There is a crisis in our health services and in the Government. The Taoiseach and the Minister for Health have proved utterly incapable of resolving the various issues before us.

Yesterday, we had general practitioners outside Leinster House due to the lack of Government investment in primary care. Our hospitals have the worst waiting lists right across Europe. Last month, there were 10,000 on hospital trolleys. Last year was the worst year on record in terms of the constant trolley crisis. The debacle surrounding the national children's hospital is beyond farcical now and we are no further along in it being resolved.

The issue I want to talk about, and the question I want to put to the Minister for Children and Youth Affairs today, surrounds the issue of 37,000 nurses and midwives who have engaged in another day of industrial action. It is a 24 hour stoppage as a result of a complete and utter failure on the part of the Government to deal with the issues of recruitment and retention that have gripped our health service for many years.

I met nurses this morning and I have met them on many occasions since this industrial action started in late January. Their message is very clear. Their message is crystal clear to Government. None of them wants to be out on the picket line. All of them want to do what they do best, that is, caring for patients in our hospitals. Their actions are not selfish because they are taking their action and their stand on behalf of every one of us. The public, the people at home, know that. That is why their actions have the support of people throughout every community in the State, because they know that nurses are fighting for a better health service for all of us. That is at the core of it. That is what the people understand. That is why they are standing with the nurses and midwives in this battle.

The Government has, to this point, refused to engage on levels acceptable to the nurses and midwives. Earlier this week we had the Minister for Health and the Minister for Public Expenditure and Reform issuing a joint press release stating that they were willing to engage in talks at the Workplace Relations Commission. They said they would engage in talks on everything bar what is at the core of this issue, which is the issue of pay. The Government has spouted that line time and again and it has been rejected by nurses and midwives and the Irish Nurses and Midwives Organisation, and rightly so.

It is time now for the Government to get real. It is time for the Minister for Children and Youth Affairs, as a Cabinet colleague, and the rest of her Cabinet colleagues to get their heads out of the clouds and deal with the issue at hand. The Minister said the Government will engage with the nurses but what the Government needs to accept and act on is the urgent need for that engagement without clauses or preconditions.

The approach that the Government has taken so far has failed utterly and dramatically. Let me be clear on this and let me spell it out to every Cabinet colleague. The Cabinet is putting patients at risk because nurses never put their patients at risk. The refusal and intransigence of the Government to deal with this issue on the basis of no preconditions is putting patient safety at risk. That is not surprising given this Government's record on health and the record of the Minister for Health. Despite this, within a number of days we will have industrial action involving a three-day stoppage planned for next week.

Your time is up, Deputy.

What we need is proper dialogue before that. Does the Minister accept that the Government's approach to tackling the recruitment and retention crisis so far has failed? Does the Minister accept that pay is an issue and is going to need to be addressed? Will the Minister accept that a process of engagement is needed right now without any preconditions and without any clauses?

First, in respect of Deputy Pearse Doherty's first question, we are not there yet. Clearly, we are not there yet. As he has identified, with great eloquence, the risks are escalating. We understand that. That is why there is such significant contingency planning going on between the Irish Nurses and Midwives Organisation and the HSE. I am fully with Deputy Doherty and aware of that with regard to the risks that are escalating.

Second, I am here today as an Independent Minister because I am part of the Government and it is my responsibility to answer some of these questions as well. In my view, we need something to shift to bring the people to the table. That is what needs to happen. On what basis do I say that? First, there is reasonableness on both sides. There is reasonableness, as Deputy Pearse Doherty eloquently set out. I have spoken to nurses as well about their concerns. The issue of the safety of their patients is primary to them. Their understanding is that they need the issue of pay addressed to address the issue of safety effectively. That is what they are saying to us. On the other side, including the Government of which I am a part, there is reasonableness as well. When I came in I was listening to the Minister for Public Expenditure and Reform, Deputy Donohoe, identifying issues relative to pay, the collective pay agreement and all of the other aspects of that. These are reasonable for us as the Government to lay out. We have reason on this side and we have reason on that side.

At the same time, we need something to shift to bring the parties together to begin to have that conversation. Deputy Pearse Doherty asks whether it has to do with pay. The Minister for Public Expenditure and Reform, Deputy Donohoe, has laid out clearly an understanding of that in terms of the current agreement as well as the future agreement, and pay is part of that. No doubt that will be part of those discussions in terms of the safety and conditions that are required. How that is discussed and what is decided will be determined once they get to the table. This is the most important thing that needs to happen. The talking needs to begin. We require significant engagement and genuine and real intensification to find what the Minister for Health, Deputy Harris, referred to as innovative solutions. In my view, and I imagine Deputy Pearse Doherty shares it, before the significant intensification and the potential disruption that will happen next week, we need something to shift to get intensification in terms of engagement. This requires the support of the INMO as well as ICTU and the wider union movement.

The Minister for Children and Youth Affairs says something needs to shift. I put it to her that what needs to shift is that the Government needs to indicate – it can be done today, right here, right now – that it will enter into negotiations with the INMO on the basis of no preconditions. What the Minister for Public Expenditure and Reform, Deputy Donohoe, and the Minister for Health, Deputy Harris, have said is that the Government will enter into talks, but not about pay. The Minister for Communications, Climate Action and Environment, Deputy Bruton, was on "Morning Ireland" this morning. He said, "I think we are prepared to talk about pay in the context of an agreement". Is that the position of Cabinet today or is it the position of the Minister for Health and the Minister for Public Expenditure and Reform that pay cannot be discussed? We need something to shift but those in the Government have dug their heels in and do not want to talk about what is the core issue of this dispute.

Will the Minister for Children and Youth Affairs give clarity? This is Leaders' Questions and not oral questions. What is the situation of the Government at this point? Is the Minister for Communications, Climate Action and Environment correct in his proclamation this morning in which he said the Government was willing to enter into talks to discuss pay in the context of an agreement? Is it the old position of the Minister for Public Expenditure and Reform and the Minister for Health in their press release that the Government will talk about everything bar pay?

This is a dispute in terms of two parties. I know which side I am on. I know which side the public is on. I believe the public believes the Government is being intransigent on the matter.

Thank you, Deputy. Time is up.

What we need is meaningful dialogue without preconditions.

Will the Minister clarify who is right and who is wrong or is it the case that everybody is right with their differing messages in Cabinet?

I am aware that this is Leaders' Questions. I also listened to the Minister for Communications, Climate Action and Environment this morning. I did not think the way he answered the question was necessarily at odds with what the Minister for Public Expenditure and Reform, Deputy Donohoe, was saying or how I answered the Deputy. As I have already said, we agree that we need a shift shortly to bring the parties together. When that happens there will be discussion on the issue of pay, whether in the context of what has been agreed, which will start soon, or of allowances that have been determined in relation to nurses, which will also begin soon. No doubt issues in relation to the future will also be discussed. That is all. That is what the Minister, Deputy Bruton, was saying and I think the Minister, Deputy Donohoe, would accept that if we get there, while at the same time identifying that there have been agreements and they are beginning to be followed up in relation to what the Government has promised.

I do not think that there is a difference, but based on the concern that the Government and nurses share for the safety of our patients, we need to come together.