Louise O'Reilly (Dublin Fingal, Sinn Fein) | Oireachtas source

Was Mr. O'Brien right? Were his figures correct? Were they exactly right or roughly correct? Are the actual figures worse? Is it the Minister's position that there are recurring overspends and that there is not a single incident which places unprecedented pressure on the health service?

Deputy Bernard J. Durkan was also right to say patients had to be at the centre of health services, but there will be no health service without staff to work in it. There will just be big empty buildings with a lot of sick patients in them. We need some strategy to deal with the issue of recruitment. We might disagree on whether the Minister's strategy is failing, entirely or in part, but staff will be required to implement Sláintecare. Nurses are engaged in consultations and have signalled that this issue may lead to industrial action. I understand doctors and consultants are more or less in the same space. The health service is haemorrhaging staff and potential industrial relations difficulties are mounting up. This makes the service a very unattractive place in which to work. In some respects, the purpose of Sláintecare is to ensure those who are graduating and bright health professionals working within the system, as well as all other staff who keep it going, will see that there is a plan and that in time the HSE and the health service will be an attractive place in which to work.

There was a very unfortunate incident where the number of student nurses increased overnight from 435 to 870. They had been counted as 0.5 equivalents and then they were counted as a whole-time equivalents. That does not add a single extra person but it makes the figures look good. It does not add a single extra body to a ward. We do not need any more of that but we do need honesty regarding where the recruitment challenges lie and about a detailed plan to be put in place.

The Dáil supported a Sinn Féin motion on nursing recruitment and retention and it was very clear in saying that pay has to be at the heart of it. We spoke to Kevin Duffy, the chair of the Public Service Pay Commission last week at another committee, and he said he was explicitly told not to focus on pay and that it was not a pay review. We can all pretend that pay is not an issue but we are ignoring the nurses, doctors and allied health professionals who tell us that pay is definitely an issue, not simply in the health service but also in the section 39 agencies and other sectors. I understand there was some progress in that regard. I do not wish to put Ms Magahy on the spot, particularly as she has only been in the job for 22 days, but I would be keen to hear if she has any thoughts on how she is going to be able to crack this nut because no plan will work without the staff to implement it.