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FactCheck: Nursing union leader Liam Doran's claims about the Irish health service

The INMO General Secretary made a series of claims on Claire Byrne Live this week. Here’s our FactCheck roundup.

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WITH FRONTLINE MEDICAL professionals considering their options after the government’s pay deal with gardaí, high-profile nursing union leader Liam Doran appeared on Claire Byrne Live earlier this week.

The General Secretary of the INMO (Irish Nurses and Midwives’ Organisation) firmly defended his members’ record over the past decade or so, in a robust exchange with John Moran, former Secretary General of the Department of Finance.

Doran made a series of factual claims about the number of patients on trolleys, the number of hospital admissions, and nurses’ pay, over the past several years.

We’ve done a FactCheck roundup of five of his claims, and will be giving each a verdict, before tallying them at the end. For an explanation of what each verdict means, check out our Reader’s Guide.

(Send your FactCheck requests to factcheck@thejournal.ie, tweet @TJ_FactCheck, or send us a DM).

What was said:

You can watch an excerpt of Liam Doran’s claims in the video below, or watch the episode in full, here.

Source: TheJournal.ie/YouTube

Claim 1: The previous government cut the number of nurses and midwives by 13.5%

Verdict: FALSE

Your policies, when you were in high office, cut the workforce by 13.5%.

A couple of notes here. John Moran was Secretary General of the Department of Finance from March 2011 until August 2014.

However, it’s unclear whether Doran’s claims are directed toward John Moran personally, or against the previous Fine Gael/Labour government as a whole.

FactCheck attempted to clarify this with Liam Doran, but did not receive a response to that particular question.

The Facts

In response to FactCheck’s request for evidence, Liam Doran claimed that between 2008 and 2016, the number of nurses and midwives has fallen from 39,000 (in 2008) to 35,250 now.

According to HSE data, the most recent figure for nurses and midwives in the public health service is 35,534, as of September (pg 12).

(Note: all these staffing figures refer to WTE – “whole time equivalent” staff).

Doran did not specify which months he was referring to, but for the sake of fair comparison, let’s take the same month (September) in 2008 (pg 104).

The number of nurses and midwives then was 37,898. That’s a decline of 6.2%.

However, Doran’s claim is inconsistent with his evidence, since the claim was levelled at the government John Moran served, which only took office in 2011.

In September 2011, the number of nurses and midwives was 35,993 (pg 19), which means there has been a fall of 1.3% since then.

The number of nurses and midwives since 2008 and 2011 has fallen. But not nearly to the extent claimed by Liam Doran (13.5%). So the claim is FALSE whatever way you look at it.

As explained in our Reader’s Guide, this means “The claim is inaccurate”.

Taking into account the fact that, on Claire Byrne Live, Doran addressed the claim to the previous government (which started in March 2011 and ended in February 2016), the claim is also FALSE.

This is because, the number of nurses and midwives in March 2011 was 36,782 (pg 19), and in February 2016 it was 35,845 (pg 83). That’s a decline of 2.6%. Not 13.5%.

Claim 2: Activity levels in the health service are up by 5-6% per annum
Verdict: Half TRUE

File Photo The Irish Nurses and Midwives Organisation has accused St Vincent's University Hospital in Dublin Source: RollingNews.ie

The health service has gone up by 5-6% per annum in terms of activity levels.

The Facts

In his response to FactCheck, Liam Doran clarified that by “activity levels” he was referring specifically to attendances at emergency departments in 2016.

(“The number of attendances at Emergency Departments has increased by 5.3% this year alone”).

This is just one very specific measure of activity in Irish hospitals, but let’s take a look at it.

So far this year (up to July), there have been 639,178 new emergency department attendances (pg 3). By July 2015, there had been 639,184 (pg 34).

Year-on-year, that’s actually a decrease of six attendances, or 0.001%.

If Doran was comparing July 2015 (91,593) with July 2016 (96,352 – pg 28), that’s an increase of 5.2%.

However, as the year-to-date figures show, one month’s attendances are often not representative of the broader trend in the year.

We rate this claim Half-TRUE. As our Reader’s Guide explains, this means:

“There are elements of truth in the claim, but also elements of falsehood. Or, the best available evidence is evenly weighted in support of, and against, the claim”.

Claim 3: The number of hospital admissions is now at its highest ever level
Verdict: Mostly TRUE

Highest number of admissions ever.

The Facts

20/1/2010 Mater Private Hospital Protests Source: RollingNews.ie

Unfortunately, and despite our request, Liam Doran did not offer specifics as to which kind of admissions he was referring to.

Unfortunately, HSE monthly performance reports only go back as far as 2009, so that’s our starting point, and certain admissions measures (like emergency admissions) were not counted in previous years, or are no longer counted.

