Nurses pay and hospital overcrowding
Deputy McDonald linked the nurses and midwives ballot for industrial action to Government pay policy and the worsening health crisis. The Taoiseach replied that public sector pay is already at the limit of affordability, cited trolley figures, and argued more beds, primary care and management reform are needed alongside pay restraint.
This week, balloting for industrial action began among more than 40,000 nurses and midwives. This is a mark and a measure of the desperation and frustration of nurses and midwives. The Minister for Finance, by way of response to this ballot, is hard-balling nursing and midwifery staff by claiming that their pay demands would compromise budgetary policy. He made this claim just two days after the Taoiseach promised a €3 billion tax cut at the Fine Gael Ard-Fheis. The threat of industrial action by nurses and midwives is the inevitable consequence of this Government's failure to deal with the recruitment and retention crisis in our health service and among nursing staff in particular. For years now nurses, midwives and their unions have highlighted this recruitment and retention crisis and have proposed reasonable and responsible solutions to address it but there has been complete disengagement from the Government on the issue.
Our nurses and midwives, as everyone will agree, provide an invaluable service to patients in our health system and we should expect that their jobs pay well. We should also expect high morale in their ranks but that is not the case. Nurses are justifiably frustrated at the current state of affairs. It is little wonder that there is just one application for every four nursing and midwifery vacancies in the health service. That in itself tells the story. All the while, the Taoiseach and the Ministers for Finance and Health do not want to talk about the issue of pay but they must. We have a very troubling situation now with desperate and frustrated nurses and midwives on one side and a Government that is happy to resort to megaphone diplomacy rather than direct engagement on the other.
In April, the Dáil passed a Sinn Féin motion calling for the introduction of recruitment and retention measures based on realistic proposals, with the prioritisation of pay. It called on the Government to work with the unions to draw up a roadmap to full pay equality for nurses and midwives, with an implementation plan to deliver that equality within a short timeframe and not the eight year period proposed by the Government. Will the Taoiseach now commit to acting on that motion? Will the Government engage with the unions to ensure that nurses and health professionals get a fair deal and we are not facing into industrial relations chaos?
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I remind Deputy McDonald and the House that we have a public sector pay deal, not just with nurses but with all public servants. That pay deal was only negotiated and agreed a few months ago and its cost is €400 million this year, another €400 million next year and €650 million the year after that. The deal comes at considerable expense to the taxpayer, is about at the limit of what can be afforded and has cost a lot of money already. It is important to remind the House of what is in the pay deal agreed with all of our public servants. It includes a pay increase of approximately 7% over the period of the deal, with a pay increase next year for all staff and a special additional pay increase for low-paid staff earning less than €30,000. It also includes an extra pay increase in March for staff recruited after 2012 to bring their salary scales more in line with those of staff recruited before then. The deal provides an increment for the vast majority of public servants next year and in addition to that, €20 million has been set aside for targeted recruitment and retention measures for the nursing and midwifery professions. That is what has already been offered, agreed and promised and is on the table. We will honour that agreement in full.
We are happy to engage with the nursing unions, of which there are three - SIPTU, the PNA and the INMO. We are very happy to engage with all three of the unions that represent nurses and will do that in the way that we have always done in the past, namely, through the oversight group for the public service stability agreement, as agreed and, if necessary, through bodies such as the Workplace Relations Commission and the Labour Court. That is how industrial relations are handled and have been handled very well in this State for decades. That is what we will continue to do but we must bear in mind that this is an agreement that applies to all public servants and we will honour it.
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This morning, there are 425 people on hospital trolleys, including 14 children. There are 63 people on trolleys in Limerick, for example, 34 in Cork University Hospital and 34 in Tallaght Hospital. I could go on and recite the litany right across the State. In my opening remarks I said that there is only one application for every four nursing and midwifery vacancies in the system. The Taoiseach has acknowledged and accepted that there is a crisis at the heart of our health system, yet he seems unprepared to do what is necessary to resolve it. The very last thing that we need now is industrial action by nurses and midwives. The HSE will only introduce its winter plan at the end of November. That is how far behind the curve the system is in dealing with the burden of health care. The nurses have a legitimate claim and grievance. The Taoiseach has said the Government will engage with all of the unions. What form will that engagement take? He cited the industrial relations apparatus, with which I am more than familiar, but it will take more than that. Will the Taoiseach and the Ministers for Finance and Health meet the unions? Will they sit down, face to face, around the table to seek a resolution to this crisis?
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The Minister for Health regularly meets the trade unions, as do all Ministers in their respective briefs and-----
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-----the Minister for Public Expenditure and Reform engages with the Irish Congress of Trade Unions, ICTU. This is the system we have had for a very long time and it works very well. According to the HSE, the number of patients on trolleys is 289 today, a decrease of 14% on last year.
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The HSE cannot count; it never could.
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It is also a decrease on the year before. The count that is done by the INMO is different and includes patients on beds, patients on trolleys and patients who are not in emergency departments.
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It includes patients waiting on chairs.
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It is a wider measure of overcrowding but is not a trolley count anymore. It has been changed over the years to include many more categories of patients.
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It is a bed count as well. That is on the INMO website so I am not telling any tales in that regard. Whether the figure is 300 or 400 does not really matter.
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That is not the point. There are far too many patients waiting for admission to a proper hospital bed almost every day of the week, all year around. What can we do about that? Obviously better and proper management systems make a difference and we know that from the hospitals that are performing well. We also need more beds and better primary care so people do not end up in hospital in the first place. Additional beds cost money as does additional funding for primary care and general practice. Additional staff also costs money but if we put too much money into pay rises for existing staff, there will be less money available for more beds, more staff and for primary care and patients will lose out.
