Alan Kelly (Tipperary, Labour) | Oireachtas source

We debated this last week so I will repeat what I said then. We are now in a different space where an agreement has been reached. I will not interject on that because it is up to the individual unions to vote on it over the next few weeks after having debated the proposals and reached decisions.

I wish to make a few points, however. What probably distinguishes this Government from previous Administrations is the fact that we should not have reached this point. The solution with regard to how we got here from where we were a few weeks ago, and before the nurses had to go on strike, was regularly outlined to the Minister for Health and the Minister for Public Expenditure and Reform. We always said that clauses three and four of the pay agreement could be used to deal with these issues. This was denied. However, when the solution was found, that was used as the excuse for how it could be kept within the pay agreement. Why bother? Why let it get to the stage where there was a strike? Why could this not have been intercepted? Tens of thousands of patients missed their appointments and that backlog will now have to be chased. Why could that not have been avoided? Was it that the Government had to have a show of strength? Did it have to be seen to face it down? It was unnecessary, to be polite. Was it ideologically driven? Was it the fact that it was a sign for other unions? What was it?

I and many other Members made the point that the potential savings from agency costs, income tax returns, recruitment costs, delivery of efficiencies and the resulting shorter bed stays would create savings that would neutralise much of the pay cost in the first instance. Including some other items that have been added on the employer side means that, essentially, this is not far from what the agreement will do. The agreement includes different pay recommendations that have to be debated. I will not discuss them because it would be inappropriate to do so while they are being debated among the unions. My point is that all of this was avoidable. It was unnecessary to reach this point, and the consequences and hardship for the public have been brought about because the Government just would not listen and debate.

It required a firmness on the part of the unions. I acknowledge the way in which the PNA and the INMO organised themselves. The withdrawal of labour is the final opportunity that trade unions have to force employers to recognise the issues before them, and those unions did that en masse. It was a pleasure to be with them last Saturday. If anything was needed to wake the Government up to the issue by which it was starkly confronted, it was the show of support from the volume of people who were in Dublin last Saturday.

There are other issues that are deeply worrying. We all know the tenure of this Government will not be long. However, the manner in which it purported to deal with this through the media was concerning. In industrial relations, where there is a serious dispute, potential strike or strike, there must be a manner whereby the dispute is discussed. It must be behind closed doors, without leaks and without innuendo. The way many of the communications were carried out, particularly before the agreement was reached, certainly left a great deal to be desired.

I have some final points. There is an opportunity as a result of this potential agreement. It is based on workforce planning. We have always known that the nurses were fighting for issues surrounding recruitment and retention. Part of that was better pay because of the need for safe staffing and to be able to attract people into the workforce.

There is a real issue in regard to the various plans, some of which the Minister of State, Deputy Byrne, who is present, was part of. I refer to Sláintecare, which I and my colleagues on the health committee spent 11 months putting together, the national maternity strategy, the mental health strategy and a range of other strategies, many of which are very good and which I fully endorse. However, the roll out of primary care is pointless unless we learn from the Government being forced to come to the table to reach a form of agreement and we move on to the issue of long-term workforce planning in the health service. Frankly, all of these strategies are a waste of time unless they go hand in hand with workforce planning. Central to that, obviously, are all the various occupational roles and nursing is at its core because it is the oxygen for many services in acute and primary settings. The issue must be dealt with differently. There was much discussion of that at the health committee and more broadly in the run-up to the strike. We need a plan for the future across acute and non-acute services and all of the various sectors which will encompass educational needs, geographical requirements and interaction with GPs. The issue of the GP contract, on which GPs took to the streets last week, is intrinsically linked with this issue. In addition to addressing the points I raised on negotiations, communications, interactions with unions and respect, the area of workforce planning into the future must be dealt with in order to avoid continuous recruitment bottlenecks. New units at South Tipperary General Hospital and Limerick Regional Hospital, the two most overcrowded hospitals in Ireland, will not open on schedule because of recruitment difficulties. I ask the Minister of State to take that on board.

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