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Dáil Éireann debate -
Wednesday, 25 May 2022

Vol. 1022 No. 6

Strike Action by the Medical Laboratory Scientists Association: Motion [Private Members]

I move:

That Dáil Éireann:

notes that:

— medical scientists carry out the same work as other scientist colleagues in hospital laboratories, but are paid on average eight per cent less, with fewer promotional opportunities and less support for training and education;

— pay parity with clinical biochemists was awarded in 2001 following the Report of the Expert Group on Medical Laboratory Technician/Technologist Grades and was agreed by the Health Service Executive (HSE) and the Department of Health, however, this was lost due to an unintentional procedural effect of the 2002 benchmarking process;

— there is an ongoing and large national shortage of medical scientists across the public health service due to lesser pay and conditions, insufficient third-level places, poor career structure and limited promotional opportunities, and up to 20 per cent of medical scientist posts in hospitals are vacant;

— the Medical Laboratory Scientists Association (MLSA) warned against the Government's decision in 2006 to outsource testing to the United States, due to the different testing and screening protocols in place and the disconnect between the outsourced screening programme and the clinical services in Ireland for women subsequently diagnosed with cervical cancer, and concern was also expressed about the loss to the State of the skills to provide the service;

— medical scientists are the hidden heroes of the health service, as they are the people who process test samples for Covid-19, who do blood tests, who test urine and stool samples, and they have been under intense pressure during the Covid-19 pandemic;

— there is huge frustration and burn-out of medical scientists because of a severe recruitment and retention problem which has been ignored by the HSE and Department of Health for many years;

— last November, MLSA members voted 98 per cent in favour of taking industrial action in pursuit of their pay parity claim and recruitment for vacant posts; and

— the MLSA planned for strike action in late March/early April 2022, but deferred this action to accept an invitation to meet the Public Sector Agreement Group (PSAG), however, satisfactory progress was not achieved, and industrial action began last week and continues this week;

further notes that:

— inflation has reached seven per cent and pay increases, at least equal to the rate of inflation, are necessary to protect all workers' real incomes;

— the MLSA action follows many rounds of unsuccessful talks with the HSE, Department of Health, Department of Public Expenditure and Reform (DPER) and the PSAG;

— the HSE has told the MLSA that funding for pay parity is a decision for DPER, but DPER has not engaged meaningfully with the MLSA over its pay claim;

— the MLSA has made every effort to avoid the disruption to patients and fellow healthcare workers, but has been left with no alternative but to take this action;

— up to 14,000 outpatient appointments were cancelled on the first day of strike action, with significant impacts on Emergency Departments, the number of patients on trolleys and on general practitioner services;

— the vast majority of MLSA members have been on picket lines at all public voluntary and HSE hospitals during the last week and have received enormous public support for their action; and

— further days of strike action are planned next week on 31st May and 1st-2nd June; and

calls on the Government to:

— ensure that DPER and the HSE agree to the long-standing pay parity award recommended over two decades ago, and immediately implement the average eight per cent pay increase sought by MLSA members;

— begin a recruitment campaign to fill the estimated 20 per cent of medical scientist posts that are currently vacant; and

— publish a plan for the rapid rebuilding of testing capabilities and capacity in the public health service, and to end the outsourcing of testing to the private sector.

I welcome to the Public Gallery some members of the Medical Laboratory Scientists Association members. They are very welcome. It was not too long ago that we were all clapping for them, but the Government has forgotten to clap for them in relation to pay and retention of staff.

It is 21 years since a report of the expert group on medical laboratory technician grades recommended pay parity between medical scientists and clinical biochemists. The HSE and the Department of Health accepted that recommendation 21 years ago. It is an established fact that MLSA members are paid on average 8% less than their colleagues doing the same work. This is only the second time the association has taken industrial action in the 60 years of its existence.

Medical scientists are sometimes the workers we do not see but they play a vital part in our health service. Never was this more evident than during the continued fight against Covid-19. The Minister for Health, Deputy Stephen Donnelly, will share my view in that regard. They are the hidden heroes among front-line staff. They process test samples to make sure medical procedures go ahead. Despite this, one in five medical scientist positions remains vacant. In November last year, 98% of MLSA members voted in favour of industrial action. For medical scientists it feels as though the Government, the HSE, the Department of Health and the Department of Public Expenditure and Reform have all absolved themselves from responsibility on this issue. In addition, our motion calls on the Government to rebuild the testing capacity in the public health service system and end the outsourcing of testing to the private sector.

