say that investing in more nursing and midwifery led services is the piece that is missing. When given the resources we can make tangible differences. I know that we can takea waiting list that is over a year long and when you let a nurse lead on the service we can bring the waiting less than 12 weeks to be seen and sorted like we have in my own area.
We have just celebrated International Day of the Midwife. You know that there is a deficit of over 1 million midwives globally, so what are we doing as a country to keep our midwives working within the public health system?
What are we doing to educate more midwives? We are not doing enough to expand the practise of our midwives within the scope of their education.
Our system still relies too heavily on consultant-led, hospital-based care, even though the National Maternity Strategy calls for expanding women's choices. Progress has been painfully slow, and political promises haven't turned into real action. Funding for midwives and midwifery-led units remains insufficient.
Women want choice, our members in Cavan and Louth have showed that midwife-led systems work, so why aren’t we replicating their model?
Collective Bargaining for All
Minister, at the end of this year the EU Minimum Wage Directive is expected to be transposed by member states.
Ireland must ensure that the strong commitment contained within this directive to strengthen collective bargaining across all employments is fully implemented. The full transposition of this directive is a key priority of the entire trade union movement.
In Ireland, we have many nurses, mostly immigrants from non-EU countries who are recruited to work in private acute hospitals and private nursing homes. They are vulnerable to rogue employment practices, and we need to ensure they have the same rights as their colleagues in the public sector to be represented by their trade union in raising issues of concern with their employer.
We have a long and proud history of supporting nurses and midwives in their professional development and employment issues, regardless of where they work.
What we witness now in too many employments are attempts to deny this right to some of the most vulnerable- simply put - collective bargaining cannot be a privilege it must form the basis of all State contracts with private providers as an absolute right when working in the European Union.
Likewise, the protection and support for trade union representatives must be strengthened and given a legal basis as is the case for health and safety representatives.
Ireland lags well behind the 80% target for collective bargaining coverage and it is now time to fully implement this Directive without any delays or derogations.
Year ahead – Budget 2025 and General Election
Minister, it is going to be a very interesting year ahead politically and one that this organisation will be watching carefully.
A lot of promises will be made over the coming months in relation to the health service, staffing and bed capacity.
One thing we want to make clear to you and to all those who wish to be in your position, we are not willing to stand over unsafe care.
The exemption of nursing and midwifery staff from this and any future moratorium must be your political priority, ensuring that we can provide safe care in a timely manner and that our conditions are no longer headlines of doom.
Last year, we spoke about how your legacy should be the Minister who made safe staffing a true reality. You still have time and can make it happen.