Fergus O'Dowd (Louth, Fine Gael)
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I welcome the Minister to the House and invite him to visit Our Lady of Lourdes Hospital in Drogheda, County Louth, at the first available opportunity. It is a very important major regional hospital in which there are serious industrial issues at the moment. I visited it this morning and the staff are extremely busy and extremely committed but the hospital is short 104 nurses who cannot be recruited at the moment and that is having a serious impact-----

John Lahart (Dublin South West, Fianna Fail)
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Is Deputy O'Dowd sharing time?

Fergus O'Dowd (Louth, Fine Gael)
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I do not know.

Gerry Adams (Louth, Sinn Fein)
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Yes, he is.

John Lahart (Dublin South West, Fianna Fail)
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The matter is also in the names of three other Deputies.

Gerry Adams (Louth, Sinn Fein)
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Deputy O'Dowd's time is up.

Fergus O'Dowd (Louth, Fine Gael)
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Time was up for Deputy Adams a long time ago. Is he giving me three minutes to get out or three minutes to stay? I am sorry; I am in the hands of the Acting Chairman, obviously.

John Lahart (Dublin South West, Fianna Fail)
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How do the Deputies want to divide their five minutes?

Fergus O'Dowd (Louth, Fine Gael)
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It is a pity the Acting Chairman did not say that before I started.

Gerry Adams (Louth, Sinn Fein)
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Gabh mo leithscéal.

John Lahart (Dublin South West, Fianna Fail)
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There were four names listed.

Gerry Adams (Louth, Sinn Fein)
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Gabh mo leithscéal.

Fergus O'Dowd (Louth, Fine Gael)
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On a point of order, I was given notice that I was being picked. It is up to the Chair to give me the time. I am sorry if this is something-----

Declan Breathnach (Louth, Fianna Fail)
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On a point of order, one minute 25 seconds.

John Lahart (Dublin South West, Fianna Fail)
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It is the Deputies' slot; it is up to them to share it.

Fergus O'Dowd (Louth, Fine Gael)
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I have no problem sharing with people-----

John Lahart (Dublin South West, Fianna Fail)
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Okay, we will give Deputy O'Dowd three minutes.

Fergus O'Dowd (Louth, Fine Gael)
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-----but I submitted my matter at about 6 a.m. this morning.

Declan Breathnach (Louth, Fianna Fail)
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The three minutes are nearly gone.

Gerry Adams (Louth, Sinn Fein)
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On a point of order, four of us were chosen and we were given one minute and 15 seconds each.

Declan Breathnach (Louth, Fianna Fail)
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That is right.

Fergus O'Dowd (Louth, Fine Gael)
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I have had no such notice-----

Declan Breathnach (Louth, Fianna Fail)
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I agree with Deputy Adams.

John Lahart (Dublin South West, Fianna Fail)
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Neither have I but I accept-----

Gerry Adams (Louth, Sinn Fein)
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I have it.

Fergus O'Dowd (Louth, Fine Gael)
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I am glad Deputy Adams has but I do not.

John Lahart (Dublin South West, Fianna Fail)
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We will stop the clock.

Fergus O'Dowd (Louth, Fine Gael)
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Can I just start again then?

John Lahart (Dublin South West, Fianna Fail)
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Yes.

Fergus O'Dowd (Louth, Fine Gael)
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I welcome the Minister. This is a serious issue. We are looking for 104 nurses but cannot recruit them. It is not just a national issue; it is an international and European issue. We cannot recruit enough nurses. I welcome the Minister's interest in this. I have discussed it with him already and I believe there may be a resolution to it, which I welcome. I do not want a winter of discontent. It is very important that Our Lady of Lourdes Hospital is fully and properly staffed. We need to pay nurses more, that is the key.

They need better career prospects and the public also deserves better.

Declan Breathnach (Louth, Fianna Fail)
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The fact that four of the five Louth Deputies have requested this Adjournment debate is testament to the ongoing issues associated with the major deficits in the delivery of acute hospital services to the people of the north east. Deputy O'Dowd referred to the work to rule which is about the major deficit of 104 whole-time nursing posts in the hospital. It has one of the highest trolley numbers in the country. This is a hospital that is expected to deliver safe services with a complement of what the IMO has said is three staff to a ward when there should be five staff in those wards. Not alone is such a service putting patients at risk, it is also an additional stress on the overworked existing staff. The fact that 52 of the 104 positions are for permanent vacancies shows this is not just a problem for Our Lady of Lourdes Hospital but applies equally to the many other health centres, units and hospitals throughout the country. Recruitment problems of this magnitude cause problems with patient care. Too many staff are being asked to work in excess of contracted hours which also puts patients at risk. There appears to be a dichotomy in the approach. On the one hand we have an embargo on staff and on the other hand we are talking about recruitment. The Minister for Health needs to take this issue on and give a proper service to the community I represent.

Gerry Adams (Louth, Sinn Fein)
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Cuirim fáilte roimh an Aire fosta agus go n-éirí an t-ádh leis ina phost nua. I extend solidarity to the staff at Our Lady of Lourdes and especially to the nurses and midwives who do a remarkable job in very difficult circumstances. They also are on a work to rule at this time. Many of our hospitals and nurses are at breaking point. In the past 48 hours there were 537 patients on trolleys, 52 of whom were in Our Lady of Lourdes. I know of one woman who has been on a trolley since 3 o'clock yesterday. This is a direct result of the Government's health policy. The chaos in our hospital system will not be resolved by either Fine Gael's or Fianna Fáil's two-tier approach to health or by the recruitment embargo. There is no point in the Minister denying a recruitment embargo when recruitment is conditional upon the hospital having the resources and these are being withheld. I ask the Minister to instruct the HSE to lift the embargo and to resource the employment of staff needed to fulfil outstanding vacancies.

