Simon Harris (Wicklow, Fine Gael) | Oireachtas source

On the final question, my understanding from INMO press statements and commentary on the matter is that nurses are balloting for industrial action because they would like to lodge a pay claim. Regardless of the validity of that pay claim, and it is not for me to assess people's motives, the public service stability agreement is clear on pay claims during its duration. Nurses believe they have a legitimate pay claim, the State has an infrastructure to deal with these matters and I hope everyone uses the processes available to them. While there are clear mechanisms in place to resolve this, there are also measures that we want to take to help support our nurses.

I fully accept the conclusive and definitive outcome of their ballot, but I also accept that the INMO are members of the Irish Congress of Trade Unions and public service pay agreements are in place, to which the Deputy's party and mine are subject. We are committed to supporting these agreements and we need to operate within that infrastructure. The nurses decided to take the view that their pay should be increased in a sectoral-specific way without considering the rest of the public service and the knock-on effects thereof. That is their position and I cannot comment on why the nurses decided to take it, but I accept our nurses work in a challenging environment. I also accept the recommendations of the PSPC, which would benefit many thousands of nurses, should be advanced as a priority, and that there is much more we need to do to help and support our nurses. As Minister for Health, I would like to engage on what we can do within the health service separate to the process of public service pay agreements.

Whether I used the word "crisis" or "challenge" is somewhat pedantic because whether I call it a crisis will not help or make a difference. The former Tánaiste and Minister for Health and Children, Mary Harney, used to call things an emergency, but did that help or make a difference? There is a real challenge in recruiting consultants, as there is in the retention of nurses and midwives, which the PSPC found. As for what we should do, I suggest we adopt in full the findings of the PSPC, as we have done. It made findings and recommendations which we should get on with implementing. We committed to doing that and we are funded to do it in 2019. We must also explore how we establish the process to look at the new entrant pay issue, which is not an issue exclusively in my remit. I take an active interest in it, however, and I am partly responsible.

The Deputy asked what we will do to help, and there are other measures we can take. In addition to what I outlined, we can also increase theatre capacity, build elective-only hospitals and provide more bed capacity, because we have found that when we invest in the physical infrastructure of our health service, and when we provide doctors and nurses with the tools and resources to do their jobs, they respond in kind by wanting jobs in that health service.

We are very much seeing that now in respect of the children's hospital group and I will send information to the committee illustrating that point.

I will return to the issue of engagement with consultant representative bodies, although I will not get into a back-and-forth on it here. More than one body represents consultants. Some are members of the IMO while others are members of the IHCA, neither of which is a union, as they remind me, as consultants have individual contracts with our health service. My Department rightly spent a great deal of time in recent months, along with colleagues in the Department of Public Expenditure and Reform, resolving a major issue relating to consultants and the fulfilment of their contracts, which had in their view not been fulfilled or honoured in many years. Mary Harney was Minister for Health at the time the issue arose and it continued until we resolved it this time. That resulted in a significant cost to the State but it was the right thing to do. The notion that there has not been meaningful engagement is not correct. We took what was probably the most challenging issue being put forward by the IHCA and successfully resolved it in recent months.