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Members Update 13 - 30.11.17
Public Service Pay Commission (PSPC)

Dear Colleagues, 

As you are aware, as part of the Public Service Agreement, the Public Service Pay Commission (PSPC) was requested by Government to examine issues of recruitment and retention within the public service.
As previously notified to you, the Nursing and Midwifery grades was among the first grades to be examined and submissions from employers and trade unions were requested.  The INMO submission was due on 29th November 2017, and I confirm that yesterday, the INMO sent a robust evidence based written submission to the PSPC highlighting;
  • That all Nursing/Midwifery grades are having difficulties with both recruitment and retention;
  • That Ireland is the least competitive country from a parity of pay perspective based on the earning power of Nurses/Midwives, across the English-speaking countries of USA, Canada, Australia and the UK.
  • That these countries are now the destination countries for Irish Nurses and Midwives. These countries have superior packages on offer in recruitment campaigns in countries that Ireland is seeking to recruit from, making them more attractive to prospective Nurse/Midwife recruits. 
  • The shortage of nursing in Ireland is well documented. We reiterated the issues surrounding the difficulty with recruitment. We highlighted the fact that the 2016 annual figures illustrate that:  
    • 250 more nurse managers left the public health service than joined it; and  
    • the net increase in staff nurses was 302 WTE, due to the fact that the recruitment of 2,573 staff nurses was negated by the fact that 2,271 left the workplace over the same period
  • The INMO submission cited international evidence that demonstrate the issues that staff shortages pose for Nurses and Midwives who work in this type of a health service: burnout, increasing instances of injury and violence and growing resignations. 
  • The submission presented evidence that inferior pay scales in Ireland are a major factor affecting the retention of Nurses/Midwives in the Irish health service.  Nursing/Midwifery pay scales are between 15% and 20% lower than allied health professionals, who require identical entry qualifications and have a shorter working week. This is in contrast to international standards where the pay of allied health professionals is very much on a par with the pay of professional Nurses and Midwives. 
  • The submission emphasized the negative outcome for patients, of Nursing /Midwifery shortages and increased skill mix. All relevant literature including the RN 4 Cast study of 12 European countries recording the consequences  of missed care as:  increase in mortality and increase in poorer outcomes for patients, when nursing/ midwifery ratios drop below safe levels. 
  • Evidence of unsafe hospital activity was also presented, referencing continuing overcrowding at Irish hospitals in emergency departments and wards. 
  • The reduction in workforce figures in recent years was also highlighted: in 2017 the Nursing and Midwifery workforce remains 3,500 less than the workforce in December 2007 when there was a lower activity in the Irish health service. 
  • The requirement to futureproof our health service in response to demographic changes as set out in the recent ESRI report, were included. We highlighted the projected need to expand the acute hospital services by 33% and older persons services by 54% based on our increasing and aging population.
  • These expansion initiatives will require additional Nursing/Midwifery staff. To recruit and retain at a level that allows the overall Nursing and Midwifery population to grow requires new measures. We provided evidence of the failure of all recent non-pay measures to deliver this outcome.
  • We reminded the Public Service Pay Commission that nursing/ midwifery are   female dominated professions (91%) that have, since 2007 endured chronic shortages. Low pay is also evident when comparisons are demonstrated to other professions.
  • We advocated and submitted, that the time has long passed when the requirement to break the cycle of low pay for Irish Nurses/Midwives can be ignored. 
  • The evidence supports the fact that recruitment and retention of these grades are directly affected by low, uncompetitive pay and poor working conditions.
Next steps 
The Independent Chair of the Nursing and Midwifery Recruitment and Retention agreement, of February 2017 (agreement including delegated authority via Section 10 of the Health Act to Directors of Nursing and Midwifery to recruit) Mr Sean McHugh, has advised that he has been requested by the PSPC to attend before them and set out the implementation progress of that agreement.  
The INMO have sought an opportunity to make oral submissions and presentations to the Public Service Pay commission. Additionally, we have requested the opportunity to provide expert testimony to support the evidence in our written submission. 
The process has now started. The Commission must now do its business by examining all evidence presented to it. The evidence presented by the INMO is evidence based and leaves no doubt that the chronic shortage of nurses and midwives will not be addressed until the issue of pay is addressed. 
As members were previously advised the Public Service Pay Commission has advised that it anticipates that their findings/recommendations in respect of Nursing and Midwifery will be issued in June of 2018.
Thank you for your attention to this update,
Is mise,
General Secretary Designate
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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