It is generally accepted that serious challenges face the health services on a daily basis. These challenges affect patients, staff and the wider community. Staff are firefighting on an ongoing basis. They are burned out, frustrated and fed up continuously holding services together with minimum resources.

Emergency departments are overrun, with trolley numbers in January of this year at an all-time high of almost 14,000. Waiting lists are similarly as high, and outpatient numbers are well in excess of half a million. We have reviews and investigations into hospitals like University Hospital Limerick, Portiuncula hospital and Mayo general hospital. The Government and health service management threw a grenade into this already chaotic situation with the pay and numbers strategy. That strategy abolished more than 2,000 posts, keeping additional pressure and stress on remaining staff. These posts were fully funded and filled.

If that was not enough, on Friday last, the chief executive of the Health Service Executive, in what was an aggressive, maverick and indeed bully boy diktat, instructed his regional executive officers to introduce an extended working day and extended working week for staff. That diktat is in breach of good industrial relations practice and, more importantly, is in breach of the framework agreement between the Health Service Executive and its staff and unions. It was done without any consultation whatsoever. This bombshell was thrown into an already fraught situation and has the potential to cause serious harm, not only to staff but also to patients already waiting far too long for treatments. The Fórsa trade union, representing its members, responded predictably and reasonably when it said that if this instruction is not suspended, it will necessitate an appropriate response. This is shorthand for industrial action.

In view of the clear breach of agreements and non-consultation with staff and unions, and in view of the potential for this diktat to create chaos in the health service and, indeed, seriously impact on patient safety, will the Government instruct the chief executive officer of the Health Service Executive to withdraw that instruction immediately?

I thank the Deputy for raising this important matter. Similar to the delivery of our education system, the delivery of healthcare in this country can only happen with the support of fantastic people: from our consultants to our GPs to our nurses to our clinicians right across the system. That is why over recent years we have continued to significantly invest not just in our built infrastructure in the expansion of hospitals and bed places but also in the number of people we have working in our health system. It is now higher than it has ever been and the clear objective now, as has been set out very clearly by our Minister for Health this week, is to make sure that with the significant investment that has gone into our health system, the significant investment in and expansion of the number of people working in our service and with a very clear assessment plan through Sláintecare that we have all agreed to, we get the best positive outcomes for those who use our healthcare system, be it in our communities, in our primary care centres, for those who attend our emergency departments or those who attend for scheduled care. That is absolutely the intention of the new Minister for Health, and I commend her work at the early stages in identifying how we can make sure those resources are used in the most appropriate way, how and where there is really good practice taking place across our hospitals and across our communities, and how we can then replicate that, but doing so with our healthcare professionals and with our workers.

As a Government, we will continue to invest in our healthcare system and we will continue to ensure our waiting lists are reducing. There was often a focus on how many people are on lists as opposed to the length of time people are on lists. We need to make sure we have as many people being seen as soon as possible and, where possible, those times reduce as well as the overall numbers. We need to make sure we continue to invest in our cancer care treatments and in other areas where we have seen significant progress. We are a country where people are living much longer and it is not by accident. It is because of the significant investment we are placing in our healthcare system, the advancement in technology, the expansion of overall services and the fact we are investing in new drugs, new technologies and new ways to treat people.

In terms of the Deputy's specific question, the HSE, the head of the HSE and our Minister for Health will ensure every effort is made to work with those working in our health sector to be able to provide the best outcomes possible for the people who need the services and who use the services. We, as a Government, will continue to invest in the overall capital spend but, above all, make sure the money being spent is being spent wisely and we get the best possible outcomes from it.

The Minister has not addressed the question at all. In fact, she has avoided the question. My question was whether her Government would instruct the chief executive officer to withdraw the instruction. Today's edition of The Irish Times reports that her Government instructed the HSE only a few weeks ago - in January of this year - on this very subject. I ask the Minister again to address that question.

Does the Minister accept this instruction from the chief executive is a breach of the framework agreement? Does she even accept it is in breach of good industrial relations practice? This action by the chief executive officer follows hard on the heels of a similar instruction by the management of the Department of Social Protection recently. It begs the question: has the Government now embarked on a policy of confrontation with public servants and their trade unions?

That is terrible.

It is absolutely the case that the HSE must, will and will always work within the relevant framework. That is absolutely the case. It is what we expect from the HSE and what we expect from those working in our public sector. Where issues and challenges arise, there are very clear frameworks and structures that must be adhered to and mechanisms which can be put in place to resolve any outstanding issues or disputes. We absolutely expect and insist, and it is the case, that the HSE works within any framework and works with those in our public sector and health sector and that is what this Government expects.