A Century of Service: A History of the Irish Nurses and Midwives Organisation, 1919–2019

By Mark Loughrey

In February 1919, 20 nurses and midwives meeting in Dublin to discuss their poor working conditions took a historic decision to establish a trade union - the first of its kind in the world. The Irish Nurses and Midwives Organisation (INMO) now numbers 40,000 and is Ireland's largest nurse and midwife representative association.

This book examines the heady social and economic backdrop that gave birth to the INMO, putting names and faces to the founders and delving into the challenges they encountered. It details the Organisation's conservative middle years and its recent emergence as one of the most vocal protagonists for nurses, midwives and patients in Ireland, while also exploring the vast and varied service that the Organisation provides to its members. The prospect of a nurses' or midwives' strike always raises concerns for patient welfare, and the book looks closely at how the INMO has negotiated this tension, most especially during the 1999 national nurses' strike - one of the largest strikes in Irish history. A Century of Service is brought to life by a fascinating series of in-depth interviews with the INMO's members and leaders in a story of an organisation that with talent, tact and tenacity is delivering despite the odds.

• Language: English
• Publisher: Merrion Press
• Release date: Mar 11, 2019
• ISBN: 9781788550642

Mark Loughrey

Mark Loughrey trained as a general nurse at St Vincent’s Hospital, Dublin, before specialising in intensive care nursing. He currently works as a research nurse. Mark holds postgraduate qualifications in intensive care nursing from UCD and a master’s degree in nursing from UCC. In 2011 he was awarded a PhD scholarship by the Irish Nurses’ and Midwives’ Organisation. He graduated with a PhD in history from UCD in 2015.

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Mark Loughrey trained as a general nurse at St Vincent’s Hospital, Dublin, before specialising in intensive-care nursing. In addition to his postgraduate qualifications in intensive-care nursing from UCD and master’s degree in nursing from UCC, he was awarded a PhD in history from UCD in 2015. He currently works as a research nurse.

A History of the Irish Nurses’ and

Midwives’ Organisation, 1919–2019

Mark Loughrey

Foreword by Liam Doran

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First published in 2019 by

Irish Academic Press

10 George’s Street

Newbridge

Co. Kildare

Ireland

www.iap.ie

© Mark Loughrey, 2019

9781788550628 (Cloth)

9781788550635 (Kindle)

9781788550642 (Epub)

9781788550659 (PDF)

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Library of Congress Cataloging in Publication Data

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alone, no part of this publication may be reproduced, stored in or

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Typeset in Minion Pro 11/14 pt

Jacket front: ‘Charlie’s Angels’: nurses protest in Dublin in 1978. Courtesy

Derek Speirs.

Jacket back: INMO Whitworth building.

Courtesy Lisa Moyles.

INMO Logo

Contents

Author’s Note

Acknowledgements

Foreword. No Pressure – No Progress by Liam Doran

Introduction. 100 Years Young: 1919–2019

Presidents of the Irish Nurses’ and Midwives’ Organisation

General Secretaries of the Irish Nurses’ and Midwives’ Organisation

Headquarters of the Irish Nurses’ and Midwives’ Organisation

1. Setting the Scene

2. The Foundation of the Irish Nurses’ Union

3. The Early Years of the Irish Nurses’ Union, c.1919–24

4. New Name, Familiar Aim: From Trade Union to Professional Association, 1925–37

5. War and Wage Rounds, 1938–47

6. Religion and the Religious: Roots and Repercussions, c.1948–59

7. Promise and Progress, 1960–9

8. Marriage, Money and (Moderate) Militancy, 1970–7

9. Some Striking Developments, 1978–90

10. Resemblance amid Rupture: The 1999 National Nurses’ Strike, 1991–9

11. From Aftershow to Afterglow, 2000–8

12. A Decade Never to be Forgotten, 2009–19

Conclusion, Epilogue … and Over to You

Endnotes

Bibliography and Sources

Abbreviations

Index

Author’s Note

The views expressed in this book are those of the author and various commentators who took part in oral history interviews or supplied testimonies. They do not necessarily reflect the official position of the Irish Nurses’ and Midwives’ Organisation. The author apologises for any and all errors and omissions; these are honest and unintentional. All reasonable efforts have been made to contact the owners, or descendants of owners, of copyrighted images/text reproduced herein; no copyright infringement is intended.

