My daughter attends a small day-centre which caters for people with severe disabilities, and is headed by a nurse. Half the clients live at home, most with Aged P’s—a goodly number of whom are pensioners. This unit remained closed for the nine days of the nurses’ strike last October. No emergency service was offered; the service provider indicated that the nurses had agreed cover to residential units only on condition that ‘nursing’ day services were closed—although some more-able clients were able to keep their day service.
Like most people I thought that the nurses deserved higher pay. Though I’ve met the odd nurse whose halo is askew, I have found most nurses conscientious and hard-working, and their treatment by the higher medical echelons leaves a lot to be desired. I don’t understand why Brian Cowen did not begin talks before the strike. Staff shortages alone should have told him that higher pay was necessary. And given the cavalier attitude of former Fianna Fáil administrations to public money, Mr Cowen was in no position to give a sermon on moderation.
However, to this battered parent, his attitude was in no way surprising; this is the way disabled people are treated by the Department of Health and Children. What was surprising and hurtful was the attitude of the Nursing Alliance to emergency cover- In their organisation of strike cover they reproduced exactly the inequalities and the dismissive attitude to community care of our health services. Hospitals for the rich carried on without a hitch—if Brian Cowen had become ill he wouldn’t have noticed any difference; ER-type emergencies were dealt with efficiently; treatment for chronic illnesses was curtailed, and the community service disappeared altogether. The Nursing Alliance appeared to share the Department of Health and Children’s belief that community services are an optional extra. In this dispute, the old and the chronically sick and disabled were seen as expendable and not deserving of consultation. As usual, other people decided on their ‘real’ needs.
This particular pawn survived. My workplace was very understanding and allowed me to work at home. My other daughters and my friends helped with babysitting so that I could put in a few appearances in the office. Aoife was very chesty for the first couple of days and slept a lot, so she probably didn’t notice too big a change. Other parents were not so lucky; many people with learning disabilities became extremely distressed by the change in routine.
Every second day I tried to arrange an event—we went out to lunch with a friend; we drove to Blanchardstown Shopping Centre (very wheelchair-friendly); Aoife went to her local ARCH club (thankfully, volunteers don’t go on strike); she stayed with a cousin who lives near my work for a day (I rushed back at lunchtime to feed and change her); we went to the shops and down to the seafront. I moved her around, put on her tapes, played the piano with her—all while doing my own work as well. I got pretty tired.
Aoife needs a nursing service to deal with her constipation—not a doctor’s thing, I’m afraid. I gave her suppositories, Sennakot, prunes, but nothing happened. By Tuesday I was wondering what I was going to do. The stories from the hospitals were not reassuring; an old lady suffering for almost an hour when a nurse refused to insert a catheter; a man who was changed but not washed afterwards. I felt pretty sure we’d be judged undeserving. And if I asked one of the nurses of my acquaintance? A refusal wouldn’t just offend, it might lead me to violence! And what if I got ill? Respite had disappeared: residential services were on a knife-edge. And the rhetoric was disturbing—talk of a total walkout, a threat of possible deaths. Part of me knew it was only war-games, but there was a worrying callousness about union statements.
On Wednesday the strike was deferred. Aoife’s unit opened the following day and it was all as if nothing had happened. No explanations, no apologies. (Don’t mention the war!) Aoife came home all smiles, her bowels sorted out.
The only thing that isn’t sorted out is parents’ trust in professionals. The nurses who organised the strike strategy knew how much my daughter and I, and others like us, need a service, and yet they decided we were expendable in the cause of more money and of gaining serious ‘professional’ status.
But what is professional? I used to think it referred to constancy and quality of service, but now it seems to mean status and demarcation lines. I’m not a professional. In the past I got a Domiciliary Care Allowance for minding Aoife, but now I’m too well off for a Carer’s Allowance, so I get nothing. Paid or unpaid, I do the same work. My outside-the-home job depends on my ability to juggle the inside-the-home tasks. My daughter’s welfare makes downing tools impossible. I thought nurses, too, realised that caring for people restricts strike possibilities. Now I feel grave doubt.
And my doubts affect how I view Aoife’s future. If industrial action becomes a feature of care, what would happen to her if she went residential? Would she be left in bed all day (as happened in some homes for the elderly) because of mean-minded demarcation lines? Does she really need people with that old-fashioned thing—a vocation?
Yet the fact that people with disabilities now have a right to services should change things for providers and unions. It should create a duty of care. It would be open to an individual, whose chronic condition was worsened by lack of services during the strike, to take legal action against both the Department of Health and Children and the Nursing Alliance. The ICTU urgently needs to work out guidelines for strikes in essential services, so that innocent civilians are not taken hostage in other people’s wars. And is consulting people just for management?
I worry about writing this. I don’t like criticising unions, both because they have supported progressive policies in the past and because I fear repercussions for Aoife and myself- Sometimes the drive towards worker unity can promote a ‘un duce, una voce’ attitude which makes honest dissent difficult. But both sides of the story must be told. Better pay for nurses is a legitimate end, but it doesn’t justify the use of any means against those on the lowest rungs of the ladder.