Tá an stailc atá tógtha ag na heolaithe leighis, agus na himpleachtaí ar na seirbhísí sláinte dá bharr, ag tarlú mar gheall nár dhéileáil an Rialtas leis na fadhbanna ag croílár an aighnis. Tá cothromaíocht i gcúrsaí pá, deiseanna traenála agus coinníollacha oibre fíorthábhachtach do sheirbhísí sláinte nua-aimseartha. Níl aon oibrí ag iarraidh a bheith amuigh ar stailc. Is an rogha dheireanach atá ann. Medical scientists are on the picket lines today, and will be again tomorrow, fighting for fair pay and decent career and progression opportunities. We are seeing significant and widespread disruption to the health service, with up to 30,000 medical procedures and appointments being cancelled. That follows on from the 14,000 appointments that were cancelled last week.

This dispute has been left to fester by successive governments for more than 20 years. The issues at the centre of this strike did not fall out of the sky. Medical scientists are paid 8% less than colleagues who perform identical work in hospital laboratories. Laboratory aids who report to medical scientists receive a higher starting salary than the medical scientists do. Medical scientists have fewer education and progression opportunities than comparable colleagues do. These issues have been raised continuously with governments for more than two decades by medical scientists and their representatives but nothing has been done. Unfair pay and a failure to address poor conditions have led to a chronic retention and recruitment crisis in the profession. We see that 20% of approved hospital posts are currently unfilled and the Medical Laboratory Scientists Association, MLSA, states that the Department of Health and the HSE are ignoring burnout in the sector.

Let the Taoiseach make no mistake about it - medical scientists are on strike today because of a basic lack of respect and recognition of the crucial role they play in delivery of health services. They are among the unsung heroes of this pandemic. Medical scientists essentially designed our Covid-19 testing system from scratch. They suspended industrial action for more than two years. They put aside their grievances for the good of the people and their contribution in the fight against the virus was invaluable. Medical scientists stood up and went beyond the call of duty. Now the Taoiseach's Government has left them standing on the picket line for a second week.

The MLSA says that since the first strike action last Wednesday neither the Department of Health nor the HSE has come to it with a meaningful proposal or an invitation to talks that could resolve the issues. That is incredible. Medical scientists deserve far better than that. The tens of thousands of patients whose medical appointments have been cancelled deserve much better. What we need is a fresh set of urgent talks. We need talks urgently with the aim of getting a resolution. Crucially, these talks must involve the Department of Public Expenditure and Reform, which puts the money on the table at the end of the day. It has to be at the table. Last week the Taoiseach said that he recognised the hugely important work done by medical scientists. He also urged them to engage with the industrial relations mechanisms. That is exactly what they are doing, but there is still no resolution to this issue. It comes down to this: does the Taoiseach accept that medical scientists have a legitimate and fair claim? If so, will he now intervene with the Department of Health, the HSE and, crucially, the Department of Public Expenditure and Reform in order that together they may bring a meaningful proposal to the MLSA to resolve this dispute and ensure it does not go into a third week?

Tá ról faoi leith ag na heolaithe leighis sa chóras sláinte. Bhí an ról sin soiléir le linn na paindéime. Admhaím go bhfuil ceist ann agus go bhfuil siad ag lorg parity idir iad féin agus na clinical biochemists le fada an lá anois. Is í an chaoi is fearr chun na ceisteanna seo a réiteach ná trí cainteanna laistigh den phróiseas atá ann chun ceisteanna den saghas seo a réiteach. I mo thuairim, dá mbeadh cainteanna substaintiúla ann, beimis in ann na ceisteanna seo a réiteach sa deireadh.

