Today, front-line emergency workers are on strike. Paramedics, advanced paramedics, specialist paramedics, emergency medical technicians, EMTs, and supervisors are all on strike. People who save lives are on the picket line. They stand there as a result of the Government's refusal to resolve long-standing issues relating to pay and conditions and staffing. Ambulance workers do not want to be on strike; they want to be at work helping people and saving lives. The Government, however, forces them to fight for respect, recognition and fair pay. It is to their credit that they will continue to respond to life-threatening situations during this stoppage.

This strike could have been avoided, but the Government has let the situation fester for six years. Back in 2020, an independent report recommended the modernisation of ambulance services. This was to be driven by the upskilling of front-line staff and the delivery of pay that recognised their enhanced roles. Ambulance workers kept their side of the deal. They have taken on advanced training, education and additional responsibilities. They have transformed this service from a transport service to full pre-hospital emergency care.

The Government broke its side of the deal, however. For years now, it has refused to deliver the fair pay ambulance workers deserve. It has left the ambulance system stretched to breaking point. Six years ago, the Government was told that more than 2,500 additional ambulance workers would be needed by this year. Only 500 have been recruited since. Overworked paramedics are under extreme pressure as a result and are struggling to plug the gap caused by acute staff shortages, and patients pay the price. People are left waiting far too long for ambulances. The situation is particularly bad in rural areas, where it can be hundreds of miles to the nearest hospital. People have died after delays in an ambulance getting to them. The Taoiseach is aware of this. I previously raised with him the harrowing death of Stephen Lavelle in Mayo, and there have been others.

I spoke to one paramedic yesterday who told me that the workers have children to feed, bills to pay, rent, mortgages and kids in college in respect of whom they have to pay big fees. She said that a strike was the last thing they wanted but that they had no other option. She also said that the matter could be sorted out at the stroke of a pen if the Minister just looked at the work they do and ensured they are paid fairly. The Minister, Deputy Carroll MacNeill, refuses to intervene, however. Yesterday, at a meeting in Clare, she shocked people when she referred to paramedics and EMTs as ambulance drivers.

Excuse me?

There is the problem in a nutshell. The Government is blind to the expertise and skill of those who save lives every day. It asks ambulance workers to upskill and then refuses to pay for the upskilling properly.

Is iad Fianna Fáil agus Fine Gael atá freagrach do staid na seirbhíse otharchairr inniu. Is teip ghlan é nár chuir siad pá cóir ar fáil d'oibrithe. D'fhág siad iad gan aon rogha. Ní féidir leanúint mar sin. Caithfidh an Rialtas idirghabháil a dhéanamh chun teacht ar réiteach láithreach.

The Government's inaction and refusal to listen has effectively left people without an ambulance service today. What is the Taoiseach going to do about it? So far, he has stood back and acted as a commentator but he is not a commentator; he is the Taoiseach. The striking ambulance workers are right to demand fair pay, proper conditions and safe staffing. When will the Government deliver?

I must say that is a very dishonest portrayal and presentation of the situation. In her heart of hearts, Deputy McDonald must know that. It is very dishonest and a distortion of what has actually happened. Surely she realises that the HSE has been engaged with the trade unions on this issue for quite some time. By the way, for well over two decades now, the State has invested very significantly in the modernisation and transformation of our National Ambulance Service, pre-emergency hospital care and the first responder area. That has been a continuing reality for well over two decades. To be fair to all involved, including those working on the front line, they have participated in that transformation. They sought it. In the early part of the 2000s, I was involved in establishing the Pre-Hospital Emergency Care Council.

With regard to this current dispute, the State has always accepted that pay structures need to be modernised. Previous engagements at the WRC actually concluded in very significant outcomes. In particular, the State offered pay increases of between 3% and 14%, depending on the grade and so on, linked to reform. That was on top of the 9.25% increase under the current public service pay agreement. Union leadership recommended this proposal to their members. How then can the Deputy say that we refused to resolve the issue, forced them to fight and let this fester for six years?

