We have grown accustomed under this Government to crisis in the health service but the withdrawal of the services of the country's most senior doctors is unprecedented and will pose a grave threat to the health of our people.

In the past week, 89% of the consultant members of the Irish Medical Organisation voted for strike action. On Sunday, at an extraordinary general meeting, the 1,600 members of the Irish Hospital Consultants Association were balloted for strike action and there is no reason to believe the result of that ballot will be anything other than an overwhelming vote for strike action.

The dispute is long-running and has been exacerbated by the actions and words of all parties involved. It is already affecting the health service in that for the past year consultants have refused to co-operate with the health reform process of which they are a vital part. Other than a few organisational name changes in the past month, the health system remains stalled. The chronic problems of the health service remain unaddressed and the crisis in accident and emergency units around the county continues to reach even more dramatic proportions on a daily basis.

Does the Taoiseach agree that while the three parties involved in this dispute, the Government, the consultants and the Medical Defence Union, will be affected to varying degrees by the consultants' strike action, the major losers in any such process will be the patients for whom the Government and the consultants have a duty of care?

Does the Taoiseach accept that if this strike takes place and consultants withdraw their services, it will result in the cancellation of all outpatients clinics in both public and private hospitals, there will be no elective surgery admissions and the acute hospital system will effectively grind to a halt for all but the most urgent and critical patients? Will the Taoiseach update the House on the response the Government is giving this impending crisis and the action he is taking to prevent it?

On Friday, 4 February, the consultant members of the IMO voted by a large majority for industrial action arising from the dispute over the introduction of the clinical indemnity scheme and responsibility for historical medical malpractice claims. This was followed by the meeting of the IHCA on Sunday at which a secret ballot for industrial action was conducted, with action taking the form of the cancellation of elective procedures and outpatient clinics, with consultants only available to deal with emergency cases from mid-March.

The Department of Health and Children has been engaged in ongoing discussions with the Medical Defence Union which has, to date, refused to assist up to 25 Irish consultants and former members, predominantly obstetricians, who are facing medical negligence claims. The purpose of these discussions is to seek to negotiate an arrangement with the Medical Defence Union under which it would continue to be liable for all known obstetric malpractice cases, with the Irish Government assuming responsibility for all such cases incurred but not reported prior to 1 February last year, the date on which the clinical indemnity scheme was extended to cover claims against hospital consultants. Progress in these discussions has been extremely slow due to the reluctance of the MDU to submit to a due diligence exercise. Such an exercise is essential to satisfy the public interest requirements of Irish law and the State aid issues that are likely to arise under European Union law.

Last Friday, the MDU notified the Tánaiste and Minister for Health and Children that it was withdrawing from negotiations in response to comments made about the MDU before the Oireachtas Committee on Health and Children on the previous Wednesday. In the light of this development, the Minister will meet the Government's legal advisers this week to discuss the legal options open to her to compel the MDU to honour its obligations towards Irish consultant members and former members. That is how matters stand at the moment.

I thank the Taoiseach for his reply. The dispute, as the Taoiseach has pointed out, is effectively triangular. It involves three parties, each of whom is in dispute with the other. The Government is in dispute with the consultants and the Medical Defence Union. I accept that the Medical Defence Union should honour its commitments. The consultants are in dispute with the Medical Defence Union and the Government. The Government states it will provide cover and that nobody will be left off cover, and the consultants say that statement is not legally comprehensive enough. The Medical Defence Union is in dispute with the Government and the consultants. A Medical Defence Union representative yesterday stated this could be sorted out in an hour if the Minister were willing.

Nobody in this House wants this dispute. Everybody wants a solution before a crisis develops. Given that it is a three-sided dispute, no progress will be made if people keep sounding off from their respective corners, and highly qualified and eminent personalities, both here and abroad, are involved, will the Taoiseach, on the basis of legal advice and in an effort to deal with the matter, consider calling in an independent arbitrator to call all three sides together to create a situation where common sense will apply, where responsibility where it is vested will be honoured and where the end result is that the patients, who are the persons involved at the centre of all of this, will not suffer in any way because of disputes regarding legal issues of responsibility that should be owned up to by all sides?

There is no doubt that if all elective and emergency cover were removed, it would be patients and the general public who would suffer. The Government has endeavoured for a long time to resolve the issue and will continue to do so. However, there are legal issues that cannot be set aside.

Following the Minister's meeting with the IHCA on 2 February, a meeting between the Government's legal advisers and the legal representatives of the IHCA is being arranged for later this week to discuss the written assurances given by the Minister that no consultant would be left without cover and no patient would be left without compensation, a commitment given as a result of the actions of the MDU. The IHCA does not consider that this assurance goes far enough and seeks a legally binding commitment. However, the Government has been advised that such a commitment could undermine any subsequent legal challenge by the State against the MDU and that that possibility cannot be ignored.

I accept that Deputy Kenny is being constructive and we are trying to avoid a crisis. As I have stated, the Minister's legal advisers and the legal representatives of the IHCA are to meet in an effort to resolve the issues. The issues cannot be set aside but we will do our utmost to make progress. I discussed this matter with the Minister this morning and she is anxious to try to bring the matter to resolution. However, she cannot set aside the legal issues at stake.