I put it to the Minister that no set of workers should be in this position of pay discrimination. Yesterday, when most of us were on the picket line, there was a huge outpouring of public support for the workers. The workers did not want to be there. They wanted to be in their workplaces. They were forced, however, by this historical legacy of pay parity injustice. I am aware that the dispute has gone to the Labour Court but the issue must be resolved, not only for the workers themselves, but also for staff retention in the general public health system. We must keep professional staff in the health system. If we do not, we will keep haemorrhaging staff and returning to this issue year after year.

That the situation has been allowed to get this far is pretty shambolic. As I said, a number of months ago we were all clapping for front-line staff in the pandemic. That reflected a genuine feeling for these workers who were going into their workplace each day, sometimes in fear that they might catch the virus or bring it back to their families. These workers were at the front line of Covid-19 as regards testing and capacity. It is shambolic that this was allowed to happen and workers are on strike. I hope the dispute will be resolved very soon. The workers do not want to go back out on strike. They want to be in their workplace. We have gone beyond platitudes. This strike and dispute need to be resolved immediately so the workers can go back to the job and continue to play their vital role in the health service.

I pay tribute to the medical scientists in the Public Gallery and the thousands of medical scientists who are not in the Gallery but back at work again on the front line. It is interesting that our motion and the Government's countermotion refer to the medical scientists as the "hidden heroes" of the health service. No matter what happens, after the vote tonight, the Dáil will officially recognise these workers as hidden heroes. This is what they are, as was demonstrated, above all, during Covid-19. Yesterday, workers in Tallaght hospital told me that during Covid some of them had to work for 14 and 15 days without a day off. That causes incredible pressure and stress. These workers suffer from pay inequality and burnout because a number of positions remain unfilled. They also suffer as a result of a lack of clear and appropriate career progression for the vast majority. While I am sure these workers will welcome being described as hidden heroes officially by the Dáil, I am also sure that, like clapping for the health service generally, they would like this type of rhetorical commitment to be matched by an actual commitment to pay them for the work they do and treat them equally with their colleagues, the biochemists, who do very similar work. This is what they and we want to see.

Obviously, there have been many changes since we announced our plans to introduce the motion. The MLSA and HSE are now in the Labour Court with the strike has been called off for the time being. We hope the political pressure from the strike and from Opposition parties, including People Before Profit, has helped the workers. We hope the motion has also helped them. We intend to keep up the pressure to ensure these workers get the pay equality they deserve. Too often, however, and this has been the experience of the medical scientists again and again, workers have been promised something only for those promises to be forgotten. In this case, the workers were promised talks. The workers are engaging in that very genuinely, but there is a need to keep up the pressure. It is only action and pressure that have brought us this far. It is crucial that we keep up the pressure until the point that pay parity is achieved, and we commit to doing so.

In participating in debates during Leaders' Questions last week and listening to Leaders' Questions again yesterday, as I presume I will do again today, I have been frustrated by the fact that the Government speaks about this as if it was someone else's fault. I presume we will also get this from the Minister today. We will hear words of sympathy and he will speak of "hidden heroes" and so on but that somehow this is someone else's fault and it is not within the Government's gift to resolve this matter right now with a relatively small amount of money and to say these workers deserve pay equality. When we look at the history of this, that is evidently clear. Back in 1997, the then Labour Relations Commission recommended the establishment of an expert group for medical laboratory technicians and technologists as part of a set of proposals to settle their pay claims. The expert group recognised the increasingly scientific and clinical role of the profession and the increased educational requirements for the role. The continuous professional development required for medical scientists came across again when speaking to the workers. The expert group recommended restructuring the profession of medical scientists based on an existing grade in laboratories, namely, that of clinical biochemist. Clinical biochemists work in one section of the laboratory. They provide a service interacting with clinical pathways and furthering scientific influence on patient care. The vision for laboratory medicine was to extend that to all sections.

In 2001, the then Minister for Health and Children, the Taoiseach, Deputy Micheál Martin, received the expert group report proposing pay parity for the medical scientists. It was a promise made to these workers 21 years ago but 21 years on these workers are still paid 8% less, on average, than biochemists. The medical scientists have fulfilled their end of the bargain. They have done everything the report suggested. The HSE and successive Ministers for Health have broken their promises. There can be no more kicking the can down the road. There can be no more washing their hands of the issue. The then Minister for Health is now the Taoiseach. The Government should simply pledge that it will provide the funding for pay parity so this wrong can be righted.

