HEALTH SERVICE management is to seek nurses to take on some roles traditionally carried out by doctors and to relinquish some tasks to other healthcare staff under demarcation reforms to be sought as part of the new national pay talks.
It is understood that as part of the talks, management will propose that nurses should in future insert and replace intra-venous drips for patients and carry out suturing in hospital AE departments. Both of these tasks are currently performed by doctors in hospitals.
As part of the reform proposals, health service management will also suggest that non-nursing staff should carry out tasks such as checking patients’ blood pressure or temperatures.
Health service management is also to seek hospital staff to work over an extended working day.
At the start of the pay talks last Thursday, the chief executive of the Health Service Executive Employers Agency, Gerard Barry, said it was absolutely essential that any new pay rises were matched by changes and improvements in work practices, specifically the ending of lines of demarcation which, he maintained, had always been a difficulty in the health service.
He said the key message of health service management was that it was seeking change in return for money.
“If there are going to be any pay increases they have to be matched by corresponding improvements in both productivity and efficiency. It has got to be cash on delivery,” he said.
It is understood that health service management has indicated that it will not accept promises of future reform but will want to see actual change in return for pay rises.
Health service management told trade unions earlier this year that it was seeking the expansion of the working day from the traditional 9am-5pm arrangement.
Management indicated that it wanted the day to run from 8am-8pm – along the lines set out in the proposed new contract for hospital consultants.
In a document circulated in February, management told health sector unions that it wanted all new staff appointed to work more flexible rosters, which would see them start work earlier in the day or finish later in the evening.
Management also said it wanted union agreement to allow local discussions to take place with existing employees “where there is a defined and urgent need to implement revised work practices”.
Grades that would be affected by the proposed reforms include non-consultant hospital doctors, medical staff employed in public health or community health settings, as well as personnel in dental, nursing, health and social care, craft and clerical and administrative areas.
The management document said it was clear “that in certain situations attendance patterns do not reflect value for money, nor indeed are they reflective of a service which operates on a 24/7 basis”.