1. The
first named Plaintiff, Mr. Fennelly, is one of eight male co-Plaintiffs all of
whom are or were psychiatric nurses employed by the Defendant, the Midland
Health Board in St. Fintan's Psychiatric Hospital, Portlaoise. Two have taken
early retirement. They each claim that they were and are employed to look
after male patients only. They rely on Section 265 (1) of the Mental Treatment
Act, 1945 (the "1945 Act") which provides:-
2. Subsection
(2) allows subsection (1) to be breached in an emergency. It does not arise
for consideration in this case.
3. The
Plaintiffs seek declarations that the Defendant is in breach of statutory
duty, in particular Section 265 of the 1945 Act and in breach of their
contracts of employment. They also seek damages.
4. An
interlocutory injunction was granted to the Plaintiffs on the 9th March 1992
restraining the Defendant from requiring the Plaintiffs to work in or about the
personal custody or restraint of any female patient.
5. Mr.
Fennelly, whose circumstances are representative of his co-Plaintiffs, was
employed in St. Fintan's Hospital by the Defendant for twenty two years. He
was appointed to the permanent post of trainee psychiatric nurse (male) by
letter dated the 19th October, 1973. Enclosed with the letter of appointment
was a sheet with "Qualifications and Particulars of Office" for his information.
8. Until
1989 he worked with male patients exclusively. He was rostered to work in the
rehabilitation unit (a mixed unit) in 1989. He refused, was suspended and then
did work there for a year. In 1990 he was rostered to work in the assessment
unit (also a mixed unit). He wrote on the 18th March, 1990 to the Assistant
Chief Nursing Officer asking to be reassigned. He was not successful.
9. On
the 25th February, 1991 he wrote to the Chief Nursing Officer (C.N.O.)
requesting rostering away from the rehabilitation integrated ward. He was told
in reply by the C.N.O. on the 28th February, 1991 that the deployment of nurses
was the prerogative of the C.N.O. and was based on professional judgment acting
in the interest of patient care and service needs. He was told that he could
not opt out of the arrangements and would be rostered accordingly.
10. Dr.
Liam Hanefy the former Resident Medical Superintendent (R.M.S.) from 1978 to
1995 said that as the mental health service evolved it was felt that the
hospital milieu should resemble the home situation i.e. both sexes
should mix as part of the therapeutic process. He explained that in integrated
wards the dormitory areas are separate and the integration of patients is
during the day in communal work and at meal times. He estimated 10% of acute
patients at some time become so disturbed as to need restraint and seclusion,
particularly in the Assessment ward. They are obliged to keep a strict record
of restraint and seclusion.
11. Dr.
Ronald Augustine, the current R.M.S., also stated that it was important for
patients to function as full members in the community. They had to change the
social circumstances in the hospital so that men and women met each other and
learned to get on and cope. He said the R.M.S. is responsible for the medical
treatment of all patients and for their well being and safe custody. He said
if someone is professionally trained they should treat challenging behaviour in
a clinical way.
12. Evidence
about the organisation of the hospital was given by Patrick Smith, the C.N.O.
There are five wards in St. Fintan's Hospital, one exclusively female, one
exclusively male and three mixed or integrated wards - the Rehabilitation ward,
the Assessment unit and the Admission unit. There is no male nurse in the
female ward and there are male and female nurses in the male ward. In the
mixed patient wards there are male and female nurses.
13. Due
to a change in thinking in the Psychiatric Services, integrated wards were
first introduced in late 1985 to prepare individuals for discharge into their
own communities. The Rehabilitation unit opened in 1985 and the Assessment
unit in 1988. Male and female nurses were employed because of male and female
patients. The two segregated wards, male and female, are psychogeriatric
wards, where the average age is in the mid-seventies. The Rehabilitation ward
has 30 patients able to leave the ward and go into the grounds. They are free
to move about although a doctor or nurse might say not to leave the ward on a
particular day.
14. In
the Assessment ward or unit people are admitted as acute or recurrent patients,
generally of short duration. How long they remain, depends on the opinion of
the psychiatrist. The ward is generally locked because of the acute cases.
15. In
certain cases it may be necessary to recommend special nursing if an individual
required more attention or if a patient was transferred temporarily to a
general hospital. Special nursing is one to one and the duration depends on
the doctor's decision. It is generally reviewed every 24 hours. It is not a
management decision. To the knowledge of Mr. Smith, a male nurse had not been
required to give special nursing to a female patient. However, he did say it
could have happened.
16. Following
the repeal of Section 17(2)(c) and (d) of the Employment Equality Act, 1977 by
the European Communities (Employment Equality) Regulations, 1982 (S.I. 302 of
1982), Mr. Smith believed he could deploy male nurses into wards with female
patients. He said that while he could roster male and female nurses to a ward,
during the day people are sent off to deal with different matters. It could
happen that there would be two male or two female nurses left there. It is for
the ward manager to say who is to go on errands. From
17. Under
the old system of promotion there were two streams, male and female. Promotion
depended on seniority. Those streams have now disappeared. Promotion is now
on merit following interview. To be considered for promotion to deputy nursing
officer or nursing officer, the nurse would be expected to work with mixed
patients. He could not recall any specific complaint of a sexual nature being
investigated.
