Paul Murphy (Dublin South West, Solidarity)
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We are 14 hours precisely from the placing of pickets on hospitals across the country as part of the nurses' strike. The fact that strike is happening is an indication of the crises that exist in the health service, of which the nurses are at the front line, and a scenario whereby their wages are inadequate.

They endure pay inequality and they cannot survive considering the cost of living increases, particular in respect of housing. That strike looks as if it will go ahead.

It is also only one week since we had a day-long strike of 500 paramedics in the National Ambulance Service, NAS. I was on the picket line last Tuesday with those workers, as were many of my colleagues. I can report back to the Government that the strike had great public support. A lot of people were beeping indicating their support for the strike. I can report back that the paramedics who are organised in SIPTU refused to cross the picket line and the strike was incredibly successful. If the Government does not know, I can tell it that the paramedics gave reports of the kind of difficult working conditions that they face. They are also underpaid and they are at the very front line of an under-resourced health service and dealing with people at the first point of contact in difficult circumstances. They have very difficult jobs.

Some 98% of them voted for strike action in this instance for a simple reason. They are part of the National Ambulance Service Representative Association, NASRA, which is a branch of the Psychiatric Nurses Association, PNA. The HSE refuses to engage with the union of those 500 workers, who make up a significant proportion of ambulance workers. It refuses to engage with the union of choice of these workers. It is outrageous that a public sector employer would refuse to engage and it gives a green light to private sector employers to engage in the short of union busting we have seen.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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At the end of the week an announcement will be made by NASRA, which is a branch of the PNA, on the future days of action it will be taking and that will include a two-day continuous strike. Without the Government wishing to give itself more grief on the question of the health service, this dispute could be ended simply and without costing anyone a penny, except for the paramedics and ambulance drivers themselves because then they could properly pay their union dues.

The HSE deducted union dues from members of NASRA for seven years. NASRA has between 500 and 600 members out of a total of 1,300 paramedics. Approximately 50% of the membership of the paramedic services and the NAS are members of NASRA and, for seven years, the HSE formally recognised them by deducting their fees and then last year it stopped taking deductions at source from any new members who joined NASRA. The Minister of State knows exactly what I am referring to, being a long in the tooth trade unionist like myself. Then in August it ceased all NASRA deductions. The HSE has provoked and manipulated the situation and it has goaded these workers into a dispute because it is refusing to deal with them. The HSE suspended four of its members in Cork last week who refused to work for a continuous 20 hours because they said it would have been contrary to their health and safety. Those members have since been reinstated.

I put it to the Minister of State as somebody who has fought for trade union rights for as long as he has, that it is not his decision, the Minister's, the HSE's or my decision who represents the paramedics, which union they join and when they walk into a meeting, and who they take with them to act on their behalf as members of a trade union. It is their decision and their right. In a liberal Government that talks a lot about choice and moving forward and all the rest of it, the very least it could do is give these workers a right to be recognised and join the trade union of their choice, not the Minister of State's choice nor mine. All that the Minister and the HSE are doing is causing more havoc in the health service by refusing them that right.

Finian McGrath (Dublin Bay North, Independent)
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I am taking this debate on behalf of the Minister, Deputy Harris. I thank the Deputies for raising this important issue. Industrial action was taken on Tuesday, 22 January, between 7 a.m. and 5 p.m. by NASRA, a branch of the PNA.

The PNA held a meeting of its executive on Friday last, 25 January, to determine its course of action. Media reports are stating that NASRA members intend to go on two more strikes on consecutive days, the dates of which are yet to be announced. I understand that the NAS has yet to receive formal notification of these strikes.

NASRA represents approximately 350 front-line ambulance personnel out of a total NAS workforce of 1,800.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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Not true. It has at least 500 members.

Finian McGrath (Dublin Bay North, Independent)
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They are mostly based in Cork, the south east and Tullamore.

NASRA advised that its members would not provide inter-hospital transport and patient transport in the intermediate care service for the duration of the action. The HSE was advised that full emergency cover would be provided during the action. This meant that all emergency calls would be responded to. In addition, the NAS put robust contingency arrangements in place to provide additional emergency cover. The Defence Forces were also on standby, if required. The intention was to minimise any disruption and to ensure that patient safety was not compromised. The service responded to more than 600 calls by 5 p.m. These included a number of hospital transfers, more than 70 intermediate care calls and two helicopter call-outs. There were 12 calls involving Army personnel. The situation was closely monitored by NAS management until 8 p.m. The service confirmed that there was no negative impact on its ability to provide patient care and service delivery. This was due to the implementation of its contingency plan.