Let us look at the impact of the years of austerity and the damaging public sector agreements on the medical scientist workforce, as well as the impact in terms of the public sector testing capacity. Speaking yesterday, some of the workers said they thought there are currently 25 vacant positions in the Mater Hospital. That is incredible. Across the country, one in five positions is unfilled. That means extra pressure on those in work. Services have reached a level where staffing is no longer sustainable. There is not the throughput to replace those positions, in terms of the number of people who are coming through the three college courses. Then we have a situation of pay inequality. Workers say to me that they want to work, they want to contribute to the public health service but if they want to get better pay, there are jobs they can move to in private industry. These workers would like to contribute to the public health service, but they also have to pay the bills. They have to try to move out of home. They have to try to pay rent and groceries in the context of the cost-of-living crisis, yet medical scientists continue to be paid at least 8% less than promised when the recommendations of the expert group were agreed. All medical scientists ask is to be paid the same as other scientists carrying out identical work side by side with them.

An interesting point emerged yesterday when I was speaking to the workers. It is very clear when on the picket line that it is an overwhelmingly feminised workforce, with about 80% women. Is it an accident that the group of workers to whom they do identical work but are paid 8% less is a workforce that is 50:50 men and women or slightly more men? It raises the question again of the undervaluing of the work of women, which is a consistent feature right across society in terms of care work generally being undervalued and underpaid and a predominantly feminised profession.

Medical scientists were put in an impossible situation. None of them wanted to withdraw their services but they were faced with a situation where again and again the can has been kicked down the road and they had no choice but to engage in action. A sign of their resolve is that 98% of members voted for industrial action, their first since 1969. They deferred it in order to accept an invitation to talks but again satisfactory progress was not achieved and industrial action began and got us to this point.

The Government's counteraction says a lot about the Government. The MLSA has been seeking a breakdown of the numbers of medical scientists' grades for 18 months, but it took this Dáil motion from People Before Profit finally to get the figures from the Government. The total number of medical scientists remains virtually unchanged since 2011 when the core working day was increased. It goes from 8 a.m. to 8 p.m., which is longer than most other grades. Since then, the workload and complexity of work has increased exponentially but, again, the workforce has remained stagnant.

In the amendment, the Government talks about the review by Dr. Colm Henry, but the MLSA was told in March 2021 that the report would be done within three or six months. The working group was only formed in February 2022 with no representatives of the MLSA. The Government cannot be allowed to use such reviews to kick the can down the road or to dodge political responsibility. The workers are very determined. They have very broad public support. They have our unstinting support. I encourage the Government to act to settle this dispute to grant pay equality.

People Before Profit is extremely proud to present this motion in support of medical laboratory scientists. I commend them for taking the action they did not want to take, but felt compelled to take, in order to force the Government to listen to them and engage with them. The only reason we are here debating this is not because of People Before Profit or anybody else, it is because the medical laboratory scientists made the decision to strike after trying every other avenue available to them. They engaged with the WRC, the HSE and others. After waiting for 20 years and being reasonable, they were finally forced to take industrial action. It took that for the media, the Government and politics to listen to them. That is why we are here. If anything positive comes out of the new round of engagement, it will be because of their action.

People need to understand just how important the medical laboratory scientists are to the health of people in this country. It is not just a cliché about being the hidden heroes. It is absolutely critical, as medical science and technology advances - it is advancing all the time - and as the role of testing and the analysis of tests are ever-more important to the accurate diagnosis and treatment of illness. We do not have enough medical laboratory scientists, given that 20% of posts are not filled, or worse in many laboratories. When I was at St. Vincent's Hospital the other day I spoke to people in the various laboratories and in some of them the staffing rate was as low as 50%. That results in an unsafe situation, because people have to work excessive hours to cover for those who are not there. Their workload is increasing all the time, as is the importance of the work they are doing, but it is the same number of people doing it and the posts are not adequately filled. That puts the health and safety of patients - the public - in danger through no fault at all of the medical laboratory scientists, but through the fault of the Government, the HSE and the Department of Health who think because they are hidden nobody really notices what is going on. In a sense, the Government and the HSE have taken advantage of the fact that they are among the hidden heroes. We had all the clapping during Covid but, in reality, these people, who are critical to the functioning and quality of the health service and therefore to the health of people who need that service, were taken for granted.