Acknowledgements

This book would not have been possible were it not for the help I received from a number of people and organisations. First and foremost, I would like to thank the Irish Nurses’ and Midwives’ Organisation (INMO) for facilitating me in accessing their archives and for welcoming me each time I visited their headquarters and attended their Executive Council meetings and annual delegate conferences. In particular, I would like to thank Liam Doran, Martina Harkin-Kelly, Dave Hughes, Phil Ní Sheaghdha, Clare Treacy, Elizabeth Adams, Cathriona Lacey, Marion Behan, Olympic gold medallist Lorcan Byrne, Albert Murphy, Dr Edward Mathews, Muriel Haire and the organisation’s Executive Council, past and present. I would also like to thank P.J. Madden, Noreen Muldoon and Lenore Mrkwicka, all former staff of the organisation.

Some individuals went over and beyond the call of duty in assisting me and deserve a special mention. At the INMO they include Lisa Moyles, Freda Hughes, Oona Sugrue, Annette Kennedy, Sheila Dickson, Claire Mahon, Michaela Ruane and the excellent staff at the INMO’s library, namely Niamh Adams, Aileen Rohan, Rhona Ledwidge and Edel Reynolds. At the School of Nursing, Midwifery and Health Systems at University College Dublin (UCD) they include Dr Martin McNamara and Professor Gerard Fealy – gentlemen and scholars alike. A big thank you too to Dr Una Molloy for sharing a desk (and a few coffees and laughs) with me while we completed our PhDs at UCD. (We finally made it, Una!) A very big thank you also goes to all those who took part in oral history interviews and contributed testimonies – this book wouldn’t have been the same without you. A special mention must go to the INMO’s Editorial Committee for their many suggestions and for keeping me on the straight and narrow, especially Kay Craughwell for her mind, memory and meticulous attention to detail. Sincere gratitude also to Conor Graham, Fiona Dunne and the team at Irish Academic Press/Merrion Press for taking on this project and bringing it to fruition.

A number of other individuals and organisations were also of assistance. They include MedMedia, Dublin; Dr Odette Best, Queensland University of Technology; Noelle Dowling, Dublin Diocesan Archives; Francis Devine; the Irish Association of Directors of Nursing and Midwifery; John Kane, Medical Laboratory Scientists’ Association; Séamas Sheils, Irish Bank Officials’ Association; the Irish Municipal Public and Civil Trade Union; the Services Industrial Professional and Technical Union; the Teachers’ Union of Ireland; the Association of Secondary Teachers, Ireland; Professor Adrian Frazier, NUI, Galway; the National Archives, Ireland, in particular, Brian O’Donnell; Fiona Bourne, Royal College of Nursing Archives; Dr John Sweeney, University College Cork; Martina Kearns; Liz Gillis; Derek Speirs; Press 22; Lensmen; Mark Stedman; Áine Duggan; Photocall Ireland; the Nursing and Midwifery Board of Ireland, in particular, Catherine Rooney; Professor Richard English, University of St Andrews; Dr Emmet O’Connor, University of Ulster; the International Labour Organisation; the International Council of Nurses; Debbie Emerson; Warren Hawkes, Michael D’Amario and Helen Anotoniak, New York State Nurses’ Association; Christen Tracey, Australian Nurses’ Federation; Victoria Branch; Rita Martin, New South Wales Nurses’ Association; UCD Archives; Phillip Martin, Irish Newspaper Archives; the Irish Press; the Irish Independent; Irish Labour History Society Archives; the National Archives, Kew, England; James Hardiman Library Archives, NUI, Galway; Cork City and County Archives; Therese Bradley; Ruth Geraghty; Dr Mary Bell; Dr Seán Lucey; Eamon Devoy, the Technical Engineering and Electrical Union; the administrative staff at Mount Jerome Cemetery, Dublin; the greatly missed Margaret Ó hÓgartaigh; the Military Archives, Dublin; the Catholic Nurses Guild of Ireland; the National Library of Ireland; Proinnsíos Ó Duigneáin; John Vanek; Tony Cotton; Carl Mortished; Anne MacLellan; Eric Wilkinson; Siobhan Horgan Ryan; Mary Hawkins; the Irish History Students’ Association; Desmond Bates; Elizabeth Anne McMahon; Ida Milne; Rosemary Cullen Owens; Christiaan Corlett; Sandra Lefroy; Pearse Street Library, Dublin; Trinity College Library, Dublin; NUI, Maynooth Library; UCC Library and Audrey Drohan and staff at UCD Library.

Finally, a really, really special word of thanks to my good friend, comrade and mentor Dr Joan McCarthy at the School of Nursing and Midwifery at University College Cork, for giving me a start.