Because you have.

Negotiations happened-----

I am sorry a Cheann Comhairle but the question was put to me.

Negotiations happened and there was an agreed outcome. The two unions recommended the agreement to their members. The members were entitled to vote against it. I accept that point but the Deputy's portrayal of this is clearly dishonest when set against the facts. This is not something we should play politics with. People need the services of first responders. The HSE, the Government and I are all saying that the only way to resolve this is through dialogue and exhausting the well-established industrial relations machinery of the State, whether the WRC or the Labour Court. It is very clear that the HSE remains available to meet and engage with the unions. There will have to be discussions on this.

The investment has been significant. Overall funding has increased 41%, to €285 million, between 2022 and 2025. A 41% increase is significant. Staffing is up 28%, bringing total numbers to 2,655. About €126 million has been invested in the ambulance fleet. A further investment of €20 million is planned for 2026, with additional recruitment expected to bring the total workforce up by a further 263. There are also plans to deliver 21 extra crewed ambulances operating at peak demand, four additional intermediate care vehicles and the continued development of clinical hubs and alternative care pathways.

With regard to reforms, strengthening workforce availability and supporting new models of care, including the expanded use of special paramedics in community and urgent care settings, formed part of what was negotiated. Workforce availability measures related to night-time and weekend services and so on. Critical care retrieval and air ambulance services were also to be expanded. This is all part of what was negotiated with the unions, as was wider geographic and 24-7 coverage. Modern clinical roles were also to be recognised and grading and pay structures were to be updated to reflect the evolution of paramedic and specialist paramedic roles into autonomous, degree-qualified and professionally regulated positions. That was all negotiated by Government in good faith.

If everything is so hunky-dory, why are they on strike? Is the Taoiseach trying to suggest that the ambulance workers are wrong? Is he trying to suggest they are imagining the circumstances they are in? Here is the core dishonesty in the Taoiseach's reply. This situation has dragged on for six years and the Government has demonstrated an absence of good faith and respect.

It asked the paramedics to step up. It asked them to upskill, to retrain and to take on greater responsibilities. They have done all of that. They were happy to do it, because they want to provide the most excellent service they can. For its part, the Government promised recognition, staffing and fair pay and it has not fulfilled that. The Government has left them understaffed, overworked and underpaid. That is why they are on the picket line today. The Minister said the quiet bit out loud. Ambulance drivers is how she described skilled professionals and paramedics.

The Deputy's time is up. The Taoiseach to respond.

The Government has on three occasions taken a confrontational approach to workers-----

Deputy, the Taoiseach to respond.

-----namely with the SNAs, the agricultural contractors and farmers.

Deputy McDonald, your time is up. You are out of order.

It is now taking the same approach with the ambulance workers. When will it act in good faith with these people?

Prepare in time, Deputy.

The Deputy again ignored the core reality that the HSE negotiated this with the unions. The unions recommended what was negotiated to the membership.

And the workers rejected it.

The Deputy has ignored that reality.

And what?

Allow the answer.

That is not festering. That is not delaying. That is not letting things drift. There was substantive agreement which would modernise it even further and draw in a lot more resources and investment, and there is an increase of between 3% and 14% on top of the 9.5% increase. That is substantial by any yardstick in terms of public service pay and increases. However, the Deputy ignores all of that. As far as she is concerned-----

Never mind me, what about the workers?

The Deputy should agree with me in saying that they should get back into talks. It is the only way to do this. There have to be discussions and dialogue.

With no preconditions.

It is the only way we can resolve any disputes-----

Who is going to negotiate if you are going to break promises?

-----in the public service or in the private sector for that matter. We have good industrial relations machinery, and it should be used properly.

It is not working.

There is evidence that it is broken.

I believe it can be-----

Thank you. I call Deputy Bacik.

-----and it can pave a pathway to resolve this dispute.