Liam Twomey (Wexford, Fine Gael)

Patient safety is a very important issue at the centre of this dispute. Everything must be done to resolve the dispute as quickly as possible to protect patients in the Irish health care system. They must be our foremost concern and we must ensure nobody dies or is put at risk on our wards, increasing the anxiety of families, because we have not done our best to resolve the dispute.

Like all political parties, Fine Gael has met the INO and the PNA, both of which bodies have been vocal in the course of the dispute. Their representatives told us they did not trust the current benchmarking process and the Minister must address that lack of trust. She must make clear to the House exactly what options are available to her to resolve the dispute. Is she saying the Government will do absolutely nothing, only wait for the benchmarking process to deal with the nurses' pay issues? Is she saying it has nothing to do with her and that she will stand back while that process takes place? That will create the impression that the Minister was stringing the nurses along by asking them to go to the national implementation board, particularly in the context of the letter the Taoiseach wrote to the nurses' organisations to the effect that he would look for an imaginative solution. If she now says she was never going to do anything but was always going to leave it to the benchmarking process, what is the imaginative industrial relations solution about which the Taoiseach spoke?

The Taoiseach appeared to say today, during Leaders' Questions, that of the main concerns of the nurses, the claim for a 35-hour week seems to have been sorted out, apart from the timeframe. Am I correct that the pay anomaly seems also to have been sorted out for the nurses involved? A pay increase of 10% under partnership seems to be available now and the Minister says the 10.6% increase, to which the nurses say they are entitled, is available if they are willing to take their chances with the benchmarking process. The Minister talks about holding the line as if she were controlling the public finances, but, as well as being careful about how we spend taxpayers' money, we are also responsible for patient care so we must exhaust every possibility to resolve the dispute. The concerns I have pointed to, however, do not seem to be as insurmountable as they have been portrayed up to this point.

When we met the nurses on 9 January, two months before the Taoiseach wrote his letter to them, they stated their willingness to change their rosters and work practices to counterbalance, to some degree, the costs involved in the changes they sought. How far did the Government take that discussion? I do not have the same amount of information as the Minister but I have heard from the national implementation body that the nurses felt they had almost achieved agreement on those changes. Significant changes will take place to nursing in the next decade. Nurses will be involved in prescribing and advanced nursing practitioners will come into being. Nurses will take up duties currently performed by doctors and will delegate some responsibilities to care assistants. There seem to have been significant discussions on those changes so if everything is going in the right direction, why are nurses going on strike?

I spoke to nurses on this issue and some of what they say does not bode well, perhaps explaining why the INO takes such a hardline stance. Nurses feel unacknowledged by the HSE and the Government and undervalued as people and as professionals. They feel incredibly frustrated in their dealings with Government and the HSE, which I can understand, and there seems to be a significant lack of trust, which might have its roots in the last benchmarking process. As the Minister said, frontline staff nurses received an award under benchmarking of 8% but administrative nurses received 16%. The Government made it clear in the last round of benchmarking that it valued administration more than it valued frontline nurses, who deliver the service every day to elderly patients and people in accident and emergency units. A lack of trust has developed because nurses feel a lack of appreciation, which is a serious issue and must be addressed.

We have no idea why some received 8% and others 16% in the last benchmarking process because, in its wisdom, the Government shredded all the background material. That lack of accountability and transparency has contributed to the lack of trust. The reason for that lack of trust can also be traced to the Minister's statement on the "News at One" yesterday. She implied that the dispute contributed to the fact that some elderly patients could not be moved to the Beaumont nursing home. If she had made a simple telephone call she would have found that the Beaumont nursing home, which had closed down three years ago but had recently been redecorated, did not have medical cover for elderly patients. More important, the nurses who would look after those patients were not in dispute with the Government because the HSE is in India looking for them. Unless nurses in India are on a work to rule with their colleagues in Ireland, that was a red herring. The nurses know that and it contributes to the lack of trust they have in the Minister. The Minister is playing mind games with nurses, with patients in the middle. She should get off her hobby horse and resolve the dispute.

The HSE has taken a very active part in the spin-doctoring in which the Minister loves to partake. It is great when the TV cameras are around to show its incidents room, manned with personnel, but if one was looking for staff in an emergency one would not be able to get hold of them. The HSE owns St. Joseph's Hospital in Raheny, which had plans to build a long-term care unit for the elderly, which the HSE said would be constructed by the end of 2006. However, not even a single shovelful of dirt has been dug from the site to construct that care facility. It was galling to watch the HSE shedding crocodile tears on the television news. The Minister should stop playing such public relations exercises with patients. This issue is serious and neither she nor the HSE can simply spin their way out of it. While I was surprised the HSE has participated in this exercise, it has begun to act like an arm of the Government, which is of concern to me.