FOREWORD

No Pressure – No Progress

Iwish to begin by saying what a privilege it is to be asked to write the foreword to this book celebrating the first one hundred years of this great, vibrant and growing organisation. I wish to thank the President of the Irish Nurses’ and Midwives’ Organisation’s (INMO), Martina Harkin-Kelly, the organisation’s Executive Council, the book’s publishers, Irish Academic Press, and, most of all, the book’s author, Mark Loughrey, for inviting me to give my reflections. I have had the great privilege of working for this organisation, in various capacities, for almost thirty-five years. In that time, I have seen it become the most visible, vocal, dynamic and active professional trade union in Ireland, and I am sure the best is yet to come.

The story told in this book and the journey travelled in the past century confirms that, in relation to nursing and midwifery, there has never been any progress without the INMO applying pressure for change and improvements in the interests of nurses, midwives, patients and other service users. I cannot remember one situation over the past one hundred years when employers have been willing to recognise, respect and pay nurses/midwives for the role they play and the work they do in the provision of health care. In fact, both the government’s and management’s approach over the decades has been to consistently exclude nurses and midwives from policy-making decisions and from the management of services. The years are filled with warm words, which proved nothing more than empty rhetoric from ministers and senior management. The time was never right to recognise the contribution of nurses and midwives, so the INMO had to work harder, much harder than others to ensure any degree of recognition.

The Early Years

I have often wondered what the atmosphere was like, and what was actually said, when that small group of nurses and midwives gathered in South Anne Street in 1919 and agreed to formally establish the Irish Nurses’ Union (INU). These were women who had undoubtedly seen and worked through appalling working conditions and had come to the realisation that collective action was necessary to improve their situation. On that evening in February 1919, the struggle to establish a national union must have seemed daunting, but their courage overcame their concerns. Therefore, as we celebrate one hundred years, I wish to begin this foreword by saying I stand in awe of these women who started the journey that now sees the INMO represent almost 41,000 members across all health services in this country while also enjoying global recognition. The courage of that small group of women who gathered on that cold February evening in 1919 must never be forgotten and always recognised and respected.

As the early decades of this organisation’s growth and development tell us, those first years saw it grow as it fostered relationships with other bodies, i.e., the Irish Women Workers’ Union (IWWU) and also international bodies such as the International Council of Nurses (ICN). It can also be seen that the organisation, while constantly seeking improvements in pay and conditions, had a social side, i.e., the ‘Nurses’ Dance’, which was also vibrant – we might smile now, but at the time this was an integral part of the organisation and what it did.

It is said history repeats itself, and I was so pleased to see the INMO purchase, redevelop and open the Richmond Hospital as our national Education and Event Centre in 2018. I also note that the first programmes for members took place in February 2018, some eighty years to the week when the Irish Nurses’ Organisation (INO, as we were then known) held its first professional development programmes in the Richmond. This reaffirms the twin objectives of meeting both the socio-economic and the educational and professional development needs of members, which has always been the hallmark of this great organisation. It should also be noted that within the first fifty years, the organisation was instrumental in the commencement of programmes leading to registered qualifications in general, psychiatric, intellectual disability nursing and midwifery, together with specialist programmes in such areas as theatre and intensive/coronary care. The commencement of all of these programmes, leading to formal recognition and ultimately additional pay for certain qualifications or for those working in certain areas, only happened because the INMO applied pressure leading to progress. No pressure – no progress without the INMO.

The 1970s: Significant Change Begins

I think it is fair to say, based upon Mark’s excellent work reflected in this book, that the winds of real change, leading to greater visibility, assertiveness and militancy, began in the early to mid-1970s. In the early 1970s, the public service marriage ban was lifted. In 1973, Ireland joined the European Common Market (now the European Union). Both of these events changed the face of every workplace and injected new energy into the INO.

In the context of the organisation’s growth and development, perhaps the most significant event of the 1970s was the decision, taken at the Annual Conference in 1978, for the organisation to seek affiliation to the Irish Trade Union Congress (ICTU). This was a watershed moment in the history of the organisation. It was, without doubt, an expression of frustration at the treatment of nurses and midwives at the hands of government and management. It demonstrated a willingness to be more militant, assertive and demanding in the interests of members. Irreversible change had begun and continues to this day. The debate, chaired by the then President, Carmel Taaffe, was determined, eloquent, inclusive and ultimately decisive. The INO was to write to the ICTU to seek affiliation. At this point, I think it is only appropriate that I would recognise the leadership role played by Ms Taaffe, who, as a Director of Nursing, was not expected to lead the INO into a more militant ‘trade union’ stance. I clearly remember, as I was beginning my third year as a student intellectual disabilities nurse in St Mary’s, Drumcar, Co. Louth, the vital role played by this great president as she realised the organisation must join with the wider union movement in pursuance of the interests of its members. She was a great leader.

