Madam, - Some supporters of the nurses' current action comment on their kindness, care and dedication to patients, as if these qualities were particular to nursing staff only.
As someone who has had the benefit of hospital treatment, both as an out-patient and in-patient I - like most people, I suspect - can testify to the professionalism, kindness and dedication of all hospital staff, be it the reception staff, the cashier, the radiologists, physiotherapists, doctors, consultants and all ward staff, from the cheerful comments of the catering and cleaning staff to the comforting comments of the chaplain and the assistance of social workers.
By virtue of custom and practice alone, it is part of the job of nurses to answer telephones and use computers. By refusing to carry out these functions nurses are neglecting their duties and not serving the full interest of their patients.
Nurses do provide an excellent service but it is their job to do so. They currently hold the respect of the public - as secondary-school teachers once did - but as patients and loved ones become affected by this dispute, this respect will dwindle quickly.
Nurses may have a case but like all other workers in the health service they have a mechanism for dealing with their claim. They should use it. - Yours, etc,
ROBERT S. KING, Donaghmede, Dublin 13.
Madam, - As front-line healthcare professionals and patient advocates, we write to express our concern regarding the negative propaganda and scare-mongering from the HSE in relation to the current nurses' dispute.
Overcrowding in A&E, cancellations of procedures and delays in out-patient departments are regular features of our current healthcare system, and result from chronic underfunding and poorly co-ordinated administration. Transfers between hospitals of seriously ill patients needing specialist treatment are delayed for days on end because of bed shortages, not because nurses are not answering telephones.
Contrary to what has been suggested by the Minister and others, the crisis in A&E never went away. Because overcrowding in the actual A&E department may be used by the HSE to cut hospital budgets, hospitals are forced to hide the problem. Emergency patients are housed instead in other parts of the building, including day wards and out-patient clinics, forcing the treatments in those facilities to be cancelled, while the HSE claims success. The result is worse care for patients and demoralisation of doctors, nurses and other health staff.
Trust between all of the health professions and the HSE has been seriously eroded. Trust between the public and the public health system is at an all-time low. Since the establishment of the HSE, front-line health workers have little chance to interact with managers and policy-makers. Differences that should have been handled by open and effective communication cannot now be easily resolved, and are at risk of rapid escalation. This is because healthcare professionals often feel that their only option is to appeal to industrial relations mechanisms or to make their case through the media.
Similarly, patients are being forced to publicise their most intimate personal details to highlight the gross inequities they experience every day in acquiring basic care for serious illness. This is clearly bad for the health service, bad for health workers and bad for patients. The stream of misinformation from the HSE about the impact of the nurses' dispute on patient care is making things worse. The HSE is creating a feeling of fear about the public health system, and contributing to the huge burden of worry for patients.
Whatever the outcome of the nurses' dispute, the HSE must be reconfigured, and must recognise that healthcare is first and foremost about patients. We believe that the way forward for the health service is for the HSE to engage directly with health professionals and patient representative groups at local, regional and national levels. Reform of the system must begin from within. Building trust would be a good place to start. - Yours, etc,
Dr ORLA HARDIMAN, Prof JOHN NOLAN, Dr EAMONN SHAHANAN, on behalf of Doctors' Alliance for Better Public Health Care;
JANETTE BYRNE, on behalf of Patients Together;
NOELLE DUDDY, on behalf of Co-operation for Cancer Care (NW), c/o Beaumont and St James's Hospitals, Dublin, and Farranfore, Co Kerry.
Madam, - I believe that doctors and nurses and some other health professionals should never go on strike. The stakes are too high and death can follow delayed care, cancelled surgery, stalled reports, etc. It is completely different to an industrial situation.
It is also my belief, having experienced strike action in my former hospital, the Central Mental Hospital, Dundrum, that strikes can quickly become irrational and go out of control. Leadership during strikes can disguise subtle personal agendas which, in turn, make solutions less likely. Normally caring and decent health professionals can change as they form into striking groups, surprising one with what appears to be callous indifference to the plight of the patients for whom they are ethically responsible.
I believe that patients and their families can do something to challenge striking nurse or doctors. The patients, as a group, have rights which can be asserted.
One obvious right is that to be free of "inhuman and degrading practices". I suggest that these have a wide definition - including, for example, a patient being left in a wet, dirty unchanged bed while his/her "carers" are on the streets waving placards looking for public support, for the anxiety, the pain, the uncertainty and even the progression of illness from less serious to more serious as a result of postponed surgery.
The threat of legal action that might just empty union coffers would, in my opinion, introduce a note of realism to a strike process that is indefensible in the first place. - Yours, etc,
Dr CHARLES SMITH, (Former Medical Director, Central Mental Hospital),
Madam, - Staff in the State agencies authorised to take life in certain circumstances, the Defence Forces and An Garda Síochána, are not allowed to strike - and for good reason. However, staff in State agencies tasked with saving and preserving life, including including nurses, doctors and other clinical staff in the HSE, are allowed to strike.
Is there not something wrong with this? - Yours, etc,
ROBERT HALLIGAN, Castledermot, Co Kildare.