The PNA states that its industrial action is in connection with the following: a dispute over the automated deduction of union subscriptions from member's pay - the HSE is refusing to facilitate payroll deductions at source of union subscriptions to NASRA, as it does not recognise NASRA; and refusal by the HSE to engage in negotiations with the PNA or to recognise the PNA as union representatives when representing its ambulance personnel members.

It is important to again state the factual position on this dispute. NASRA, which is affiliated with the PNA, is not recognised by the HSE and, therefore, does not have negotiating rights. The PNA also does not have negotiating rights on behalf of ambulance personnel. The legal position is clear. The HSE and the NAS have no obligation to recognise NASRA or the PNA for ambulance personnel. The PNA, which is a non-Irish Congress of Trade Unions, ICTU, affiliated union, has negotiating rights for nurses working in the psychiatry and intellectual disability sectors. The main union recognised by the HSE for ambulance front-line grades is SIPTU. Fórsa and UNITE also represent ambulance grades. The HSE deducts subscriptions at source for ambulance staff who are members of SIPTU, Fórsa and UNITE. This is consistent with the fact that these are the unions recognised as representing ambulance grades. The HSE does not carry out deductions for subscriptions to NASRA, as it is not recognised. Facilitating deductions at source is not a legal right, rather it is a concession granted to recognised unions. As far as the Government is concerned, there are sufficient unions available to ambulance staff and it does not intend to recognise this group. Of course, individuals have a right to membership of any trade union. However, they do not have a right that such membership is facilitated or recognised by their employer.

Paul Murphy (Dublin South West, Solidarity)
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That is a scandalous answer from the Minister of State on behalf of the Government. He said: "As far as the Government is concerned, there are sufficient unions already available to ambulance staff." As my colleague, Deputy Bríd Smith said, we do not care what the Government thinks about which unions workers should be in. The workers decided that their membership of SIPTU was not sufficient and they set up NASRA. That is their right. It is not 350 but 500 of them who are in NASRA and it is outrageous that a public sector employer would not negotiate or deal with the union of choice of its workers. It is absolutely scandalous and what message does it send to employers such as Lloyds Bank, Tesco, etc.? It sends a message that the Government will actively encourage the kind of union busting, derecognition tactics that are ongoing. It is scandalous and anyone who would call him or herself a trade unionist and would participate in a Government that would stand over such a line is making a big mistake. The HSE is making a big mistake. It is opening up and it will be faced with two different fronts where it is taking on the nurses on the one hand while, on the other, NASRA would be absolutely correct to take further action.

The Minister of State's response is full of holes and spin. Ministers spend much time on spin. More than 500 members of NASRA are in the paramedic and ambulance service. That figures obviously relates to what the HSE gave the Minister because it refused to take new members in the last year. However, new members have been joining because they are not happy with their current representation. The fact that the number involved is only 350 odd has nothing to do with the discussion. UNITE, which is recognised, represents 100 paramedics nationally. That point has nothing to do with the discussion. The spin the Minister of State is putting on the matter is quite outrageous.

I was really shocked by the Minister of State's comment to the effect that "As far as the Government is concerned, there are sufficient unions [already] available ... and it does not intend to recognise this group." I understood that, according to earlier discourse and according to what the union has told us, it was a decision of the HSE. Now we have it in black and white that it is the Government that is blocking the recognition of these workers. As the strike escalates, and it will, let this be on the Minister for Health's head, just as the proposed strike action by nurses the scandal relating to the national children's hospital are on his head. This Government is outrageous when it comes to health.

Finian McGrath (Dublin Bay North, Independent)
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It is very disappointing that the PNA has decided to take industrial action. While our ambulance service plays a key role in providing emergency medical cover, it is also fundamental to the provision of inter-hospital transport and patient transport in the intermediate care service.

It is important to reiterate the position in respect of this dispute. NASRA, which is affiliated with the PNA as a group, is not recognised by the HSE and, therefore, does not have negotiating rights. Also, the PNA does not have negotiating rights in respect of ambulance personnel. The legal position is very clear. The HSE and the national ambulance service have no obligation to recognise NASRA or PNA in the context of ambulance personnel. The National Ambulance Service is committed to maintaining positive industrial relations with all staff and is fully satisfied that personnel are adequately represented through the agreed and recognised industrial relations process that exists within the health sector.

I will of course raise the points the Deputies made with the Minister.

Bríd Smith (Dublin South Central, People Before Profit Alliance)
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The Government will not recognise this group. That is a statement from the Government, not the HSE, and the Minister will be held to it.