Stephen Donnelly (Wicklow, Fianna Fail)
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We have covered much ground but I would like to return to the specific questions. Does the Minister accept there is a crisis in recruitment and retention, either for nurses and midwives or consultants? He accepted that new entrant pay is a driver of challenges, whether he accepts it is a crisis or not.

On the IHCA, I accept that the Minister intended to speak at its conference although the Minister of State, Deputy Jim Daly, spoke on his behalf, but I am not talking about public events. I am talking about meaningful engagement. The Minister may disagree, but the association tells me it cannot get meaningful engagement from the Minister or the Department, and it has not been able to get it for more than a year.

There is a crisis and people are suffering and dying while waiting to see doctors, but we are running out of doctors. While the overall number may have risen, it is falling relative to the need, in view of the fact that one in five posts are not filled. What does the Department propose to do as a result? It feels as though there is no action, and as though there is a clearly identifiable problem, namely, running out of specialists across a variety of areas in a variety of hospitals, but it does not appear as though those representing consultants are being engaged with in any meaningful way.

On the nurses and midwives, I agree it is about more than pay and there are many issues. Why has the situation got so bad in comparison with the past 20 years? Why have they become so frustrated and demoralised that they are balloting for strike action, which they have not considered for decades?