The medical laboratory scientists have again gone into discussions, but when we look at the Government's amendment, which I strongly recommend the medical laboratory scientists do, frankly it is an insult to the medical laboratory scientists because there is lots of praise but then it states: "there was extensive engagement between health management and the MLSA on the use of the sectoral bargaining fund in the last number of months, however, there are insufficient funds to fully or partially resolve this matter to the satisfaction of the MLSA". That is just not true that there are insufficient funds, but that is what it is about, namely, penny-pinching on the part of the Department of Health and most importantly on the part of the Department of Public Expenditure and Reform, which has been asked repeatedly to engage in this process. Quite honestly, the Taoiseach and Government representatives, in responding to the questions about this dispute, did not own up to their own responsibility in all of this. Some of us were raising this issue before the strike and appealing to the Government to prevent the strike from having to go ahead by listening to, engaging with and responding to the legitimate demands dating back 20 years, where the pay parity sought had already been recommended and the Government just did not listen. It did not engage. The Government did not own up to its own responsibility in all of this, but somehow claims that the very small amount of money that is involved in reality is unavailable when it was just not willing to go there. That is why we are here.

It is the Government's fault that we are here: that the medical laboratory scientists had to go out on the picket lines and that the public health services were impacted in recent days as a result of the strike. The medical laboratory scientists did everything to engage. They deferred strike action earlier this year in order to engage again, but the Government did not listen and it did not respond because it is penny-pinching on giving these people what it was already accepted they deserved, namely, pay parity with the clinical biochemists. The urgency from the point of view of the health service is based on being able to retain these people and prevent them going into the private sector where they can get decent pay. It is the Government's fault. It is still dragging its heels, even in the amendment claiming it does not have the money when it clearly has. That is one thing we learned about Covid.

We were told for years that we did not have the money for this or that but then billions were found, and rightly so, to respond the Covid pandemic, money that we were told previously did not exist. The money does exist. The economy continues to grow. We had an Oxfam report this week showing that the nine billionaires in this country saw their wealth increase by €15 billion during the two years of the pandemic. Some people are doing extremely well but apparently we do not have the money to pay the medical biochemists who are so critical to the quality of our health service. It is absolutely disgraceful.

The Government needs to step up to the mark and stop saying that has to work in tandem with the partnership process. The medical scientists in the MLSA are proof of the failure of the partnership system because they got left behind. For 20 years, they were left behind because of this convoluted benchmarking system involving relativity and so on. The Government must engage with the people themselves. It must value and respect these workers for the work they do for all of us. In a way, they are fighting for many other workers in the health service who are also undervalued. We are understaffed across so many areas of the health service because we do not treat our health workers with the respect they deserve.

I move amendment No.1:

To delete all words after "Dáil Éireann" and substitute the following:

"notes:

— the dedication, professionalism and commitment of all medical scientists throughout the country, and that they have performed a crucial role in the Covid-19 pandemic response;

— that medical scientists are the hidden heroes of the health service, as they are the people who process test samples for Covid-19, who do blood tests, who test urine and stool samples, and they have been under intense pressure during the Covid-19 pandemic;

recognises that:

— the Medical Laboratory Scientists Association (MLSA) have a long-standing concern in relation to the pay and career structure of the medical scientist grade, and they want pay parity between medical scientists and clinical biochemists, as parity of pay with clinical biochemists was given to medical scientists via the Report of the Expert Group on Medical Laboratory Technician/Technologist Grades in 2001, however, the 2002 benchmarking process broke the link between the two grades and, consequently, eliminated the parity;

— medical scientists are an integral part of the provision of laboratory services across many disciplines, and the current medical scientist workforce stands at 2,135 Whole-time Equivalents;

— the Chief Clinical Officer in the Health Service Executive (HSE) has commissioned a review of the strategic direction of laboratory services;

— the HSE plans to undertake a national recruitment campaign for medical scientists, both nationally and internationally, and investment in development posts has been confirmed via the National Service Plan 2022 with circa 160 development posts being recruited in addition to replacement posts;

— there is a clearly defined grade structure with promotional opportunities for medical scientists within the HSE, and since 2019 there has been a six per cent growth in the number of medical scientists, while the number of basic grade medical scientists has reduced since 2019, the number of senior and specialist grade medical scientists has increased;

