James Reilly (Dublin North, Fine Gael)

There was an overrun of €70 million in our hospitals from last year. We are trying to retrench the runaway and out of control budgets in our hospitals which occurred during the first three months of this year under the watch of the previous Government either by intent or through neglect. On top of this, to address the financial morass in which the previous Government left the country we must take almost €1 billion out of the health system, keep the service running and put in train a reform programme.

I put it to Deputy Kelleher that this industrial action serves no useful purpose. I am concerned about the further stoppage planned for tomorrow and urge the INMO to reflect on the impact this action will have on the general public and on patients in particular. I find it hard to reconcile that the nursing unions are taking this industrial action given they are parties to the public service agreement which focuses, in particular, on the need to deliver services in the changed circumstances in which, thanks to the previous Government, we now find ourselves and on co-operation between management and unions.

The shared focus of all those working in the health service should be on safeguarding front line care in the face of our continuing very serious economic situation. The Mid-Western Regional Hospital Limerick was €16.2 million over budget at the end of July 2011 and has had to take measures to reduce its spending, including a prohibition on staff overtime and the hiring of agency staff. As in all areas of the economy and the public service, we must focus on solutions, including efficiency, flexibility and innovative working in order to maintain our public services in the face of economic crisis.

Industrial action by any group will simply exacerbate our problems and, in the case of nurses, may impact negatively on patient care. In recent months, I established a Special Delivery Unit, SDU, under the leadership of Dr. Martin Connor. The SDU is working to unblock access to acute services by improving the flow of patients through the system. It is focusing initially on emergency departments and will be working to support hospitals in addressing excessive waiting times for admission to hospital. The SDU is due to submit a report on the Mid-Western Regional Hospital Limerick to me on Thursday. I look forward to the co-operation of all health service staff with the Special Delivery Unit, which is aimed at ensuring that patients receive safe and appropriate service when they present at our acute hospitals.

In the case of Mid-Western Regional Hospital Limerick, it is vital that we focus on solutions, including the introduction of new rosters and redeployment of nurses to areas of greatest need in the hospital. New rosters become even more important in light of the need to maintain and improve services in a financially constrained context. As regards pressures in the emergency department, it is clear that risk issues arising from overcrowding should be regarded as a problem with which the entire hospital must deal. Hospital management cannot accede to a demand that no extra beds should be put up in wards. This is provided for in the escalation policy and represents a lesser risk than allowing an unsafe build up of trolleys in the emergency department.

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