Imelda Munster (Louth, Sinn Fein)
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Our Lady of Lourdes Hospital in Drogheda is at breaking point. The nurses and the front-line staff are also at breaking point. Every single ward and department is short staffed every day. Consider the nurses in their continued dedication and their caring professionalism every single day despite the stressful and Third World conditions which they endure daily. It is not just affecting Our Lady of Lourdes. Nurses provide the same level of caring professionalism right throughout our public health service under the most stressful conditions. It is something this Government ought to be ashamed of and the questions must be asked.

What type of Government allows this chaos to continue for so long in our public health service? What type of Government consistently fails to see the urgency of these issues or to resolve them? There are 104 whole-time equivalent posts still to be filled. Is this a Government hell-bent on running down our public health service? If that is not the case, what plan has the new Minister for the public health service? What is his new, innovative recruitment drive campaign for nurses? Perhaps the Minister will tell the House what that plan is and explain to Deputies what is new about it and what is going to be different from the past five years of this Government. Perhaps, given the urgency of the situation, the Minister will also clarify if there is a timeframe attached to the recruitment. The Minister should know that the public is 100% behind our nurses. The public is also 100% behind our public health service and it is high time the Minister and the Government supported the nurses and the public health service with resources, funding and staff.

Simon Harris (Wicklow, Fine Gael)
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I thank Deputies O'Dowd, Breathnach, Adams and Munster for raising this issue and for allowing me to address the House on the matter. In direct response to Deputy Munster's question, the first thing I am going to do is stop playing party politics with the health service, and that is why I received Cabinet approval today to move ahead with the motion - which I understand Deputy Munster's own party and indeed every party in this House feels very strongly about - to set up a cross-party committee to meet within six months to look at a single vision for a single tier public health service and how we are going to fund that. I look forward to constructive ideas on that measure.

I regret that a decision was made to undertake industrial action in Our Lady of Lourdes Hospital, Drogheda following the breakdown of talks at the Workplace Relations Commission, WRC, last Friday on resolution of the staffing difficulties at the hospital. I believe that the interests of patients are always best served through negotiation and by avoiding industrial action. Industrial action, even if it is limited to non-core duties, is not in the best interests of patient care and cannot resolve the staffing issues. Nonetheless, I take the point made by Deputy Munster about caring professionalism and I am sure it is not a decision any nurse takes lightly. I am pleased, therefore, that the INMO and the HSE have accepted an invitation from the WRC to attend a meeting tomorrow to discuss the issues. I welcome this progress and this recommencement of talks. I am satisfied that the issues raised by the INMO can be best addressed through engagement at the WRC.

Meanwhile, the hospital is implementing a contingency plan to minimise, in so far as is possible, the impact of the industrial action on patient care. The emergency departments will remain open over the course of the industrial action in an effort to continue to meet patients’ emergency medical needs. Unfortunately, the contingency plan included cancelling all planned, non-urgent elective procedures today other than cancer related care. Patients whose appointments are affected were contacted directly by the hospital and a new date will be re-scheduled as soon as possible.

I want to correct the impression that there is a recruitment embargo at present. This is not the case and there is no blanket embargo on recruitment. While there has to be compliance with national pay structures and management of employment numbers within budget in the HSE, there is scope for hospitals to continue to recruit, particularly across key departments such as intensive care units, theatre and emergency departments.

Our Lady of Lourdes recognises the need for ongoing recruitment drives due to the movement of staff across the HSE and to other health care services in Ireland and abroad. To date, 34 nurses and midwives have been recruited to the hospital this year and 21 staff nurses are in the process of being recruited. At present there are two campaigns of particular relevance: a Royal College of Surgeons in Ireland hospital group competition and an initiative to offer all nursing graduates of 2016 the opportunity for permanent nursing posts.

The HSE has continually increased staffing levels since the beginning of 2015. By the end of March 2016 overall health service employee numbers had increased by 5,856 whole-time equivalents, the vast majority in front-line positions. During that 15-month period from January 2015, the numbers employed in acute hospitals increased by 3,500 whole-time equivalents, with nursing numbers up by more than 1,700 whole-time equivalents during the same timeframe.

I assure Deputies that the Government is fully aware of the difficulties and challenges. I am due to meet the INMO tomorrow to discuss nursing issues in general and I look forward to engaging constructively with it and to continuing the very constructive role it plays in co-chairing the emergency department task force as we all work together as stakeholders to try to address the issues facing our emergency departments and hospital staff, including nurses and midwives, in delivering care.

It is my intention to continue to grow the health budget as the economy improves and to obtain the resources necessary to improve working conditions for front-line staff to enable us to deliver the level of service that we all want to provide to our patients. I wish to put the health service employee numbers on the record in this House. While it does not always fit the political narrative, the numbers are the numbers. I absolutely accept there is still some way to go to get back to the numbers of front-line staff working in our hospitals before the recession but it is important to note that the numbers have continued to increase since December 2013. At that time, there were 47,934 people working in the acute sector. In December 2014, that figure had increased to 49,742. By December 2015, it had increased to 52,539. In March 2016, that number stood at 53,253. With regard to nurses, including midwives, at the end of 2014 there were 34,211, which rose to 35,036 in March 2015 and to 35,918 in March 2016. Since December 2014, there has been an increase of 1,707 nurses, which is a 5% increase. Since March 2015, there has been an increase of 825, which is a 2.5% increase. There is significantly more to do but it is simply not correct to put the narrative out there that nursing numbers and front-line staff are declining when in fact the opposite is true. Deputy O'Dowd's invitation to visit Our Lady of Lourdes Hospital is absolutely something I would like to take up and I look forward to visiting shortly.