Róisín Shortall (Dublin North West, Social Democrats) | Oireachtas source

The arguments in regard to this dispute have been well rehearsed here and in other places. There are undoubted serious shortages within nursing and, of course, there is then a vicious cycle because, when there are shortages, it means those who are left to carry the can within our health service are carrying a heavier burden, and stress levels increase as a result. We also know that, in many cases, we are at a point where services are unsafe as a result of staff shortages.

That scenario is having a very serious impact on the operation of our health services as they stand. We have been talking for a long time about the need for reform of our health services and to switch to putting the focus on primary care to ensure that nurses' roles are expanded and that they play a key role in regard to, for example, chronic illness management, child health programmes, the maternity programme and all of those different reform plans, such as Sláintecare. All of those plans are predicated on a situation where we have an ample supply of nurses who are well resourced and well motivated. However, we are not going to have that unless the Government responds to the current crisis.

Nurses are going abroad. They are voting with their feet. They are going to places where they are valued and respected, and where they can live a life that is affordable. They are living in countries and cities around the world where there is an affordable cost of living, unlike this country. They are also going to places where there is a very clear policy context and they are not working in a system where, every time there is a new Minister, there is a new policy and everything is thrown up in the air. That is what people working in the health service have experienced over recent years in this country.

The evidence in regard to the shortage of nurses is stark. For every four vacancies, there is only one application. The HSE is spending €2 million a week on agency nurses and we also know the HSE is travelling the world, paying very high recruitment charges, to try to attract Irish nurses back to Ireland but also nurses from developing countries. We know that is the case and the figures from the HSE prove it. We also know the HSE made that very clear when it stated: "The overall picture of the nursing and midwifery workforce is one of a constant challenge to effectively recruit and retain to meet ever increasing service demands." I hope the Minister for Finance has heard that statement, which the HSE made to the Public Service Pay Commission. Unfortunately, it did not get to the Public Service Pay Commission because the Minister's Department, the Department of Public Expenditure and Reform, insisted on that statement being excised from the HSE's submission. I would like him to explain that.

There are also, of course, genuine issues of fairness when it comes to pay parity. Nurses are required to have the same academic qualifications as allied health professionals yet, at every point in the scale, they lag behind by about €7,000, which is inexcusable.

There is strong public support for nurses. The public simply cannot understand why the Government will not engage in a positive and constructive manner in this dispute. The question to both Ministers is what are they going to do about this. We cannot afford a situation where the industrial action escalates even further. This is taking its toll on patients, undoubtedly. What we need now is leadership from Government in terms of taking an initiative in order to free up the logjam that exists; what we need is constructive engagement. What the Ministers are doing is adding fuel to the fire. They have been entirely unhelpful in their response to this. Their actions have been provocative and they have fuelled the fire. What we want from them is action. We know that, under clause 4 of the pay agreement, there is provision for engagement in regard to areas where there are serious problems with recruitment and retention. They should stop the megaphone diplomacy. From Patricia King down, everybody has said it is possible to resolve this dispute within the context of the existing agreement. What we want now is leadership from Government. It should take action over this weekend to ensure we avoid what is likely to happen next week in terms of a crisis in our health service for everybody concerned.

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