Thousands of patients are being impacted as we speak because of the nurses strike. In passing, I welcome the care that is continuing to be given to cancer patients and to patients on dialysis, and that an agreement was reached with the nursing organisation. However, 25,000 appointments have been cancelled and there is a lot of anxiety out there among patients, people with chronic illness and people awaiting elective surgery in regard to what will happen in the coming weeks.

As the Taoiseach knows, this strike will be followed by more intensive action, with consecutive days of strike action throughout February. It is my view there has been no proactive engagement from Government in regard to this dispute with the nursing representatives. The belated, 11th hour activity that we witnessed in the last number of days was far too little and far too late. The sense from officialdom was, "We are going to let this strike happen today and then see what happens after that." I do not think any genuine attempt was made to engage with a view to preventing today's strike.

The Government, in my view, is also in denial about the recruitment and retention issues within the health service, specifically in nursing. Agency nursing is costing €1.4 million a week. We are haemorrhaging nurses from our colleges to the United Kingdom and further afield. A young student was on Today with Sean O'Rourke this morning saying he will be offered six months accommodation in London and that he has three job offers, which is fairly typical. The UK hospitals come over to all of our college campuses on a regular basis. There will always be toing and froing, and I get that, but the imbalance today is extraordinary. We are talking about 80% to 90% of final year students not staying in the Irish system and going overseas - those are the estimates being made, so it is a serious issue. Meanwhile, we are spending hundreds of thousands on trying to recruit from non-EU countries to fill the gaps in our service. There is an imbalance that reveals something is unattractive to those who are qualifying as nurses which means they do not stay in Ireland. I have no doubt about this. Morale is low. Nurses are working in a very high-pressure environment and they are very worried about the quality of the care they are giving because of the shortage of staff, high acuity levels and all of that.

Yesterday, the Taoiseach said he wants to resolve this, that these disputes do ultimately get resolved and that Government is part of the industrial relations machinery. Can he indicate what initiative he plans to take to get this issue resolved and to prevent the anxiety many patients undoubtedly feel? Does he accept there is an excessive level of haemorrhaging of nurses from our colleges to overseas locations and what does the Government intend to do about that?

I thank the Deputy for raising this important matter. I am, of course, as is the Government, very aware that a strike by nurses and midwives belonging to the Irish Nurses and Midwives Organisation is taking place today across the country. I profoundly regret and am sorry for the disruption and inconvenience that has been caused to patients. Appointments and operations are often cancelled for one reason or another but for 2,000 operations and 12,000 appointments to be cancelled on one day is without precedent. We will do all we can in the weeks ahead to catch up on the lost work, just as we did when days of work were lost last year on account of the storms and bad weather. I am confident we can catch up on those lost appointments and lost operations over the spring period.

I want to recognise the fact nurses are providing cover in emergency departments, cancer care, maternity units and some other essential areas as well. I have no doubt, nor does anyone in the Government have any doubt, about the strength of feeling on the part of nurses and midwives about their pay and conditions. We have no doubt about their resolve and their willingness to strike again. I have no doubt the public is strongly behind them. We want to resolve this dispute but I believe it can only be resolved within particular parameters, which I outlined yesterday. Any solution has to be affordable to the taxpayer, has to be fair to other public servants and has to be fair and beneficial to patients as well. We are available to engage, as is the normal process, under the auspices of the Workplace Relations Commission or the Labour Court to resolve it.

What do I mean by being affordable to the taxpayer? As the Deputy knows, we ran a small budget surplus last year and hope to run a small budget surplus this year, but that is far from guaranteed, given the uncertainty around Brexit. We are not in a position to borrow hundreds of millions of euro to fund pay increases. I can justify borrowing hundreds of millions of euro for emergency measures to save jobs, if it comes to that in the next couple of weeks. I can justify borrowing that money for one-off capital projects that will be with us for 40 or 50 years, but I think borrowing money and funding pay increases with borrowed money is bad policy. It is the kind of thing that leads to pay cuts in a few years time and I never want us to get back into that position again.

When I say it has to be fair to all public servants, we need to bear in mind we have a pay deal with all public servants and there are also other claims being made that have to be examined. If we do a special deal with one group, it will not be possible to do a special deal with all groups, so any solution has to be done under the umbrella of the agreement and with the involvement of the Irish Congress of Trade Unions.

We also need to be fair to patients. Even in one of the richest countries in the world, and we are one of the richest countries in the world, health budgets are limited. I do not want to be put in a position where we have to divert money that is earmarked for new medicines, new technologies or new treatments to pay increases - I do not think that would be right. We also need the co-operation of unions in making the kind of reforms to the health service that we want to make.

There was no limit to the budget for the children's hospital. It is wrong to try to pit against nurses the idea that if we do a deal with nursing, or if this issue gets resolved, it will somehow be at the expense of medicines and patients, and so on. The Taoiseach gave a very impressive, detached commentary and a series of observations at the beginning of his response, full of empathy and understanding of how committed the nurses are to getting this issue resolved. However, he then went on in the latter part to give every single reason why he does not think this can be resolved or that he is in a position to resolve it. I got no sense of any initiative he is about to take.

Nobody is asking him to borrow money. He is the person who, without any provocation, said he had €3 billion over the next three to four years for income tax cuts - out of the blue, he said he could produce €3 billion just like that. He can promise what he likes to those where he deems it to be in his interest but for everybody else and when it comes to climate change or the health service, different rules apply.

Thank you, Deputy.

Brexit was never invoked at his Ard-Fheis last autumn. My point is that the Taoiseach said yesterday that this will be resolved and that all disputes end up being resolved. There are mechanisms available. We had a nursing commission in the past which dramatically transformed nursing relative to the prior position.

The time is up.

There are proposals around various pay mechanisms or increments that could be deployed to help bring this to a resolution but I get no sense there is any proactivity in that regard. The Taoiseach said yesterday the Government was a party to the industrial bodies and that this would be resolved, but I get no sense of how the Taoiseach intends to set in motion the resolution process for the dispute.

I am afraid I cannot help the Deputy with his senses. I outlined in my previous answer where I believe the parameters are for a solution to the dispute. I explained that very clearly.

In relation to tax, I have always said that any tax cuts have to be affordable. I would not borrow money to fund tax cuts and have not done so in the past two years.

The Taoiseach could use the €3 billion the Government had.

Where are we getting the €3 billion from?

Members should please allow the Taoiseach to reply.

What we propose is that if the economy continues to grow-----

The Taoiseach should not forget that nurses get up early in the morning.

What I propose if the economy continues to grow the way it has been growing in recent years, because there are more people working, people are earning more, the amount income tax we have taken has gone up by approximately €1.2 billion a year, if we can afford it, is to give about half of that back to 900,000 taxpayers.

The Taoiseach did not qualify that.

The vast majority of nurses and midwives would benefit from that as well-----

The Taoiseach saved the detail for the Fine Gael membership but I suppose it went over their heads.

-----but it would not just be one group who would benefit; nearly 900,000 taxpayers would.