Today there are in excess of 493 patients on trolleys waiting for admission to our country's hospitals. I know the programme for Government is very clear on its commitment to tackle this crisis but the threat of industrial action is now looming from the Irish Nurses and Midwives Organisation, INMO, which believes that not enough is being done to recruit nurses to vacant positions in all acute hospitals throughout the country. It says there is no funded workplace plan to address the unsafe staffing levels and that these staffing deficits are compromising patient care and negatively impacting on the health and safety of nurses and midwives.

Today we have circulated an e-mail sent to the management of Tallaght hospital by the accident and emergency consultant there about the chronic situation where ambulances could not decant patients because of the overcrowding. He said the staff will do what they can in a dangerously crowded situation but unfortunately ambulances will not be able to decant patients and waiting room patients cannot be seen until capacity is found within the emergency department due to entry block. He said the entry block into the emergency department is a most dangerous consequence of overcrowding impacting on ambulances and staff and so on. There is a very real issue here in respect of quality of patient care and safety as a result of this consistent overcrowding in our accident and emergency departments.

The INMO continues to press for implementation of a range of measures to incentivise nursing recruitment and retention against the background of a 90% ballot in favour of industrial action if progress is not made. I assure Deputy Micheál Martin, the House and the public that all efforts are being made to reach an agreement with the INMO and SIPTU.

They adjourned last night under the auspices of the Workplace Relations Commission. HSE management will now revert to the INMO with detailed proposals on recruitment to take place in 2017. I note that 14 or 15 different propositions were put forward. The INMO needs to have at its disposal how that is to be funded. The Government is committed to 1,000 extra posts in 2017 as part of the programme for Government. They are fully funded and the approved posts are working within a strict public service pay bill. Obviously this is always a challenge.

The current issues refer to staffing, recruitment, and the retention of nursing and midwifery staff. They were discussed at a meeting between the parties on 12 January. The HSE, the Department of Health and the Department of Public Expenditure and Reform reverted to the INMO on 20 January with a joint proposal document setting out measures to attract and retain nursing staff. I hope this matter can continue to be dealt with.

As regards the point made by the Deputy, this is not the first time it has been raised concerning blockages into accident and emergency units and ambulances. The initiatives being taken by the Minister have had a beneficial impact in most hospitals. However, there are difficulties that arise from time to time in hospitals, as the Deputy pointed out in the case of Tallaght.

The programme for Government contains a commitment to support the long-term sustainable development of rural communities. On Monday, the Government announced its action plan for rural development but this is really a rehash. It is a compilation of previous plans, schemes and programmes. The 135,000 new jobs outside Dublin by 2020 are already contained in the programme for Government. The €60 million to be invested in 600 towns and villages over the next three years is not new money. It is actually approximately €30,000 for each town and village.

Under Fianna Fáil and Fine Gael, 139 Garda stations have been closed, many of them in rural Ireland. The Government's plan is to conditionally reopen six. The Government's new plan, therefore, is to implement its old plan. There is no commitment to keep open post offices, libraries, Garda stations, bus services, health services and other services that are essential to rural communities. The Minister has said that an implementation monitoring committee will be established but when will this happen? Who will be on it and will it produce regular reports on the plan?

Deputy Adams is being very hard. It is not a rehash.

It is.

For the first time ever, which was a demand made by Deputy Adams and others, the first senior Minister for rural affairs, Deputy Heather Humphreys, is here beside me.

Get her out on the ground.

Order please.

She has drawn together all the programmes and proposals to be monitored, implemented and published on a quarterly basis.

We had a rural Minister and the Taoiseach got rid of him.

Deputy Adams will appreciate that as we work towards a post-Brexit situation, we need to be able to have a vision for rural Ireland, including the many small towns and villages throughout the country.

We need action.

All over the country this is now under the aegis and monitoring direction of the Minister with responsibility for rural regeneration, so it is not just a rehash. I expect that every community will take that programme in all forms to see what is best suited to their area. Many Ministers will have responsibility for implementing elements of this but the new item, on foot of the demand made before the election, is a senior Minister with responsibility for rural regeneration. She is doing a really good job and will see that this programme is implemented.