The changes and events of the mid to late 1970s reflected the growing militancy and changing dynamic of the nursing and midwifery workforce. They also confirmed the beginning of radical change and transformation in the thinking, strategies and actions of the INO. This would gather further pace in the 1980s.

The 1980s

Just before 9:30 a.m. on Monday, 13 June 1983, I, as the INO’s first Student Officer, entered 20 Lower Leeson Street to start my first day in a new job. I had qualified as an intellectual disabilities nurse and as a general nurse at St Mary’s, Drumcar, Co. Louth, and at Our Lady of Lourdes Hospital, Drogheda, respectively, and had worked as a staff nurse in both services since first commencing my student nurse education on 16 November 1976. On that day, I was informed by Kevin Downey (Membership Officer), who retired only recently and was a tremendous servant to the organisation, that membership numbers were 9,200, with only 400 of these (approximately) being students. My job was to recruit all student nurses and to develop services for our student nurse members which would, following qualification, lead them to become members of the organisation. Ireland at that time was facing high levels of unemployment and mass emigration. Nurses and midwives were emigrating following qualification as there was simply no work in Ireland. The work that was available was only temporary, with payment on the minimum of the scale, no incremental credit, no holidays and no respect.

If I am honest, it is something of a mystery to me as to how the organisation, with its conservative stance on many issues in the workplace, continued to survive in the face of massive efforts to recruit nurses by the Irish Transport and General Workers’ Union (ITGWU) and Psychiatric Nurses’ Association (PNA). It became very obvious that unless we changed rapidly we would no longer be fit for purpose; we could no longer expect to make progress on our agenda, and ultimately, we would no longer remain relevant to nurses and midwives.

In 1985, following the retirement of the legendary Ena Meehan, the organisation appointed a new General Secretary, John Pepper, who remained in the post for approximately two years. I remember during his tenure that the organisation became actively involved in a dispute about the cost of accommodation for student nurses in hospitals across the country. This gave the organisation visibility on national television and radio. However, in 1987, following the departure of John Pepper, the organisation appointed P.J. Madden, who had been the General Secretary of the PNA. The organisation would never be the same again.

The health service continued to be seriously underfunded, leading to cutbacks in services, with all areas suffering from severe staff shortages. The then Minister for Health, Dr Rory O’Hanlon TD, when responding to a Dáil question, said nursing was a highly mobile, international, marketable commodity, and we would always see Irish-educated nurses and midwives emigrating, but they would come back. This flawed thinking continues to the present day and reflects again the lack of respect toward nurses and midwives shown by ministers and management. Against this background, the new General Secretary and Executive Council held a nationwide ballot in protest at the working conditions of members. This ballot, which provided for industrial action up to and including the withdrawal of labour, showed a two to one vote in favour of taking action in the absence of concrete measures to address the problem of staff shortages and poor pay.

In tandem with this industrial strategy, the organisation, again through the determination of the presidents of the time, Biddy Butler and Ita O’Dwyer, coupled with the energy of P.J., redoubled its efforts to affiliate to the ICTU. The efforts to affiliate had made little progress due to such issues as spheres of influence (the name given to inter-union arrangements about membership) and the INO’s possible approach, if affiliated, to an ICTU call for an all-out strike.

The INO finally affiliated in the early 1990s. This was a momentous development that brought the organisation into mainstream trade union activity. It also meant involvement in the periodic negotiations leading to social partnership agreements. These agreements not only covered pay, but increasingly agreements with regard to wider policy issues, thus affording the organisation input into these discussions on an ongoing basis. As a result of these developments, the late 1980s/early 1990s, were a time of great change for the INO. These changes sowed the seeds for the more visible, vocal, demanding and aggressive professional trade union for nurses and midwives that we have today.

1992–2008

It is my honest view that the period of 1992–2008 was when the organisation came of age. The INO was now getting into its stride. However, it was clear that improving the relative position of nursing/midwifery in terms of pay and conditions was not resting easily with either government or sister trade unions. I have to place on record that it is my absolute conviction that the INO, by applying pressure, initiated, led, shaped and delivered all of the changes in the area of pay, conditions, professional development, educational pathways, staffing levels and structures that took place during this time.

