HSE may focus on rostering staff on Saturdays initially as part of new reforms
Health service staff may initially be sought to work on Saturdays as part of plans by
HSE
management to introduce new patterns of working over an extended day and week.
The HSE has also indicated in a position paper given to trade unions that it may look for personnel to opt for weekend working on a voluntary basis.
However, it said if there were insufficient volunteers, 'a rota of eligible staff will be drawn up by local management to resource the required extended hours of service'.
The HSE maintained that all staff employed or promoted on or after December 16th, 2008 would be contractually obliged to be rostered for weekend working.
READ MORE
It said personnel employed or promoted before December 16th, 2008 and not subsequently promoted 'will be requested to work an extended day/week on a voluntary basis'.
In one of the biggest policy changes in the health system in years, the HSE wants up to 10 per cent of the workforce to be available for rostered weekend work.
HSE chief executive Bernard Gloster said in April that the organisation wanted to begin rostering more staff to work over weekends from the end of June.
In a position paper on the plan sent to trade unions in recent days, the HSE said 'the overarching aim of this extended hours of patient/client service initiative is to facilitate a smoother patient flow and access in all aspects of the healthcare system over a full seven-day week'.
It said the Government had committed to:
• Continuing the transition to regular hospital care being available to patients seven days a week
• Ensuring greater access to diagnostics in the evenings and weekends
• Ensuring even more routine healthcare services are available in the evenings and weekends
• Ensuring more senior staff are rostered in emergency departments during weekends and public holidays
• Standardising the opening hours of injury units to ensure a consistent seven-day service from 8am to 8pm and open at least an additional 12 such facilities
• Ensuring greater use of diagnostic equipment and operating theatres at evenings and weekends.
The HSE set out principles to guide staff engagement for this first phase of this initiative.
It said staff who had previously worked on a Monday to Friday 9-5 basis were 'being requested to deliver a different working pattern over a six- or seven-day week, to meet the requirements for services over an extended day/week'.
'The initial priority focus may be for example on extending service provisions for Saturday/five over six (day) working. However, the same principles will apply depending on the proposed plan for the extension of services outside current working patterns for staff: For example: to five/seven up to and including evenings and extended days/shift patterns. '
The HSE said delivery of extended hours of service would vary from site to site 'as it is dependent on the level of service need, the delivery approach and existing work patterns/arrangements'.
'To deliver quick and effective response over extended hours, staff will be requested, in the first instance, to participate in rostered extended hours of service delivery. It is noted that the flexibility associated with extended work patterns will suit many staff from a personal work-life balance perspective.'
'In the event that not enough staff volunteer, a rota of eligible staff will be drawn up by local management to resource the required extended hours of service. '
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Irish Times
3 hours ago
- Irish Times
Could the Israel-Iran war completely destabilise the Middle East?
Sally Hayden and Harry McGee join Jack Horgan-Jones to look back on the week in politics: Sally Hayden joins the pod on the line from Beirut where missiles flying overhead have become a fact of daily life despite the ceasefire agreement Lebanon signed with Israel last November. With Israel's attention now firmly on Iran , the rising death toll and continuing aerial attacks from both sides show no signs of abating. And is the US on the verge of joining Israel's attack on Iran? What could that mean for stability in the Middle East? Children's Health Ireland appeared before the Oireachtas Health Committee this week with politicians eager to tear strips off the embattled group responsible for running children's hospital services in Dublin . After so many controversies since its inception in 2018, can CHI be trusted to run the new national children's hospital when it opens? And how will this all be handled by Minister for Health Jennifer Carroll-MacNeill given her short time as a first-time senior Minister? Plus, the panel picks their favourite Irish Times pieces of the week: How AIB came back from the brink after the crash, and a misguided viral appeal following the death of an Irish emigrant in London.
