In a week where the cruel impact of the deficiencies in our health service on ordinary people was exposed by the "RTE Investigates" programme, we learned hospital waiting lists are still getting worse. In response to Monday’s programme, we have had much empathy and eloquent words from the Minister for Health. I do not doubt his sincerity. However, we need decisive action that will make a tangible difference to the people affected.

The latest hospital waiting lists for January are staggering. Over 632,000 people are on a waiting list of some form or another, almost 13% of our population. More than one in eight people are now on a waiting list. This is indeed truly shocking, extraordinary and frightening.

Nurses and midwives have decided to engage in industrial action because they have lost faith in the ability of the Government and the Health Service Executive, HSE, to deal with the acute nursing shortages across our health service. It is clear nurses and midwives do not want to engage in industrial action. It is not what they are about. They want to be at work providing the best service they can for the patients they serve. It has been evident for quite some time that nurses and midwives are deeply frustrated with the environment in which they have to work. They say it is unsafe for themselves, for the patients they serve and for other health professionals. The kernel of this dispute lies in staffing, recruitment and retention. In truth, it has been brewing for quite some time.

I acknowledge there have been efforts by the Government and the HSE to recruit more nurses and midwives. However, it has met with little success. A shortage of nurses and midwives hurts. It is not victimless. The shortage of nurses means operations get cancelled. Last year, 37,000 operations were cancelled, up over 50% from the previous year. The shortage of nurses means that acute beds cannot be filled. Even today, over 100 acute beds in our hospital system cannot be filled while, at the same time, people are lying on hospital trolleys. The shortage of nurses means, in essence, that patients are not being served in the way they should. The goodwill of nurses and midwives has helped to keep the system chugging along. They have had enough, however, and who can blame them?

What is the Government’s plan to deal with imminent industrial action by nurses and midwives? What reassurance can the Tánaiste give patients across the country that the situation will not get worse? They are frightened by what has been revealed about the current state of our health service, especially around waiting lists, hospital trolleys and so forth. Now, they learn of this industrial action which has the potential to make matters worse. It is happening because nurses have simply had enough. We need a reassurance from the Tánaiste as to what the Government will do to prevent this industrial action, which is less than four weeks away.

I agree with Deputy Michael McGrath that the threat of industrial action is not victimless. Undoubtedly, people would suffer if we were at that point. It is certainly something the Government and every Member wants to avoid. We do not want to be in that place.

I shared the deep disappointment of both the Minister for Public Expenditure and Reform, Deputy Donohoe, and the Minister for Health, Deputy Harris, when they heard the outcome of the Irish Nurses and Midwives Organisation, INMO, executive committee meeting the other night. Significant efforts were made to resolve this issue by all sides, namely, the HSE, the Department and the INMO. Unfortunately, we still have a situation where the announcement was put forward and the INMO rejected the proposals. Every effort was made to reach agreement.

The Minister, the HSE and the INMO recognise the challenge of recruiting and retaining nurses in the public health system. It is no consolation to patients and those who use the health services that this is an international problem. However, the truth is that almost every public health service in the world is having the same difficulty in attracting nurses. It is an enormous challenge but one we are determined to meet.

The initiatives put forward at the discussions included a commitment to substantially increase the nurse and midwifery force in 2017 with 1,208 additional funded posts coming on stream, offering all graduate nurses and midwives full-time contracts, a career break scheme, 130 additional undergraduate places in 2017 and improved educational opportunities and career pathways. Obviously, it was felt this was not enough.

The next step is that there is a meeting this afternoon of the Lansdowne Road agreement oversight group. I encourage everybody involved to make every effort to come to an agreement on the issues which I have outlined. It is clear people have to engage seriously on this. There is time as the threatened action is several weeks away. I encourage everyone to get involved in these talks. The HSE and the Department remain open to detailed discussion to resolve the dispute to ensure we do not arrive at a point where, as the Deputy said rightly, patients would suffer.

Will the Tánaiste give a commitment today that meaningful engagement will actually take place between the Government, the HSE and the INMO? I do not believe the Lansdowne Road agreement oversight group is going to be the forum for resolving this issue. The Tánaiste outlined what was in the document put forward by the HSE and the Government but it was rejected.

I did not say the industrial action is not victimless. I said the shortage of nurses and midwives is not victimless. That is what is at the root cause of this dispute. Until the Government recognises that, then we are not on the way to resolving this issue. The Minister said 1,200 nurses will be recruited over the course of the year.

Nobody believes that will actually be delivered and that is the problem. The nurses and midwives have heard it all before. There has been a litany of broken promises from three successive Fine Gael Ministers for Health in the past number of years on ending the scandal of people lying on trolleys, cutting hospital waiting lists and bringing in universal health insurance. We are not seeing progress on these issues and nurses are frustrated. The decision to take industrial action is borne out of that frustration. They see no other way of resolving the issue. There has to be meaningful engagement and a genuine commitment on the part of the Government now to deal with the underlying reasons for this industrial dispute.

If the Deputy is looking for reassurance that absolutely every effort will be made and that there is an absolute agreement that serious engagement will continue from the point of view of the HSE, the Department and the Minister with the INMO, the Deputy has that reassurance. Every effort will be made to come to an agreement on these important issues. When we are focusing on the problems in the health service, we tend not to really pay tribute to the extraordinary work that is done for so many patients and the extraordinary successes we have seen in the health service. It is worth making that point because huge efforts are made by doctors and nurses and people get excellent treatment. Clearly, the issue of recruiting and retaining is extremely difficult. There have been open recruitment periods and recruitment remains open and continuous. Every effort is being made to attract new staff. It is worth noting that since December 2013, numbers of staff in the area have increased by 1,657. We have had that increase. The extra €1 billion that has gone into the health service for a range of issues is having an impact but there is more work to be done. As the Minister said, it is also about changing the GP contracts so more people can get better service in the community and it is also about looking at the bed capacity review. No new hospitals have been built since 1988 and we need to change that.