The HSE also frequently introduces new accounting models and KPIs (“key performance indicators”), which makes HSE data notoriously difficult to compare across years.

Nonetheless, we’ve attempted to compare year-to-date figures for July 2016 (the most recent available) with year-to-date figures for July from previous years (unless otherwise stated).

The source in all cases is the HSE’s monthly performance reports.

  • Up to July 2016, there have been 796,498 emergency presentations. This is the highest number we could find on record.
  • Up to July 2016, there have been 639,178 new emergency department attendances. During the same period last year, that number was 639,184 – very very slightly higher.
  • Up to July 2016, there have been 1,945,704 outpatient attendances. During the same period in 2009, there were 1,986,299, and in 2010 there were 2,077,684. Both higher.
  • Up to June 2016, there have been 320,210 inpatient discharges. This is the highest number we could find on record
  • Up to June 2016, there have been 526,844 day case discharges. This is the highest number we could find on record.

(Note: we also analysed these numbers after adjusting for population, but it did not make a difference to the years in which various measures were higher or lower than this year).

So, in three out of five admissions categories, this year so far does have the highest numbers. And in another, it effectively has the joint-highest on record. We rate the claim Mostly TRUE.

As our Reader’s Guide explains, this means: “The claim is close to accurate, but is missing significant details or context. Or, the best available evidence weighs in favour of the claim”.

Claim 4: The previous government cut the pay of graduate nurses by 39%
Verdict: FALSE

2/3/2016. Nurses Protests Health Service Crisis Source: Sam Boal/RollingNews.ie

You cut the pay of young graduate nurses by 39%.

Again, Doran’s claim was directed towards John Moran, in studio, but we are interpreting it as an allegation against the previous Fine Gael-Labour government, which Moran served.

And again, we must point out that Moran did not serve that government for its full duration, leaving in August 2014.

The Facts

In his response, Liam Doran outlined the claim as follows:

  • 7% pension levy – 2009
  • 7% salary cut – 2011
  • 10% new entry cut – 2011
  • Further 15% cut (graduate nurse scheme) – 2013

Although, unfortunately, Doran did not provide further detail or sources, there are a couple of very obvious problems with this, which render the claim FALSE:

  • The introduction of the pension levy (on average 7%) happened in 2009, before the lifetime of the last government
  • The 10% cut for new entrants to the public service was agreed by the Fianna Fáil-led government in December 2010, and implemented in January 2011, before the Fine Gael-Labour government entered office

We rate the claim FALSE. 

Claim 5: Between 2008 and 2016, the number of people on hospital trolleys has increased by 80%
Verdict: Mostly FALSE

Between 2008 and 2016, the number of people on trolleys has gone up by 80%.

The Facts

24/11/2015 INMO Nationwide Ballots On Strike Action Source: Sasko Lazarov/RollingNews.ie

In his response, Doran clarified that he was actually referring to 2007-2016, not 2008-2016. But let’s take a look at both periods, for the sake of completeness.

Doran presented figures for January-October 2007, as compared with January-October 2016, taken from the INMO’s Trolley and Ward count.

A crucial piece of information here is that the INMO only began counting the number of patients on wards (as well as trolleys) in March 2013.

So comparing figures from 2016 with 2007 or 2008 is misleading – they are not like-for-like numbers.

However, FactCheck went back through the data in 2016 so far to separate out the trolley count from the ward count. Here’s what we found (Spreadsheet download).

  • Between January-October 2007 (42,105) and January-October 2016 (58,511), there was a 39% increase in the number of patients on trolleys.
  • When we add ward numbers for 2016, that increase was 81.5%.

However, as we’ve explained, 2016 figures (which include both trolleys and wards) should not be compared directly with 2007 figures (which include only trolleys).

So the claim, as clarified in Liam Doran’s response, is Mostly FALSE.

As our Reader’s Guide explains, this means “There is an element of truth in the claim, but it is missing critical details or context”.

Even though he reasonably accurately cites the figure of 80% (in truth, 81.5%), this is based on an unfair comparison.

Looking at the claim as stated on Claire Byrne Live:

  • Between January and the first 15 days of November 2008 (53,185) and January and the first 15 days of November 2016 (63,347), there was a 19.1% increase in the number of patients on trolleys.
  • When we add ward numbers for 2016, that increase was 55.4%.

Conclusion

Of the five claims examined:

  • Two are FALSE
  • One is Mostly FALSE
  • One is Half TRUE
  • One is Mostly TRUE

TheJournal.ie’s FactCheck is a signatory to the International Fact-Checking Network’s Code of Principles. You can read it here.

For information on how FactCheck works, what the verdicts mean, and how you can take part, check out our Reader’s Guide here

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About the author:

Dan MacGuill

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