Irish Times
5 hours ago
- Irish Times
Minister in the spotlight as health controversies intensify
'It is frightening, what was happening at CHI', Sinn Féin health spokesman David Cullinane said as politician after politician at the Oireachtas health committee tore strips off the embattled group that runs children's hospital services in Dublin. The hospital group knew it would be facing a rough day given the litany of contentious issues facing it: the implantation of unauthorised springs , allegations surrounding unnecessary hip operations , controversy over lengthy waiting lists for spinal surgery, an internal report identifying dysfunctional behaviour and a toxic culture in parts of CHI as well as concerns over whether National Treatment Purchase Fund (NTPF) money earmarked for reducing hospital waiting lists had been misused. As CHI was heading to the bear pit that is the committee room on Thursday, Minister for Health Jennifer Carroll MacNeill was on her way to a European health council meeting in Luxembourg. But she and her officials were keeping a close eye on proceedings as the Oireachtas committee heard directly from those running CHI for the first time. 'There is absolutely zero confidence in the CHI board, zero confidence in the management,' said Fianna Fáil TD Martin Daly. READ MORE He later maintained he was reflecting the feelings of colleagues in the Oireachtas. On the ministerial corridors at Leinster House, senior figures may not be frightened by events at CHI. But there is no doubt there are strong concerns that after five years of relative quiet – accompanied by unprecedented levels of investment – health scandals are once again dominating the agenda. How all this is handled will be a big test for Carroll MacNeill in her first term as a senior Minister. Initially she was seen as one of the better performers in the Cabinet. But a number of figures in Government point out that in recent weeks things seem to be boiling over on a number of fronts. There is a clear sense within Government that the aggregate effect of the series of controversies represents an important moment and a shift in gears for Carroll MacNeill's ministerial career. 'It is a huge test for her, a huge challenge,' one source said, adding there were nascent concerns about keeping the centre of Government informed as the controversies develop. 'While she is the line minister, she is responsible, from a public perception point of view, the Government is responsible.' She must also master the inner workings and unpredictable dynamics of a health crisis – something that eventually falls to everyone in her position. This is particularly the case for one that is, in fact, composed of several overlapping sub-crises – a 'sprawling controversy with so many elements', as one source described it. She must keep track of timelines, keep the information flow running, keep across who knew what and when. For a first-time Cabinet minister, it is the ultimate acid test. Some of this may just be timing. The report by the health services watchdog, the Health Information and Quality Authority (Hiqa) on the unauthorised springs was always set for May and Government knew this would probably cause a storm that would be quickly followed by an equally damaging analysis into operations for children with developmental dysplasia of the hip. However, the stunning leak of an internal CHI report identifying potential patient safety risks, questionable use of NTPF-funded waiting list clinics and a toxic culture at one CHI hospital came out of left field. Ministers and health chiefs said they had been blindsided. The revelations also highlighted divisions between different parts of the health system and put the spotlight on flaws in the governance structures. Last week the NTPF confirmed it had suspended funding for waiting list initiatives at another centre, Beaumont Hospital in Dublin, on foot of potential financial irregularities. The Irish Times revealed this followed a letter sent to the chairwoman of Beaumont by consultants in which they maintained the hospital had billed the NTPF for about 1,400 patients treated in their regular public clinic. The Department of Health – and presumably the Minister – had been aware of this development since April. Carroll MacNeill had directed the HSE to send internal auditors into Beaumont . However, the public was not told until June 11th. Some highly placed sources maintain all this has led to concerns about the information flow around Government. One Minister told The Irish Times there had been discussions about what was coming out. 'As we hear things, things are being circulated,' they said. 'There is no concern about the political messaging, but there is huge concern about what we hear is going on – everything, from what you hear about [HSE chief] Bernard Gloster bringing in the gardaí to everything that is going on in terms of governance, the whole shooting match. But the primary concern is about the children.' Another Government figure said there is real concern that health may blow up (politically) in a way that it has not done in five years and that there may be too much of a hands-off approach by the Minister. The Government is only too aware there is more drama to come. CHI, the HSE and the NTPF will be before the Dáil Public Accounts Committee in early July. An external review into paediatric orthopaedic surgery being carried out for the HSE is also still awaited. A separate HSE report on 'insourcing', where some staff formed private companies to carry out