It is a constant source of frustration to me that academics, other stakeholders and the media have failed to recognise and acknowledge the role that the INO has played in the massive changes that took place over these sixteen years. I have had many discussions with academics, people from state agencies, senior people from international nursing bodies and the media. All of them, when commenting upon the changes and the events over this period, have completely underestimated the influence of, and the central role played by, the INO. That is why, in this book, I wish to state quite clearly that if you want to know why nursing and midwifery in Ireland was the subject of massive change and progress over this period, then look no further than the INO, because this great organisation made it all happen. Here is the timeframe:

1992

The INO opened its Professional Development Centre and Library for members, in its then headquarters in Fitzwilliam Place. This was a tangible demonstration of the organisation’s commitment to the entire spectrum of services required by the student and qualified member. Twenty-six years later, we opened the Richmond as our state-of-the-art Education and Event Centre – real progress.

1994: Galway Diploma

Following months of discussions with senior officials in the Department of Health, the ‘Galway Diploma’ commenced in 1994. This saw the nursing programme in University College Hospital Galway linked with a diploma awarded by University College Galway, and was the first significant step of linking nurse education to the third level sector. The programme was so successful that in 1996, the model was adopted across the country, with partnerships being formed between all major hospitals and their local university/third level institution. This reflected the efforts of the INO, as directed by numerous motions adopted at annual conferences, to seek the introduction of an undergraduate degree programme leading to registration as a nurse in this country.

1996

In tandem with the beginnings of this revolution in undergraduate nurse education, the INO was also actively engaged in discussions at national level with health employers with regard to the pay, grading and conditions of employment applicable to all grades of nurse and midwife. These discussions culminated in what became known as the Blue Book Agreement. However, this did not resolve the level of dissatisfaction felt by members in all workplaces with regard to their pay, hours of work and staffing levels. That is why, in early 1997, the organisation obtained a mandate, following a national ballot, for the commencement of nationwide industrial action in pursuance of improvements in pay and conditions. At the last moment, and again following direct discussions, the then Minister for Health, Michael Noonan, in tandem with implementing certain pay and other revised grading structures, agreed to establish a Commission on Nursing. The commission was to be chaired by a High Court Judge. It would undertake a review of the professions and make recommendations as to how they should be reshaped and revitalised to meet the expectations of nurses, midwives and the needs of patients within a changing health service.

1997

The commission, which was chaired by High Court Judge, Justice Mella Carroll (her niece Jean still works for the INMO), was established in 1997, with the organisation represented by Eilish Hardiman (now Chief Executive Officer of the National Children’s Hospital) and our then General Secretary, P.J. Madden. The commission carried out an exhaustive examination of nursing and midwifery, making some national and international comparisons, and in September 1998 it produced its final report with over 200 recommendations.

1998

As coincidence would have it, the commission reported immediately following my appointment as General Secretary. The commission’s report was launched in Dublin Castle and was the subject of much media attention. It was recognised that its recommendations would decide whether the dissatisfaction of nurses and midwives would be allayed or if the potential for nationwide industrial action remained. I can vividly recall the evening of the launch of the report when the then Minister for Health, Brian Cowen said effectively that the government accepted the 197 non-pay-related recommendations. However, in relation to the three pay-related recommendations, these would have to be considered in the context of any future national or public service pay agreement.

That evening, the INO, through a press statement, indicated that if the government failed to implement all of the recommendations with timelines for full implementation, it would hold a national ballot of all members seeking a mandate for nationwide industrial action involving the withdrawal of labour. The government, supported by other public service unions, refused to agree to implement the pay-related recommendations; the ballot commenced and an overwhelming mandate was given.

1999

In the weeks and months leading up to 19 October 1999 (when the nine-day national nurses’ all-out strike began), there were numerous efforts and offers made and rejected to avert the action. However, all of the offers made were in the context of existing public service pay policy and did not provide for the required uplift in the relative pay of nurses and midwives. Internally, in preparation for the nationwide action, the organisation, both through debates at annual conference and decisions of the Executive Council, decided that if the action was to go ahead it would be nationwide, involve all services, and all members with emergency care being provided, unpaid, by members working to an INO Strike Committee in every workplace. This approach to industrial action, the first of its kind to be taken by the organisation, was the subject of much heated debate. However, it was felt that for the action to be effective and to be accepted by all members, it had to be universal, inclusive and absolute. In these weeks and months, the INO became a union in every workplace, and we have never looked back.

