Mr. Pat Harvey, Chair of the Public Service Health Service Implementation Body urged senior managers at the HMI South Forum in Cork to continue to embrace the philosophy of the Croke Park Agreement and to have continuing confidence around what it can achieve, writes Maureen Browne.
“I would urge that management at every level embrace the Croke Park philosophy; it is vital that all supervisors and managers have the confidence around it to appreciate what can be achieved. Unions say they are receptive…the deal is done…but management must in turn always set out their plans in the various settings and engage meaningfully with the local union representatives as provided for in the Agreement”
He thought the Croke Park Agreement was very impressive. “Throughout my career, I have seldom witnessed anything as enabling. We have here an agreement which facilitates managers to cope with the wide ranging reforms that are being demanded provided of course they go through the correct process.”
“I would be the first to acknowledge that the various reform initiatives ultimately translate into very local settings personally impacting on local individuals. This can be challenging for all concerned and particularly against the background of the broader economic measures, work pressures, cross cover demanded, absence of usual locum cover, reduced take-home pay and such like. Regardless of any national view or agreement there is always the challenge for it to make sense locally.”
“Croke Park fundamentally has to be about ‘pace and product’ as distinct from processes of negotiations alone.”
He asked the packed meeting (there was standing room only) if they thought Croke Park worked. They responded unanimously that they thought it was working but they believed the public probably viewed it differently. This was a real challenge – how to convince public opinion. What was it that conditioned public opinion? Individual experiences? What they observed? The media? Public representatives?
“Unions say they are receptive…the deal is done…but management must in turn always set out their plans in the various settings and engage meaningfully with the local union representatives as provided for in the Agreement.”
Mr. Harvey said that each of the 100,000 staff working in the health service and indeed their families were in a position to influence very many more people. They should be positive “ambassadors” for the very significant changes which were being accommodated.
He warmly welcomed the role of the HMI, the support that it offered and spoke of its crucial value at this challenging time. In particular he welcomed the fact that the HMI was now reaching out more and more from its traditional Dublin base organising meetings on key health service topics all over the country.
Referring to Croke Park at the macro level he said the National Implementation Body (NIB) was chaired by P.J. Fitzpatrick, formerly CEO of the Eastern Health Board and the Courts Service. This body consisted of eight people, four from management and four from the unions and this was replicated in the various major sectors such as health and education. Health, Nicky Jermyn, CEO of St. Vincent’s University Hospital in Dublin, Barry O’Brien of the HSE (who has replaced Sean McGrath) and Laverne McGuiness from the HSE. The Unions were represented by Louise McDonnell of IMPACT, George McNeice of the Irish Medical Organisation, Liam Doran of the Irish Midwives & Nurses Organisation and Paul Bell of SIPTU.
The health service Report for the second year of the Agreement would be presented to the NIB shortly and it would tell the story from March 2011 to March 2012.
Nationally the unions reasonably wanted to know what would be the end product and what the health service would look like in a few years – numbers, structures.
He said that the exchequer public service bill was set to be reduced from 17.5 bn euro to 14.6 bn euro between 2008 and 2015. The WTEs had been reduced by 23,000 up to last December and would be down by up to a further 7,500 this year. Activity had been maintained, thousands of staff had been re-deployed, organisations rationalised in the broader public service and all of this had taken place in a climate of industrial peace. This has been a tremendous success.
“All of this was achieved in the five years that the country’s population has grown by eight per cent or 340,000 people, the live register is up 280 per cent, when there were 500,000 more medical cards issued, when 3rd level students increased by 15 per cent while the staff in the same area was down seven per cent since 2007. In health, Day Services were up by 26 per cent.”
“There is a somewhat new context in Year 2. As you ‘squeeze more and more juice out of the orange’ each year (2, 3 & 4) becomes more challenging. I met with some managers from the Kerry service today who were reflecting that it gets harder as you keep going because everyone gets more tired and weary, yet we are still only into the end of Year 2.This viewpoint is most likely typical of very many settings. Yet the challenge continues. Imaginative measures, good management and good engagement with unions and staff are demanded. Every tradition and convention seems to be up for challenge.”
Mr. Harvey said that nationally the unions reasonably wanted to know what would be the end product and what the health service would look like in a few years – numbers, structures. There were significant changes flagged. He congratulated Dr. Ambrose McLaughlin on his new appointment as Secretary General and felt from his past personal and very positive knowledge and experience of Dr. McLaughlin that he would certainly bring a new and positive dynamic to the health service. Mr. Harvey also congratulated Barry O Brien on his appointment as National Director of HR indicating that this appointment was very well received throughout the service. Locals in Cork were very familiar with Mr. O Brien’s profile and strengths and the national service will gain hugely from his personal style and great skills.
He said that the future of the Croke Park Agreement was influenced by the Government, the Minister, the media, the public, the unions and what he called the 100,000 “ambassadors” who worked in the health service.
“Much has been achieved in the health service including reforms associated with the Clinical Programmes, the reductions in WTEs, the increase in shared services and re-deployments. Hundreds of millions have been saved in the health services. And the background music for a lot of this is ‘Croke Park’ and the co-operation forthcoming from the unions.”
Capturing this entire story in the right form is one of the most difficult challenges. On the one hand there is so much that can be told. On the other how to aggregate the information, how to relate it on in digestible bite sizes is the challenge. Too often, the health service has difficulty getting coverage of good news stories so this is also a ‘nut to crack’.
In concluding remarks: “The big issues going forward still gravitate around finance, staffing numbers and activity. Clarity with regard to structures is vital. Unions would be very concerned with risks of unstructured downsizing. No doubt there will be interdisciplinary debates, concerns about any gravitational pull towards possible outsourcing, public perception issues among many other themes.
“The Government spokespersons seem happy that Croke Park is delivering in a climate of industrial peace. What is vital is that Croke Park continues to deliver.”
HMI President, Mr. Richard Dooley said that the HSE National Service showed many many Croke Park deliverables and when you peeled it back and went into each service areas there were actually many more. “We are doing much more than people realise but we need to improve our means of communicating it,” he said.