additional work outside regular hours to tackle waiting lists, is also due, as are the findings of the internal auditors sent into Beaumont. Governments have spent more than €1.6 billion on waiting lists over recent years, using the NTPF, the HSE 'insourcing' and other arrangements. Any questionable findings will undoubtedly lead to more allegations about waste. Carroll MacNeill is facing a balancing act of trying to deal with serious issues in CHI at a time when the organisation should, ideally, be concentrating on moving the three existing paediatric centres in Dublin into the new €2.4 billion national children's hospital. TDs, like Daly, may have no confidence in CHI. But in the meantime services for children have to continue and workforce planning and other arrangements for the move have to be carried out in parallel. In late May the Minister told the Dáil: 'I am trying to look at this question in relation to the broader governance of CHI in a way that enables the functional continuity of CHI, both to respond to the various patient needs and ... the broader running of the paediatric system and to move us towards opening the new hospital. I want to ensure we see the appropriate governance structure in place to make sure that we have clinical leads who are managing each team.' However, within Government the ghost of the 2018 cervical check scandal casts a long shadow. This centred on retrospective audits of cervical cancer screenings that showed that 221 women's smear test readings missed abnormalities, leading to the development of cervical cancer. The results were not disclosed to 162 women and a number subsequently died. [ Justine McCarthy: Ireland's grubby treatment of Covid-19 heroes will cause frontline workers to think twice next time Opens in new window ] The fallout caused a national outcry. Ministers, doctors and health administrators did not adequately argue their own case and in the face of relentless criticism, a narrative took root and proved difficult to eradicate. There are fears that further revelations at the Public Accounts Committee or in forthcoming reports could spark further controversy. A number of sources have voiced concerns that the health service and CHI could replicate the rolling controversy seen over the RTÉ payments scandal two summers ago. The gaps and governance flaws identified by the CHI controversy also leaves the Minister with a decision on whether further reforms are needed. Health economist at UCC Dr Brian Turner described the current system as a complex mix of public and private funding and delivery with a large degree of overlap. He said there were publicly-funded public hospitals (run by the HSE), publicly-funded voluntary hospitals (run by their own boards) and public patients in private facilities such as nursing homes. In addition, the NTPF buys treatment in both the public and private systems. On top of this HSE reforms introduced last year led to new regional chief executives appointed to oversee services in geographic areas that covered both public and voluntary hospitals. [ Flying to Spain for medical care: 'The Irish really appreciate the services; they are actually really easy patients' Opens in new window ] One obvious question from this is who does the chief executive in a voluntary hospital primarily report to? Is it to the hospital board or the HSE regional chief executive? Such questions are not purely academic. At the Oireachtas committee, it became clear CHI did not believe its internal report merited a referral to the Garda. The HSE, on the other hand, wanted gardaí involved. One experienced health service figure told The Irish Times the CHI issue was casting a spotlight on the key governance question: who is in charge of what in the health service? With some exceptions, most of the main academic teaching hospitals covering most of the main specialities are in the voluntary sector. The staff are considered to be public servants but the hospitals are run by their own boards. Voluntary hospitals tend to jealously guard their independence. One senior figure pointed to a row last year when former minister for health Stephen Donnelly wanted all hospitals to adopt a new system that would provide greater visibility over productivity. A number of voluntary hospitals objected until the minster threatened to withhold capital funding. CHI reported to the minister, not to the HSE. However, when Donnelly wanted a new chief executive appointed as the former chief executive Eilish Hardiman had served the maximum two terms under Government policy, the CHI board disagreed. Simon Harris , as minister for health in 2017 established a review of the role of voluntary organisations in the operation of the health sector. But many key structures remained in place. One senior health source said voluntary hospitals previously argued they provided a set level of services for the State under an agreement each year but were subsequently free to treat fee-paying patients and do other work. However, private practice in public hospitals is now to be eliminated over time under Sláintecare , the long-term plan to achieve universal, single-tier health and social care. One experienced health figure said it was widely known that the governance arrangements were flawed. However, he questioned whether the Government had the bandwidth or determination to deal with the aggravation that would flow from trying to change the current model of care – a process that could take several years, and possibly beyond the next general election.
