Before I begin, I take the opportunity to extend my deepest sympathy and those of my party colleagues to our comrade, Deputy David Cullinane, and the wider Cullinane family on the death of their mother Berna who is being laid to rest in Waterford. Ar dheis Dé go raibh a hanam dílis.

In just under a fortnight's time, members of the Irish Nurses and Midwives Organisation, INMO, are due to commence industrial action with a series of 24-hour work stoppages over the following weeks. Members of the Psychiatric Nurses Association, PNA, are also due to commence industrial action with a three-day stoppage due to take place from 12 to 14 February. We all know that strike action is the last thing nurses and midwives and medical professionals for that matter want to undertake. These people believe they have been left with no choice but to undertake such action given the ignorance, arrogance and the ineptitude of the Taoiseach and his Government colleagues in dealing with the crisis we face. The Government has had years to address the recruitment and retention crisis in our hospitals and we see how it is crippling our health service but it has completely failed. The situation has deteriorated year on year and month on month. Nurses, midwives and their unions have continuously sought engagement with the Minister for Health as well as with the Minister for Finance to address the question of staff shortages and pay to avert the industrial action we face. Their concerns have been routinely ignored by this Government. In fact, what has happened is that they have been verbally attacked, threatened and insulted as they have tried to achieve a resolution to a crisis and it is impacting on so many of our patients.

It is the staff of our hospitals who have acted with responsibility and in a mature manner. The Taoiseach and his Government have decided to disengage. Nurses and midwives deserve our full support. In terms of their demand for a better health service that treats them as essential, skilled workers and with dignity and value, I and my party fully support them. The Taoiseach's approach has been to dismiss these concerns and industrial action is now the regrettable outworking of his Government's policy and that of his Minister as he ignores the issue of the recruitment and retention crisis in our hospitals.

For years nurses, midwives and their unions have put forward sensible proposals to try to address this issue. Last April we in Sinn Féin passed a motion in this House calling for the introduction of recruitment and retention measures based on realistic proposals which would prioritise pay. It was supported by the majority of Deputies in this House. This motion called for Government to work with unions to draw up a roadmap for full pay equality with an implementation plan to deliver pay equality within a short timeframe, not the eight-year timeframe the Taoiseach has offered.

At the 11th hour, will the Taoiseach concede that he has failed to tackle the recruitment and retention crisis in the health service? Will he accept that the issue needs to be addressed and will he commit to proper engagement with the nurses and midwives and their unions and give them the fair deal they deserve, one that means all parties, including the Ministers for Health and Finance, will be obliged to be at the table?

The difficulties in recruiting and retaining healthcare staff, including nurses, are very real. They are not unique to Ireland: the same problems exist in places where pay is much lower, such as Northern Ireland, and much higher, namely, the Middle East and Australia. It is the consequence of an international labour market in which there is a shortage of healthcare staff. Deputy Pearse Doherty should not give anyone the false impression that what is happening means we are not making progress. The number of nurses employed in the public health service in the past five years increased by 2,330. If one compares the position year on year – it is important to compare month with month for seasonal reasons – the number of nurses working in the health service in November 2018 was 860 more than in November 2017. That is an increase of 860 in a year and it does not include student nurses. Those are the facts. People could be given the impression that there are more nurses leaving the profession and leaving the country than there are nurses going into the profession and coming into the country but that is not the case. There are 3,000 more nurses working in the public health service than was the case five years ago, and recruitment will continue.

I am aware that two of the three nursing unions have voted for strike action. The ballots were very decisive, with 95% voting for strike action. That reflects the depth of feeling among nurses and midwives regarding their pay and conditions. The Government does not believe for a second that nurses are anything other than sincere in the action they are proposing to take. We will do our best to try to avoid a strike. An engagement involving employers and unions is taking place today. A meeting of the oversight committee for the public sector pay deal, at which the Departments of Public Expenditure and Reform and Health will be represented, will take place on Friday next. There are other avenues, including the Workplace Relations Commission and the Labour Court. We will do everything we reasonably can to prevent this strike from happening but we need to bear in mind that there is already a pay deal in place. That deal, which was agreed not just with nurses and midwives but with all public servants, runs until 2020. It would not be fair or affordable to offer a special deal to one group in the public service and then say to every other group that we have no money left for them. That would not be right. That is the reason we have collective agreements with ICTU and I am of the view that it is the right way to manage public sector pay.

We should not forget what is involved in the agreement to which I refer. This year alone, there are five different ways in which public servants' pay can increase: there will be an across the board pay increase in the autumn; a special pay increase for those earning under €30,000 has just kicked in this month; there has been a reduction in the pension levy; a special increase for new entrants in March, should that be agreed, and an incremental pay increase for most public servants over the course of the year.

The recruitment and retention crisis is very real. That is evident when one talks to front-line staff, people the Taoiseach blamed for causing the trolley crisis over the Christmas period. I am sure he got the wake-up call from all their tweets as they posted pictures of themselves working on Christmas Eve, Christmas Day and New Year's Eve. The reality is that this is a very real crisis. There are 1,754 fewer staff nurses in our hospitals than was the case a decade ago. This is despite the fact that we have an ageing population. Some 71% of students who are going through midwifery and nursing training state that they are considering emigrating. The reality is that 60% of nurses recruited in 2017 were migrants. The reality is that nurses and midwives are not paid enough for the work that they do, the pressures they are under and the care they provide. What we need is a pay deal. We need the Taoiseach to give effect to the motion Sinn Féin put forward that was supported in the House last April, which was to deal with this issue and to deal with the pay constraints on nurses-----

I thank the Deputy.

-----to ensure that we deal with the situation whereby we have only one application for every four vacancies in the health service. The Taoiseach talked about inefficiencies. This is one of the greatest inefficiencies, that we are not staffing our health service properly.

The time is up.

Therefore, we have a trolley crisis, a recruitment and retention crisis and the spillover effect from that whereby numerous people are on waiting lists that are growing, month on month.

We can only deal with this issue in the context of wider concerns and wider issues. There are lots of people working in the public service, 300,000 of them, including doctors, teachers, gardaí, people who work in this House and other civil servants. They all work really hard. There are lots of areas in our public service where we are now finding it hard to recruit because we are approaching full employment; indeed, that is the case across the private sector as well. We can only do things within the constraints of a limited amount of finance. We balanced the books last year, just about, but to concede to this and all the knock-on claims which would inevitably follow would require us to pay for it through borrowing. I do not think it is prudent, right or sensible in the long term to fund pay increases with borrowed money because that inevitably will turn into a pay cut in two or three years' time.

Those are the kinds of policies that Sinn Féin would pursue and that is where it would lead us. It would offer people-----

Maybe they could tax the banks and that could pay for some of our nurses.

Just as in places like Venezuela, it would implement socialist policies, it would blow all the money in the first couple of years and, after that, it would just be austerity, austerity and austerity.

Keep waving the flag for the ones with the golden spoon in their mouths.

Deputy Doherty is finished. I call Deputy Joan Collins.