18. The
personnel officer at St. Fintan's, Mr. Lawrence Bair, gave evidence that he
understood it was illegal to make distinctions between male and female nurses
after the enactment of S.I. 302 of 1982 which repealed Section 17(2)(c) and (d)
of the Employment Equality Act, 1977. It precluded recruitment, selection or
assignment based on gender.
19. Mr.
Gerald Barry, an official of the Local Government Statutory Negotiating
Board, (head of the health division), gave evidence about the Psychiatric
Nurses Forum which started in 1980 and lasted for five years (although the
Plaintiffs claim its Report was rejected). The Forum was concerned with
methods of recruitment of psychiatric nurses and promotion and assignment. He
said that the upshot of the Forum was that the method of promoting psychiatric
nurses based on seniority changed to promotion based on merit by way of
interview. The method of recruiting changed. It was no longer from a training
school for psychiatric nurses but from staff nurses. He said it was no longer
possible to give effect to Section 265 because of Equality legislation.
20. The
Equality legislation derived from Council Directive 76/207/EEC of 9th
February, 1976. The relevant articles provide:-
21. However,
as regards the first part of Article 3(2)(c) and the first part of Article
5(2)(c) Member States shall carry out a first examination and if necessary a
first revision of the laws, regulations and administrative provisions referred
to therein within four years of notification of this Directive".
22. As
a result of this Directive the Employment Equality Act of 1977 was passed.
23. It
is common case that Section 265(1) has not been expressly repealed. In
considering the interpretation to be put on Section 265(1) Mr. Gaffney for the
M.H.B urged that it should be construed as referring to special nursing. I
think this is putting too specialised a meaning on what is in essence a general
provision. It does not refer to the care of patients. It refers to custody
and restraint. A strict interpretation would preclude a male R.M.S. from being
employed to look after female patients as one of the duties of an R.M.S is to
be responsible for the medical treatment of all patients in the hospital and
their well-being and safe custody (see Article 13(2)(i) of the Mental Hospital
(Officers and Servants) Order, 1946) (S.I. 203 of 1946). I am sure that such
an interpretation would not be justified. It seems to me that Section 265(1)
does not preclude a male nurse from being employed in connection with the care,
medical or otherwise, of a female patient. Article 33(2) of S.I. 203 of 1946
which sets out the duties of a mental nurse does provide that a male mental
nurse should not enter the female departments of the hospital save on the
direction of the person in charge. So a male nurse could be directed to enter
female departments.
24. However,
if S. 265 of the 1945 Act is still in force it would preclude the Hospital from
employing male nurses for the purpose of restraining a female patient or
keeping her in custody.
25. The
Plaintiffs argue that S. 265 of the Act is still good law as it has not been
repealed. The Health Services Act 1981 (S.7) did repeal the 1945 Act but was
never brought into operation. In the Government White Paper on a new Mental
Health Act published in July 1995 it is stated that the government proposes to
repeal S. 265 of the 1945 Act (para. 11.18) saying:-
26. On
the interlocutory application Keane J. took the view that the Courts in the
case of modern statutes are slow to suppose the legislature overlooked an
express repeal but intended to repeal a section by implication. He held that,
bearing in mind that the Courts are slow to do that and bearing in mind that a
general Act does not impliedly repeal a more specific Act, Section 265 should
apply.
27. However,
the question is not so much whether the Employment Equality Act, 1977 as
amended, impliedly repealed Section 265, but rather whether there is an
effective derogation by the State from the Council Directive 76/207/EEC to
support the continued application of Section 265.
28. The
Court also said at paragraph 56 concerning the Chief Constable as the official
responsible for the direction of the public service:-
29. This
case is unusual in that individual Plaintiffs are seeking to uphold
discriminatory provisions against a public body. It is those private
individuals which are seeking to take advantage of the failure of the State
specifically to repeal S. 265.
30. In
my opinion Section 265 is discriminatory. Once the derogation contained in
Section 17(d) of the Employment Equality Act, 1977 which was permitted by
Article 2.2 of Directive 76/207/EEC, was repealed in 1981, there was no
justification for the continuation of Section 265 in domestic law. As stated
in the
Johnson
case, the obligation to achieve the result envisaged by a Directive and to take
all appropriate measures is binding on all authorities of the Member State
including the Courts. The Court is required to interpret national law in the
light of the wording and purpose of the directive. Therefore in my opinion
Section 265 ceased to have any application in domestic law once the derogation
contained in Section 17 of the Employment Equality Act, 1977 was repealed. In
the hierarchy of legislation the Directive takes precedence over domestic law.
31. It
cannot make any difference that it is individual Plaintiffs who are seeking to
uphold the discriminatory provision and it is a public body which claims it no
longer applies. If the situation were reversed, the Court would have to hold
the section is discriminatory and has no application. The same law must apply
in both cases.
32. The
Plaintiffs claim they must have the benefit of their existing contracts of
employment unless varied by agreement.
33. However,
their duties are set out in Article 33 of the Mental Hospitals (Officers and
Servants) Order, 1946 (S.I. 203 of 1946). This Article sets out the duties of
male and female mental nurses. They are identical except for the provision in
sub paragraph 25 already mentioned. However, where male nurses are directed to
enter the female departments of the hospital, it means there is no difference
between the duties of male and female nurses.
35. It
follows that the Plaintiffs are not entitled to succeed on grounds of breach of
statutory duty or breach of contract.