Mr. Tony Fitzpatrick:

I thank the Chairman. The Irish Nurses and Midwives Organisation thanks the committee for taking an interest in this issue. I will be brief. Obviously, our members working within the services, and there are various section 39 organisations, are extremely troubled at what is going on. They are aware of their colleagues in SIPTU who have balloted. Indeed, the INMO has been involved in numerous third party processes, whether in the Workplace Relations Commission, the Labour Court or with our colleagues in other unions.

We talk about waste in this regard. Our estimation is that there is a 33% premium for agency staff vis-à-visdirectly employed staff members.A staff nurse on the first point of the pay scale costs €30,000, in contrast to the cost of €40,000 for the same nurse via agency. It is a blatant waste of money.

Mr. Paul Bell referred to the public health service's reliance on sections 39 and 38 organisations. It is also the case that in the independent and assisted living sector, 70% of the services are provided by section 38 and 39 organisations, so this will have a major impact in that area.

There is a major problem around recruitment and retention for nursing and midwifery roles in the public service currently. Section 39 organisations cannot compete, and their staffing shortages will be exacerbated. That will ensure that service provision is adversely affected. We are all approaching this from the point of view that there are service users who require this service. It is a service without which they cannot live. Staff members are deeply invested in the process and in their clients. They want to provide quality care, but that has been impeded by the issues we have discussed.

With regard to the estimates and the costs, we can share the Labour Court recommendations with the committee. We contend that the HSE's insistence that section 39 workers go through the Workplace Relations Commission, WRC, the Labour Court, etc., is a waste of their time, because it has acknowledged the difficulties facing the section 39 agencies. It acknowledges that there is pay parity and pay relativity and, as Mr. Bell has said, it is calling on the parties to engage in the process to try to resolve these issues.

It is important that the committee is aware of the pressure coming from our members. Let us be clear. Our members, nurses working within this sector, do not want to have to engage in industrial action to pursue this issue, but they are now left with no option. Next Monday and Tuesday, our executive will have to consider requests from the service to ballot for industrial action. That is very regrettable, but it is the reality of the situation.

Industrial action is due to begin on 14 February. It is likely that other unions, given their members' angst around issue, will have to respond. It is important that the committee is aware that there will be further angst in this area. It is very important that this is recognised.

The majority of the questions raised have been answered. There is a major problem with recruitment and retention in the sector, as there is in nursing and the public service. As Mr. Bell said, there is a scale of blame. There is no doubt that in 2010 the HSE instructed these organisations to cut pay. Then, when the time for pay restoration came, the HSE chose to put the unions through the industrial relations machinery of the State, namely, the WRC and the Labour Court. This was disingenuous because they did not have the money to pay and, therefore, they were not in the room. We record our disappointment that the Department of Public Expenditure and Reform is not represented here today. The committee has already covered that, and we agree with all the comments that members have made on that point.