I thank the Deputy for raising the issue. I acknowledge and pay tribute to the dedication, professionalism and commitment of medical scientists throughout the country. They were instrumental and crucial in respect of our response to Covid-19 and the pandemic and are clearly an intricate part of the delivery of care within our health service. The MLSA wants pay parity between medical scientists and clinical biochemists. It was recommended by an expert group in 2000 or 2001. That was broken by benchmarking between the two grades at the time of the 2002 benchmarking process. There is a clearly defined grade structure with promotional opportunities for medical scientists within the HSE. The Building Momentum public service agreement provided for sectoral bargaining within that overall framework. In addition to that, we believe it is particularly important that this gets into a proper process either in the Labour Relations Commission, LRC, or within the Labour Court. In my view, optimal use must be made of the industrial relations machinery of the State - whether that be the Workplace Relations Commission, WRC, or the Labour Court - in order to resolve this issue. Significant informal contact occurred over the weekend on the issue of getting all sides into the process at the WRC or the Labour Court to get this resolved within a broad industrial relations framework.

At the end of the day, the Government wants a resolution of this. I am sure the MLSA wants a resolution on behalf of medical laboratory scientists. However, such a resolution must always be conscious of potential implications and relativities and so on. It must be clearly and transparently done and signed off in respect of the processes in play. The objective of all the informal contacts over the weekend has been to get people comfortable about going into a process, in terms of a proper outcome for all concerned. We are anxious to get this resolved. There has been overall growth in the number of medical scientists of about 6% since 2019. I acknowledge there have been increases at the higher level but not at the basic grade.

We want to improve that. The HSE is embarking on a recruitment campaign. Additional funding is being made available in the Estimates for 2022 to facilitate that. Approximately 160 development posts are being recruited in addition to replacement posts.

The resolution of this lies in the full utilisation of the labour relations machinery of the State.

Medical scientists have been waiting for 20 years for the Government to turn up and deliver. They do not need plaudits. They do not need applause. What they need is a government to step up to the plate, recognise the invaluable work they do in the health service and recognise all the work they have done over recent years. They have been waiting 20 years for a government to hear their legitimate grievances and act. They are out on strike today because they have had enough.

We cannot allow this to go into a third week with the disruption that that will cause to the health services with three more strike days next week. The Taoiseach says we need to use the industrial relations mechanisms. I agree with that, but all parties need to turn up. The Department of Public Expenditure and Reform needs to be at the table. The people who will pay at the end of the day need to be involved in these talks. I am asking the Taoiseach, again, if he will direct the Department of Health, the HSE and the Department of Public Expenditure and Reform to get around the table with the medical scientists to come up with some sort of resolution.

First, the health sector management has engaged with the Medical Laboratory Scientists Association, MLSA, through the WRC over the course of 2021 and, more recently, through the sectoral bargaining process under Building Momentum 2021-2022. The Public Service Agreement Group, PSAG, recommended that the parties re-engage at the WRC. That is where it has been over the past week or so - endeavouring to get back into the process. There was further engagement with the MLSA in that regard. Unfortunately, no resolution was reached last week in respect of that, but I am hoping. I urge all parties to use either the WRC or, potentially, the Labour Court to bring about a resolution to this. The full arm of Government, in terms of the full continuum of the Government through its different Departments and agencies, then would be involved in that process to get an outcome, once and for all, on this particular issue.

We understand the role that the medical scientists play. We understand the impact of this disruption of patients as well. We are very concerned about that.

The time is up.

That is why we want to get this resolved. We believe it can be if we can get a proper basis for engagement with the WRC or the Labour Court.

I too want to raise the issue of the medical scientists' strike this week. The health services are under severe strain and this is really showing that. It is reported that 30,000 procedures will be cancelled this week due to the two-day strike, but the reality is that the disruption is much greater than that. Another 14,000 outpatient appointments will be cancelled each day as a result of the strike. Thousands of inpatient procedures, day-case elective procedures, maternity appointments and all the routine GP testing appointments will also have to be cancelled. The strike is completely disabling the health service. It just shows the importance of this particular profession.

We must be clear that the dispute is doing that and it is having serious consequences for patients right across the country. To give an indication of how serious it was, this morning, on "Morning Ireland", Mr. Tony Canavan, the CEO of the Saolta group, said he was concerned that deteriorations in the conditions of inpatients in hospital would not be detected because of the lack of regular testing. We cannot go on with this. Certainly, we cannot countenance another three days of strike action next week.

