Northern Ireland's health service 'can't survive another winter without change'
A failure to meet the demands of unions will result in irreparable damage to the health service, it has been warned.
Pat Cullen, the director of the Royal College of Nursing in Northern Ireland, said the local health service here could not survive another winter without improved pay and conditions for NHS staff.
The service was brought to its knees on Wednesday as thousands of staff, including nurses, paramedics, domestic staff and laboratory workers, went on strike.
Health bosses said there was widespread disruption to services as a result, although some striking staff questioned why they were so vocal about concerns over patient safety.
"I'm disheartened that for one strike day health chiefs are up in arms over safe staffing, yet many other days I have worked way under the safe level of nurse-to-patient ratio," said one nurse.
The strike went ahead after health bosses honoured a commitment given to unions that they would not announce a major incident which would force employees off the picket lines and back into work.
Meanwhile, as staff braved atrocious weather conditions to show their disgust at their treatment, it emerged that Northern Ireland is the only part of the UK in which the number of registered nurses has dropped.
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According to the Nursing and Midwifery Council (NMC), the number of local nurses on its register fell from 23,324 in April this year to 23,280 in September.
"The health service is in crisis. We have 306,000 people on the waiting list for a hospital appointment and we have a severe nursing shortage, which is highlighted by the NMC figures," added Ms Cullen.
"Our members have been out on strike to fight for patient safety and to improve conditions for everyone. Quite simply, we cannot afford to wait any longer to address the problems facing the health service.
"Another winter like this and the health service will be irreparably damaged."
Further strikes are planned for January 8 and 10 ahead of the January 13 deadline for politicians here to re-establish the Assembly.
A breakthrough to bring an end to the health service crisis appeared unlikely on Wednesday night, with the relationship between the Secretary of State, the Department of Health, unions and politicians disintegrating even further.
Northern Ireland Secretary Julian Smith has refused to budge from his position that health is a devolved matter.
After roundtable talks with the political parties, he said again he was unable to intervene and approach the Treasury for additional funding.
However, unions have rejected this stance. They have also accused Mr Smith of using the crisis as leverage to force the political parties back into talks to re-establish the Assembly.
Patricia McKeown from Unison launched a stinging attack on the head of the local Civil Service, David Sterling.
He and the permanent secretary of the Department of Health, Richard Pengelly, have insisted that they cannot bring pay into line with the rest of the UK because it would mean overturning a ministerial decision.
In an open letter to Mr Sterling, Ms McKeown argued this position was incorrect and hit out at comments he made in a letter sent to the leaders of the political parties on Tuesday.
In the correspondence, Mr Sterling said that in order to meet pay parity demands, the Department of Health would need an additional £30m every year.
He said this money could alternatively be used to pay for additional activity to reduce the number of people on waiting lists each year by 120,000.
"It is important to note that other Northern Ireland departments are currently dealing with serious budgetary pressure, including pay pressures," he wrote.
"Indeed, there are currently industrial disputes in other parts of the public sector.
"The principle of public sector pay parity is clearly cross-cutting, with potential implications well beyond health."
In response, Ms McKeown hit out at the fact that Mr Sterling has still not responded to a letter Unison sent to him on November 28, in which the union sought his intervention to resolve the ongoing dispute.
Describing Mr Sterling's letter as "a deeply unhelpful intervention", she said she was "shocked by the apparent attempt to mislead party leaders and the overtly political tone of the letter".
She said a letter from the five political parties providing cover to allow civil servants to meet unions' pay demands was sufficient political authority for him to act.
"This having now been provided, we seriously question your failure to act," she added.
She also said Mr Sterling and the Department of Finance have been creating pay policy in the absence of ministers, such as a recent announcement of a review of public sector pay.
Ms McKeown also rejected the argument that there was no ministerial decision to break parity and said that it had instead been argued that the move was necessary to enable the Department of Health to break even.
She added: "We have repeatedly stated that the Treasury should provide whatever additional resources are needed to restore the pay gap.
"You have a clear role in making that argument to them.
"Health workers have kept the system running in the face of continued cuts and austerity."