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Before the Taoiseach became leader of the country, he spoke a lot about addressing white collar crime but we have not seen much progress on that yet.
We recently unearthed another example of NAMA breaking its own rules when, almost like magic, it sold loans belonging to Avestus, with €352 million owed on them, back to their original owners through a shell company in Luxembourg that was conveniently structured to facilitate the deal. How did the Government deal with it? It rewarded it. Avestus has been given €25 million to build and make more money.
The Comptroller and Auditor General announced last week that he had sought further information on this loan sale and he may begin an investigation. Why is his office the only one that seems to have any appetite to seriously hold NAMA to account. Sadly, I do not think the Government has done so and, sadly, the Garda has failed to do so.
I want to focus on a different area of white-collar crime today. The Taoiseach might remember back to May 2017 and the case of the former CEO of Anglo Irish Bank, Mr. Seán FitzPatrick, one of the most expensive cases in the history of the State. It collapsed due to the inadequate investigation by the Office of the Director of Corporate Enforcement, ODCE. The ODCE was then asked to do a report explaining the collapse of the trial. The report has been with the Minister for Business, Enterprise and Innovation, Deputy Humphreys, since June 2017, yet has not been published due to legal advice. I have seen the report. It is a whitewash and does not address the issues regarding the mistakes made by the ODCE during the case.
I have here the transcript of Judge John Aylmer's statement from 23 May 2017, when he had no choice but to acquit the former Anglo CEO due to the ODCE's botching of the investigation. The judge was scathing of the ODCE and, when one compares the judge's transcript with the internal investigation by the ODCE, it is clear that the ODCE is covering up its own mistakes. The white-collar crime agency, responsible for uncovering crime, is instead covering up itself. It would be hard to make it up.
On 23 October, the Law Reform Commission published an 800-plus page report into white-collar crime with more than 200 recommendations. One of its main recommendations was the establishment of a corporate crime agency and it even drafted the Bill. Will the Taoiseach bring forward this legislation immediately and start an immediate wind-down of the ODCE? Has the Taoiseach read the ODCE report? Is he concerned that the ODCE has submitted a report to Government that is, in essence, a cover-up of its own mistakes? How can we have confidence in this organisation?
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I have not read the report, nor seen it, nor has it been brought to Cabinet, so I am impressed that Deputy Wallace has. I imagine the Deputy would have come to his conclusions about whether it was a whitewash or not before he read it. I will read it and form my own opinion on it once I have. I am advised by the Minister, Deputy Humphreys, that the report will be brought to Cabinet this week or the week after and will be published thereafter.
Deputy Wallace will recall that, back in November of 2017, the Government published a package of actions that it is taking when it comes to cracking down on white-collar crime. It was entitled Measures to Enhance Ireland's Corporate, Economic and Regulatory Framework - Ireland combatting “white collar crime”. That was launched by me, the former Tánaiste, Deputy Fitzgerald, and the Minister for Justice, Deputy Flanagan, around this time last year. There are 28 actions we are taking to crack down on white-collar crime and they are very much under way. One of the key actions in the package is establishing the ODCE as a stand-alone company law, compliance and enforcement agency, and that is the direction of travel in terms of policy. We are taking it out of the Department of Business, Enterprise and Innovation and making it a stand-alone agency in its own right so that it would be better equipped to pursue cases such as this.
There has also been additional resourcing for the ODCE. An additional €1 million provided for it next year to strengthen the work it does. In terms of legislation, the Government, back in July, signed into law the Companies (Statutory Audits) Act and also the shareholders' rights directive will be transposed into law by 2019. Before the recess, we passed the Criminal Justice (Corruption Offences) Act. A lot of legislation that needed to be put in place has been put in place. Additional resourcing has been given to the ODCE and our plan is to establish it as a stand-alone agency to give it more teeth.
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The Taoiseach can talk about legislation until the cows come home, but until the Government starts engaging in enforcement, it is a waste of time. The Taoiseach made an unfair comment that I would make a judgment before I actually read the report. No, I did not, and I would not accuse him of it. What I will ask the Taoiseach to do is that I will give him the judge's statement on the day and he should read that, then read the ODCE report, and he should then tell me if this is an organisation that the Government should be reinforcing, because that is what the Government is doing. The Government is ignoring what has happened. It is ignoring the fact that the ODCE has done a complete whitewash. It has covered up its own mistakes. What the ODCE has had to say in that whitewashed report bears no resemblance to what the judge had to say on that day back in May 2017. There is no comparison. I ask the Taoiseach to read it. Is he prepared to read it? I will give it to him, since he seems to have difficulty getting access to these reports.
I remember the Taoiseach saying he did think we needed an examination as to how the case went wrong and why those mistakes were made by the ODCE. That is a long time ago for a fellow who is interested in tackling white-collar crime.
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The Deputy and I will agree that we need both legislation and enforcement because only the laws that exist can be enforced, and if the laws are deficient or do not exist, obviously they cannot be enforced. It requires a combination of actions. I have given the Deputy examples of some of the legislation that we have brought through just in the past year to crack down on white-collar crime, and we also need enforcement. We are doing that by beefing up and providing more resources for the ODCE.
I acknowledge that the ODCE, notwithstanding the fact that it has had a number of very successful prosecutions in recent years, should have done a lot better when it comes to other prosecutions, and that is why it is the Government's intention and policy to separate the ODCE from the Department. It is currently an office of the Department, but we will establish it as a stand-alone agency, a sort of national white-collar crime bureau or an Irish version of the FBI when it comes to white-collar crime. That is exactly what we intend to do.
I have not seen that report and it has not yet been brought to Cabinet. I obviously will read it before it goes to Cabinet and we will be happy to publish it and discuss it further with Deputy Wallace.