The Nursing Alliance will decide today whether to go ahead with tomorrow's two-hour strike at A&E departments in 30 hospitals across the State. Up to 800 nurses would be involved in the action.
Last night the Health Service Employers' Agency offered to establish a working group to review the role and grade of bed managers in hospitals, which could lead to their having greater discretionary power over the cancellation of elective admissions in crises. It has also promised 27 additional A&E consultants, with 10 already recruited, and new A&E units in a number of hospitals.
Security improvements and talks on a compensation scheme for injuries sustained at work are also promised. The document proposes improvements in community care, including 24-hour access to GP services, which would reduce pressure on A&E departments.
The cost of the initiatives runs to €107 million. Whether this will be enough to avert industrial action will not be known until this afternoon. The Nursing Alliance will meet at the headquarters of the Irish Nurses' Organisation in Dublin after the constituent unions have decided their attitudes to the proposals.
Last night the Minister for Health and Children, Mr Martin, appealed to the alliance to defer their action and remain in talks with the employers. The HSEA's chief executive, Mr Gerard Barry, said the proposals "show we are taking nurses' grievances seriously. This package holds out the prospect of improvement, and we are asking the unions to consider calling off their action so that this process can go ahead without disruption at A&E departments."
SIPTU national nursing official Mr Oliver McDonagh said his executive would consider the proposals and see how they compared with the demands in the union's submission last month.
He said there was a greater need for team working in the hospital structures and challenging vested interests.
The Irish Hospital Consultants Association has already outlined its objections to some of the proposals from the Nursing Alliance, particularly proposals that senior nurse managers be empowered to cancel elective work or insist on consultants and registrars undertaking ward rounds.
It says in a letter to the HSEA: "Consultants carry the ethical, moral and contractual obligation of full clinical responsibility for patients under their care. Agreement between nurses and management on the INO plan could place consultants in an untenable position."
A letter in today's Irish Times from three A&E consultants expresses concern over the effect the industrial action will have on patient care. It also expresses concern "that the precise goal to be achieved has not been defined. As far as we can understand, even if local hospital demands have been met, nurses in their emergency departments are expected to remain on a work-to-rule, with the threat of recurring withdrawal of labour, as long as demands in all hospitals around the country have not been met."
Union sources said yesterday there was a possibility, even if tomorrow's action goes ahead, that normal working might be resumed in hospitals.