The Government should begin to take patients' concerns seriously. The Taoiseach and the Minister should negotiate. They appear to have written letters and will probably meet the nurses' organisations in the corridors of Government Buildings to whisper into their ears that all will be well and that they will do the business. However, the Government should be protecting patients and, thus far, I have seen nothing in this regard that cannot be resolved to some degree.

It is not good enough for the Minister to try to wash her hands of this business and to state that only benchmarking will solve the problem. There must be a resolution to this dispute and, if not, the Minister should make it clear that she believes the Irish Nurses Organisation, INO, to be completely wrong in this regard and to be intransigent in respect of its grievances with her. This is a very serious matter and both the Taoiseach and the Minister should make up their minds. They should tell Members exactly what the Government is doing and whether it can solve this issue on patients' behalf. The Minister should stop the nonsense of belittling nursing or putting them down in some statements. While I accept that some of the pay costs involved are enormous, this matter is negotiable.

The Minister made some interesting statements, including the fact that nurses' pay has increased by between 75% and 103% across all grades since 1997. The same is true of the Minister's pay, which also doubled during that time and is far greater than the salary of €31,000 that basic grade nurses will receive this year. The mind games should stop and this issue should be resolved. Nurses are willing to make some concessions and are willing to change their work practices. New clinical nurse specialists and advanced nurse practitioners have entered the health services and have made fantastic changes to it. While I also believe that benchmarking is the route to take, the Minister must regain the nurses' trust in regard to these negotiations. If she cannot do so, she should tell the House the reason and what is happening in this regard.

At present, many patients are suffering because of what is taking place. I am under no illusions as I have worked in the health service and I am aware of the work carried out by nurses. If one loses goodwill from nursing, patients will suffer seriously. My concern is that some nurses may either become militant or despondent. They may simply give up because they feel frustrated, undervalued and unacknowledged by the Minister and completely lack trust in the manner in which she has been treating them. The Minister should have been following these concerns as they went through the Labour Court. On meeting the INO and the Psychiatric Nurses Association, PNA, in early January, Members were made aware of a problem and the Minister would have been in the same position.

As for the national implementation body's talks with the nurses, the Government was simply dragging them through a process and stringing them on, while getting closer to a general election, to ascertain whether it could get its way on this issue. I note that when concerns arose, the Government established a commission on nursing. I am unsure whether this pertained to a different matter or whether the Government's commitments in this regard are clear. However, it is incredibly important that such games stop, for both patients and the 40,000 nurses who work in the health service. Whoever is responsible for this problem should make the decisions and if the Minister really believes she is getting no help from the Irish Nurses Organisation or the Psychiatric Nurses Association, she should state what are the problems.

I know many nurses, having worked with hundreds, if not thousands, of them during my medical career. They are serious about patient care and do not take such action lightly. I am aware their anger and frustration may lose them public goodwill and may not help their cause. Moreover, being baited by the Minister and other members of the Government will not help some of those involved to keep their cool because they have been so angry with the Government for so long.

The Minister's job is to protect patients and she should tell the House exactly what is happening. As Members are only making statements, they have no idea as to how the Minister intends to respond to them. I have no method of replying in respect of any concerns she may raise. However, I wish to be made aware of what is happening and whether this issue is solvable. My only interest is in whether this matter is capable of resolution. If not, the Minister should explain clearly to the House why she does not believe it to be so and who she believes to be responsible.

The only issue that patients and potential patients of the health service want answered today is whether this issue can be resolved and, if so, who is responsible for so doing. If nurses lack trust and do not believe in the benchmark process as it is constituted at present, what commitments can the Minister or the Taoiseach give that do not disrupt social partnership but that will bring nurses back into the process? Must the terms and conditions of benchmarking be changed? How advanced are the talks regarding those work practices and changes mentioned by the Minister? Can such negotiations be resumed and can the Minister ensure that patients do not suffer during the next two months? A general election in the offing means that matters become extremely confusing and I do not wish to see patients suffer for the next eight or nine weeks because the Minister and Taoiseach are grandstanding, or, in the Minister's phrase, holding the line. I seek a resolution.

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