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Editorial - Unmanaged downsizing will not work

More than 3,800 staff from the health service have retired in the past three months under the grace period arrangement decided by government. A total of 1,778 of these were nurses and midwives from all disciplines across the health service. These staffing reductions come in addition to the 2,000 clerical and administrative support staff who left in 2010 and the 3,100 nursing and midwifery posts lost since 2008.

One of the demands of the Troika – the group that represents the European Central Bank (ECB), International Monetary Fund (IMF) and the EU, that lent us the money in the bailout package – is that we reduce the size of our public service from 310,000 to 282,000 by the end of 2014. In the context of the health service, staffing numbers will be reduced from a peak of 110,000 in 2008, to 102,000 at the end of this year, and down to 96,000 by the end of 2014.

The INMO believes that this reduction in staff, coupled with the increasing demand for health services and our unique demography, seriously compromises quality of care and the ability of nurses and midwives to practise safely. However, even if it was accepted that we have to reduce staffing numbers, it cannot be argued that the reductions in staff be left to chance and no effort made, whatsoever, to control the skill and grade mix that will prevail within that figure of 96,000.

In recent weeks, difficulties created by a lack of manpower planning have been outlined by experts in public health specialist areas such as maternity and children’s health services.

It is not acceptable that, in this first week of March, we are trying to run a health service and maintain safe care despite the loss of very experienced midwives, public health nurses, specialist nurses and other essential staff. These staff losses and the pressure to maintain safe practice is, most certainly, not the fault of the staff representative organisations and health service trade unions.

The exodus of so many staff in such a short time period is viewed by some as a test of the Croke Park agreement. The government argues that all of the gaps in the service can and should be covered by flexibility, roster changes and redeployment.

The simple reality is that no matter how flexible the remaining staff are, the skills gaps created by this staff exodus makes it impossible to maintain quality assured services without significant replacements.

This is not to suggest that redeployment will not form a significant part of delivering health services in the coming months, but redeployment and changes in rosters will not be sufficient in compensating for the loss of manpower.

All parties involved in the Croke Park agreement must have the maturity to realise that we must carefully control all further reductions in staff. We cannot neglect to manage the further downsizing of staff levels. We must accept that one policy approach, applied right across the public service, is not appropriate for the health service.

A more intelligent and targeted approach must be brought forward without delay. We must determine a proper mix between such pivotal grades as consultant, non-consultant hospital doctor, nurse, midwife and healthcare assistant. We cannot allow a continued loss of staff to leave us with an unstructured skill and grade mix in Ireland’s hospitals and health services.

Uncontrolled downsizing will not work. In the interest of patients, clients and safe practice the obligation is on all of us to find a better way to manage staff reductions.

Liam Doran
General Secretary, INMO

Editorial - Unmanaged downsizing will not work


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Irish Nurses & Midwives Organisation (Cumann Altrai agus Ban Cabhrach na hEireann). The Whitworth Building, North Brunswick Street, Dublin 7. T:0016640600 E:inmo@inmo.ie