I do not believe the people who are on the picket line want to be on the picket line. They want a resolution to this.

Patient safety is clearly being put at risk. That is having a hugely negative impact on patients, some of whom have been on waiting lists for many years, seeing long-awaited procedures being cancelled. The strike will cause further chaos with delayed diagnosis, delayed treatment, avoidable patient pain and suffering, and expanding waiting lists, with which we already have a problem.

Medical scientists are the hidden heroes of the health service, the people whom patients never get to meet, but patients' treatment and care are dependent on their hard work.

Despite this, and as has been mentioned, they are paid 8% less than biochemists and they do broadly the same work. They are paid less than laboratory aides, who have much less responsibility.

What is the Government proposing as a means to resolve this dispute? We were told last week the public service agreement group had recommended that the dispute be referred to the WRC. The MLSA has agreed to engage with the WRC but not to lift the strike action. However, the union has said that neither the HSE nor the Department of Health has approached it with any meaningful proposal or invitation to talks. There must be some talking in order to get the two sides engaged. What can the Taoiseach say he can do to bring these two sides to the table? Why has neither the HSE nor the Department of Health approached the MLSA with meaningful proposals they can talk about? The apparatus of the State is fine as long as there is something on which to engage. Will the Taoiseach tell us how he sees this being resolved?

I thank the Deputy for raising the matter and I acknowledge the disruption being caused as a result of strike action. It is having an impact and will continue to affect patients. I do not think anybody wants that and the MLSA does not want it either, to be fair, but this is having an impact. There is a very strong desire to get this matter resolved. What has been going on through informal contacts is to get a basis for participation now, following failed attempts in recent weeks through the WRC and the public service agreement group. It is about getting the basis right, if you like, for all parties to participate either in the WRC or in the Labour Court, which could be the way forward in getting a resolution to this dispute.

It is a dispute of long standing, but in these cases there are always further implications. The broader consideration of this must be within that context also. In other words, people must be fully aware of all the implications of any particular agreement on a specific matter, particularly in the health service. Anybody involved with the health service knows that to be the case historically. Experience informs us that a deal in one particular location of the health service can have repercussions across the entire service that may not have been envisaged at the outset. The best way to resolve an issue of that kind is to use either the WRC or the Labour Court so the details can be hammered out and ring-fenced to ensure we can get a resolution to this in the best interests of all concerned. That includes medical scientists, patients and the public at large. It is what the Government is endeavouring to do here.

There is no dispute about the need to get this resolved and we have provided funding to expand the numbers working. Currently we have approximately 2,135 whole-time equivalents in the sector and we want to expand that through additional posts. We want to create a framework and basis to have a lasting resolution to this dispute.

Approximately 20% of medical scientist posts are currently unfilled. It appears the pharmaceutical sector is finding no difficulty in attracting people with these qualifications but there is a reluctance to take up positions because of poor pay and a lack of parity and respect. There is also an issue with career progression. Will the Taoiseach ensure there is a formal invitation issued by the HSE and the Department of Health to the MLSA and that there is a realistic basis for a resolution to this?

We all understand there is industrial relations apparatus and it must be used. There must be a basis, nonetheless, and we must have a formal invitation in place.

Will the Taoiseach make sure a formal invitation is issued? Will he make sure there is a basis for a resolution? There is no way the other side will engage if there is not a basis for a resolution.

I take the Deputy's point but, as she knows, before a formal invitation issues one would like to know there is a basis for it to be accepted. A lot of informal work and contact goes on all of the time between parties with a view to getting the right basis to facilitate participation in these mechanisms at the Labour Relations Commission or the Labour Court. Each year approximately half of the graduates from the colleges go to the health service. There has been a significant increase in senior posts and specialist posts over the past three years and that is the way it should be. We want to continue to invest in the service. We are working to make sure we can get a proper basis and an invitation process in place that would lead to participation by all concerned in the labour relations machinery of the State to get this dispute settled.