Irish Times
13 hours ago
- Irish Times
Nurses risked everything for us during the pandemic. Now many are abandoned to its awful legacy
It's not a question of if, but when. Scientists are warning that a new pandemic is lurking over the horizon poised to pounce on us. 'It's an epidemiological certainty,' says WHO director general Tedros Adhanom Ghebreyesus. 'Are we ready for the next one?' asks everyone from Boston College and Johns Hopkins University to the Economist and the United Nations. 'No,' is the straight answer for this country. READ MORE Ireland's grubby treatment of its Covid-19 heroes will cause some frontline workers to think twice the next time before they risk their lives for the greater good. Specifically, the nurses – those people who did not have the luxury of working from home, who imperilled themselves by caring for the infected, who self-isolated while off duty and eschewed public transport to avoid transmitting the virus, who hesitated to touch their own children but held the hands of the dying when their families could not be with them in the final days of their lives and who then zipped them inside body bags and phoned their kin to inform them the one they loved had gone. They did it in terrifying circumstances under the claustrophobic weight of protective gowns, hairnets, shoe covers, gloves, face shields and masks. In the early days, the masks were the standard surgical type and sorely inadequate. There were no vaccines for the first 10 months. Nurses and other hospital workers saw colleagues fall ill and be taken away to ICU to be put on ventilators. More than 20 healthcare workers died from Covid. What thanks have they got for all that? A €1,000 crisis bonus that their union representatives had to beg for before it was eventually paid. [ My battle with long Covid: I was in disbelief. Was I making it up? How could I not stand up while the kettle boiled? Opens in new window ] To this day, there is a cohort of forgotten heroes whose abandonment brings shame on us all. They are the ones who went out and defended the barriers for the rest of us and now they are living with that awful legacy called long Covid. While normal life of honking traffic, construction sites, children in school uniforms, packed restaurants and pubs and big weddings has resumed outside their front door, they remain trapped in a post-pandemic freeze frame. Extreme fatigue, brain fog, weakened immunity, headaches, muscular pain, palpitations and shortness of breath have left them unable to go back to work. Some days, they cannot even get out of bed. One young nurse who was assigned to a Covid ward in a big Dublin hospital told me she has cardiac complications and has been on antibiotics four times in the past seven months. Another said she contracted Covid in January 2021, that zero hour following the Government's 'meaningful Christmas'. Four and a half years later, she is attending a long Covid clinic and is being treated by an infectious diseases consultant, a cardiac consultant, a GP and an occupational therapist. She is on daily medication for tachycardia (fast heart rate) as well as low-dose naltrexone (LDN), aspirin for micro-clots, painkillers and numerous supplements. [ The healthcare workers with long Covid: 'I'm living with the consequences of a 'meaningful Christmas'' Opens in new window ] She is one of 20 nurses with long Covid who are suing the HSE, the Department of Health and their employer hospitals for compensation. They issued the High Court proceedings two years ago. The State is fighting them. Simultaneously, the Irish Nurses and Midwives Organisation (INMO) was in the Labour Court last week seeking to extend a long Covid special payment scheme for public health workers who are still suffering the consequences. The scheme, which has been extended three times already following public controversy, is scheduled to expire on June 30th. Minister for Health Jennifer Carroll MacNeill has told the Dáil it will definitely be terminated this time. The departments of Social Protection and Public Expenditure maintain it is not possible to definitively identify the source of infection for each of the 120 nurses affected. The last time the State was so ruthlessly parsimonious was when Charlie Haughey precipitated the 1989 general election rather than sanction £400,000 compensation for 106 individuals who had been infected with the Aids virus by State-supplied blood. It's an attitude that brings to mind Oscar Wilde's definition of a fool as one who knows the price of everything and the value of nothing. An asinine State is one willing to pay €335,000 for a politicians' bike shelter but repays its true champions with the threat of impoverishment. Ireland and Greece are the only EU countries that do not recognise Covid and long Covid as an occupational illness for patient-facing workers If the special long Covid payment scheme ends in two weeks, its current recipients will be switched to the normal public service sick leave scheme. It means that for the first three months they will receive their basic wage – with no allowance made for the night-duty premiums and overtime many nurses rely on. They will get half their wage for the subsequent three months. With rents or mortgages to pay, their worry amid a national homelessness crisis raises the stress levels long Covid thrives on. During the pandemic, our cocooned communities gathered outside our homes in the grim lockdown evenings to applaud the country's frontline workers for caring for us. Even TDs stood in the Dáil chamber to clap. How would we have reacted had we known then that this would be the thanks they would get? 'It's gone from a round of applause to a middle finger from the Government,' said a nurse identified as Siobhán on RTÉ radio last year. Ireland and Greece are the only EU countries that do not recognise Covid and, ergo, long Covid as an occupational illness for patient-facing workers. That anomaly means nurses, doctors, porters, caterers, paramedics, fire fighters, gardaí and everyone else who contracted long Covid while protecting the rest of us are ineligible for occupational injury benefit payments. A Department of Social Protection report in November 2023 suggested that uncertainty about the condition's longevity in individual cases was a prohibitive factor. What a callous calculation that must be to ponder if you cannot get out of bed and don't know when you ever will. Our culture takes nurses for granted. We'll pat them on the head and call them our angels of mercy, because tokenism works when you are dealing with people motivated by a vocational duty to the greater good. They deserve better.