19 October 1999

I will always remember waking up at 6:00 a.m. on Tuesday 19 October and listening to the news confirming that at 8:00 a.m., the first ever national nurses’ and midwives’ strike would commence. The country would only have emergency level health services in operation, with all routine work cancelled. I spent that day attending numerous picket lines. We were dealing with massive media interest, both national and international, making constant efforts to reaffirm the legitimate claims behind the dispute and confirm that the action would not endanger the health of any patient or service user. My last media engagement was on the Vincent Browne Show at 10:00 p.m. that night. The first question I was asked was ‘Liam Doran, what gives nurses the right to let people die as a result of their strike action?’ I did my best, over a very difficult forty-minute interview, to explain that all emergency cover was being provided, and while people died every day in the country’s hospitals, they would not die that day, or any other day, because of any industrial action being taken by INO members.

Over the following nine days, INO members in every area of our health service were brilliant and showed remarkable dedication to each other in terms of trade union solidarity and also to their patients. Over those nine days, on a 24/7 basis, Strike Committees (all of whom were absolute heroes) organised shifts which involved the provision of an emergency level of cover (without pay) and rostering for picket duties.

Despite the best efforts of a small section of health management and the media, throughout those nine days no adverse incident leading to a negative outcome for any patient or client could be found. Our members, even in the heat of industrial action, were excellent, committed and dedicated professionals. While it was unbelievably challenging those nine days during October 1999 are something that I am immensely proud of as I was privileged to work with, and for, such people of pure class, professionalism, dignity and determination.

21 October 1999

On this day, over 10,000 members marched down O’Connell Street, and we held a mass rally outside the General Post Office. It was a tremendous show of solidarity as members from every corner of the country came together to demand fair pay. At 10:00 p.m. that evening, talks to resolve the dispute began in Government Buildings and continued until early in the morning of Monday 25 October. Outstanding issues were then referred to the Labour Court, which convened a hearing involving all parties at 2:30 p.m. that Monday afternoon. Throughout this period, the strike committees continued to manage the provision of services and organise pickets.

27 October 1999

After nine days of industrial action and six days of negotiations involving independently chaired engagement and a Labour Court hearing, a set of proposals emerged at 4:00 p.m. on Wednesday 27 October. The INO’s Executive Council met immediately and decided that the court’s recommendations should be recommended for acceptance by the membership. The nationwide action would be suspended to allow for information meetings and balloting, with effect from 8:00 p.m. that Wednesday night, with all normal services resuming.

For obvious reasons, the Executive Council felt it was necessary to commence information meetings with members immediately. The first was arranged for St James’ Hospital, Dublin, that Wednesday evening at 8:30 p.m. I have no doubt, having attended literally hundreds of meetings, that the atmosphere at that meeting was unique. There was standing room only, and members were literally leaning in the windows demanding access to information and answers to questions. Feelings were, for legitimate reasons, running very high, and the situation was very tense, with much initial anger. Over the following ten days we held many such meetings. On the Thursday morning of 28 October 1999 at 7:30 a.m., I met with over 400 members in Beaumont Hospital, Dublin. During this meeting I had to do an interview on Morning Ireland, in the course of which I was asked if I would resign if the members rejected the Labour Court recommendation. This period was, without doubt, very challenging for me both personally and professionally, but through great teamwork and togetherness, led by Anne Cody, another great INO President, we survived. It also marked the INO literally coming of age as a trade union.

In the end, the Labour Court Recommendation was accepted by a vote of 63 per cent in favour and 37 per cent against. The organisation moved immediately to demand full implementation of all the recommendations.

2000: Post-Mortem and Delivering

In the immediate aftermath of the strike and the decision of members to accept the recommendations, a meeting took place with the Minister for Health, Brian Cowen, his two junior ministers and all of the senior officials in the Department of Health. This was the first time that all three ministers in the department had met with the organisation. It was obvious that in addition to securing the proposals from the Labour Court following industrial action, the INO was now on the political radar screen and was recognised as being the voice of nurses and midwives. Critically, it was now a trade union with whom the government of the day would have to be prepared to do business.

It is my view that this level of political recognition and visibility in the eyes of the public which emerged from the nine-day national strike was as important as the tangible measures, and they were significant, gained as a result of the strike settlement. I am adamant that the centrality of the organisation from that November 1999 period to the present day is measurably different to anything that existed before and is still producing benefits to INMO members.

Following the settlement of the strike, the organisation, once again showing its maturity and integrity, immediately commenced two processes:

• Implementing the strike settlement and the Commission on Nursing recommendations; and

• Initiating nationwide consultation, with members, to carry out a post-strike evaluation of what had been done, what had worked, what had not worked and what lessons must be learned for any future industrial action campaigns.

In this context, the period 1999–2001 was challenging, dynamic and exciting. It was a period when the organisation showed tremendous resilience as we engaged internally and externally on matters of huge significance all the while analysing, learning and changing.

2002–6

As a direct result of the Commission on Nursing, which was established to avoid industrial action threatened by the INO and following the national strike in 1999, the government funded the introduction of a four-year undergraduate nursing degree programme in general, intellectual disability and psychiatric nursing, which commenced in September 2002. Once again, I say if there had been no pressure applied by the INO through industrial action we would never have secured the four-year degree programmes, and we would still have the old ‘apprenticeship’ model. In 2006, this undergraduate four-year pathway was extended to midwifery, which saw, for the first time in this country, a direct entry, third-level midwifery programme being available. This development, which again was a long-term goal of the INO, had the effect of requiring the organisation, in 2010, to change its name from the Irish Nurses’ Organisation to the Irish Nurses’ and Midwives’ Organisation. For the first time in a long time in Ireland, a member could be a midwife and not a nurse, and the name of the organisation had to reflect this reality.

2006: Working Hours

The organisation now moved to tackle the inequality in the working hours of nurses and midwives compared to other health professionals. This led, again after a sustained campaign involving six weeks of work-to-rule, to the introduction of a 37.5-hour week for nurses/midwives in July 2008. This was the first time in over forty years that a single group, grade, or category of worker in this country had secured for itself a reduction in the working week separate from any other adjustment in the working week for all workers in the state. The campaign of 2007/08 in relation to working hours and the working week was an example of the lessons learned from the 1999 dispute. This reduction in working hours was a remarkable achievement by the organisation and one for which I was very proud.

However, after this period of massive change, revolution and improvement in the relative pay of nurses and midwives from 1999–2008, all was now about to change. The period 2008–14 would, from a very different perspective, again test the organisation’s resilience, infrastructure and unionateness.

2008

In late September 2008, only three months after the INO secured a 37.5-hour working week for members, the government was forced to introduce measures that would guarantee all of the country’s major banks in terms of their liabilities, borrowings and deposits. This decision, taken in the early hours of a Friday morning, was eventually to cost the country over €64 billion, which the Irish taxpayer (that is, our children’s children) will be paying for years into the future. This economic Armageddon was brought about by the reckless, greedy and craven behaviour of all of the banks, which saw senior management, who were earning millions per annum, act as if they were gods, as if they were untouchable and as if they could do no wrong. The reality is that over a number of years leading up to 2008, they borrowed, lent and created a market that was unsustainable and which would ultimately bring the country to its knees.

In order to honour the bank guarantee, the government was forced very quickly to enter into a financial arrangement with the IMF. This would see the country, for an extended period, effectively lose our economic independence, sovereignty and control over the provision of public services. All government spending decisions were subject to IMF approval, and we had the spectre of officials, from the IMF and associated entities, periodically visiting Dublin to oversee the government’s recovery programme. I always thought it was somewhat ironic to see on the news these officials walk across from the Merrion Hotel (where rooms cost €500 per night) into the Department of Finance to ensure that the government imposed cuts on social welfare and pension recipients, who were trying to live on €200 or less per week. These people had the hardest of necks and had no understanding of the pressures facing ordinary families. The impact on families, and on the country, of having to avail of the loan from the IMF, was massive. All taxpayers, including all public servants, i.e., nurses and midwives, were faced with increased levels of taxes, the introduction of the Universal Social Charge and the introduction of various additional charges such as the Local Property Tax.

As part of this reflection, I would like to make the following observations about the decisions made during those dark and dismal years:

1. It is often forgotten that in September 2008, before the government introduced a public service recruitment embargo, the HSE introduced its own recruitment embargo. At that time, the HSE excluded doctors and allied health professionals from the recruitment ban. However, they refused to exclude nurses/midwives with the result that, very rapidly, staffing levels on the frontline were cut in a wholly unmanaged, damaging and indefensible way.

2. The decision to include nurses and midwives in the ban, while excluding other grades, is yet another example of management’s inherent bias against nurses/midwives and total ignorance of the delivery of healthcare in the frontline. There is also a view, held by senior people in the civil service and periodically across government, that because we have thousands of nurses we can cut numbers without any damage being done to the health service. How wrong they were, how wrong they are, and how many patients have suffered as a result of this flawed approach?

3. The insistence, particularly by the European Union that the government fully repay all bond holders (senior and junior) through the IMF programme, was, and is, indefensible, and caused hurt and damage to thousands of families across the country. We were effectively told that we had to reward risk-takers while ordinary citizens, on ordinary incomes, were faced with cuts which meant they could not pay bills, could not adequately feed their children, were forced to live in poverty and even forced to lose their homes. All of this was done to ‘protect’ the world’s banking system. However, I believe all of this was done because the elite always look after their fellow elite, regardless of the impact upon ordinary people. It was simply a modern version of the famous phrase of Marie Antoinette: ‘Let them eat cake’.

4. During this period there were repeated efforts, often as a result of alliances between the government and certain public sector unions, to target allowances and premium pay as part of the cutback measures. For the first time, we heard the phrase ‘core pay’, which effectively became code for leaving the pay of civil servants and administrators alone while cutting the pay of those who worked unsocial hours, weekends and night duty. In response to this, the INMO was instrumental in the establishment of the 24/7 Alliance. This saw the unions and organisations representing frontline staff (i.e., nurses, midwives, gardaí, prison officers and paramedics) come together and mount a campaign of resistance over any further cuts to those who worked unsocial hours. This campaign had two highlights, which I will always remember:

• The silent march, in uniform, down O’Connell Street, Dublin, which saw over 3,000 frontline public servants march in visible solidarity with each other; and

• The famous rally, at the National Basketball Arena, Tallaght, which saw over 4,500 frontline public servants come together to again show that they would not tolerate any further cuts targeted at them.

I am proud to say that the INMO was at the forefront of organising the 24/7 Campaign. I am certain that without this mobilisation of uniformed frontline public servants, even more draconian measures would have been imposed upon us.

5. One of my proudest moments as General Secretary of this great union was when, in 2013, the INMO, together with three other unions, walked out of talks with the government. The talks had begun on a Friday and by Sunday it was clear that the government, with the tacit agreement of a number of public service unions, were preparing to table measures that would see cuts in Sunday and night duty premiums. These cuts would only affect staff who worked on a 24/7 basis. The INMO negotiating team and I wish to acknowledge the strength and conviction of my great colleagues Phil Ní Sheaghdha, Dave Hughes and Eddie Mathews, who decided to leave the process as we could not accept the imposition of such measures, which would result in a further 11 per cent cut in the take home pay of an average nurse/midwife. I am happy to say that we were joined in our decision to leave the process by the Irish Medical Organisation, Unite and the Civil and Public Services Union. The remaining fourteen public service unions, together with the government representatives, remained in talks that Sunday evening, resulting in a draft agreement being finalised and made public on the Monday. In the following days, the INMO’s decision to leave the process was publicly criticised by other trade unions and government spokespersons, and our commitment to represent our members was questioned. History will show that in the following six weeks the INMO, together with the other three unions and the PNA, undertook a nationwide campaign involving town hall meetings and press conferences. This resulted in a total of fourteen of the nineteen public service unions rejecting the proposals, as ordinary members of other public service unions saw and understood how flawed and unjust they were.

6. If those proposals had been accepted, we would have seen Sunday/Bank Holiday and night duty premiums cut to time and one-sixth. As the cuts did not actually take place because the proposals were rejected, the reality is that members did not fully appreciate the importance and strength of the campaign put forward by the INMO and this union’s commitment to protect its members’ interests in the face of loud opposition from management and regrettably, from other public service unions. The reality is some of those public service unions have still not forgiven, or forgotten, the fact that the INMO understood their members more than they did.

7. I also believe that instead of building on the strength of unity arising from the rejection of the flawed Haddington Road 2 proposals, a number of unions quickly recommenced negotiations with the government on an individual basis. While the proposals that emerged from these talks, which were done on a single union-to-government basis, were far less draconian, we should have collectively refused to negotiate, stood our ground and said that the earlier pension levy and pay cuts were more than enough of a contribution from public servants.

8. To add insult to injury, the Haddington Road proposals, which were ultimately accepted by individual unions following national ballots, also included an increase in the working week of between 1.5 to 2 hours. This resulted in the gain that we had obtained in 2008, of moving from 39 to 37.5 hours, being taken back, and nurses recommenced working a 39-hour week in 2013. This, undoubtedly, was one of my saddest days as General