— the HSE is leading a project to progress advanced practice in the National Health and Social Care Professions, which encompasses developing an overarching framework incorporating all the key factors, including an agreed definition and approach across the professions, core competencies, a planned approach to meeting educational requirements, governance and regulatory considerations which can inform policy development in this area;

— a strategic decision was made, arising from recommendations of the Report by Dr Gabriel Scally in 2018 entitled 'Scoping Inquiry into the CervicalCheck Screening Programme', to develop a National Cervical Screening Laboratory (NCSL), which is due to open in the coming weeks, building capacity and resilience into the public element of the laboratory services required for the National Cervical Screening Programme in Ireland, and will enable the National Screening Service (NSS) to reduce its dependency on third party providers to meet the needs of the CervicalCheck programme;

— the new NCSL is designed to become the principal provider of cervical screening laboratory services for the NSS over time, and it will also serve as a national base for training, education and research purposes, with €20 million having been committed for construction, fitout and staffing of the NCSL, and a workforce plan is currently being developed to address the workforce resilience;

— the current public service pay agreement, Building Momentum - A New Public Service Agreement 2021-2022, includes the process of sectoral bargaining to deal with all outstanding claims across the public sector, and the bargaining fund equates to one per cent of basic pensionable pay;

— there was extensive engagement between health management and the MLSA on the use of the sectoral bargaining fund in the last number of months, however, there are insufficient funds to fully or partially resolve this matter to the satisfaction of the MLSA; and

— as this matter could not be resolved, it was referred to the Public Sector Agreement Group (PSAG), the dispute resolution mechanism set up under Building Momentum - A New Public Service Agreement 2021-2022, twice since January 2022, and at the latest meeting of this group on the 11th May, PSAG recommended that the matter be immediately referred to the Workplace Relations Commission (WRC) and that industrial peace be maintained in the meantime, however, while the MLSA agreed to reconvene at the WRC, they were not willing to lift their strike action; and

calls on all sides to use the established dispute resolution mechanisms of the State, including the WRC and the Labour Court, and to suspend industrial action while this process is ongoing."

First, I join colleagues in acknowledging and paying tribute to the dedication, professionalism and commitment of all medical scientists around the country. Medical scientists perform a valued and vital role in our health service. Their testing of samples during the Covid-19 pandemic was, and still is, a critical and essential part of our response to the pandemic. Their professionalism and dedication must be acknowledged. The daily testing of samples is crucial to the running of our hospitals, community healthcare organisations, CHOs, and general practitioner, GP, services in every part of the country. This was very evident on 18 May when medical scientists engaged in a day of industrial action and their presence in clinical settings across the country was suspended. While derogations were granted to allow for the continuation of dialysis and some cancer services, thousands of other inpatient and day-case elective procedures and hospital outpatient appointments were cancelled with a direct impact on patients around the country.

I thank the Deputies for tabling this motion and raising this matter in the House but I urge the House to support the Government's amendment. I am very aware of the ongoing and long-standing claim for pay parity between medical scientists and clinical biochemists. On that basis, health management, in conjunction with the Department of Public Expenditure and Reform, has been engaging with the MLSA at the Workplace Relations Commission, WRC, under the terms of the current public service agreement, Building Momentum. The MLSA has been clear that medical scientists and clinical biochemists should have pay parity due to the fact that they both carry out similar work, roles and functions.

Parity of pay with clinical biochemists was given to medical scientists via the expert group report in respect of medical scientists in 2000. However, the first benchmarking process in 2002 broke the link between the two grades and, consequently, eliminated that parity. As this is a long-standing claim, it is understandable that the MLSA seeks to raise it as an issue to be addressed under Building Momentum. As colleagues will be aware, Building Momentum includes the process of sectoral bargaining to deal with all outstanding commitments, recommendations, awards and claims across the public sector. It must be acknowledged that the MLSA voted against Building Momentum but as a member of the Irish Congress of Trade Unions, ICTU, it is bound by the terms of this agreement for the remainder of its lifetime. As set out under section 2.1.2 of Building Momentum, the sectoral bargaining fund equates to 1% of basic pay for each bargaining unit set up under the agreement. Therefore, under Building Momentum, sectoral bargaining is the mechanism through which the MLSA can advance its claim for pay parity. The MLSA requested, and was facilitated with, its own bargaining unit in the sectoral bargaining process to progress this claim.

On the not unreasonable interpretation Deputy Boyd Barrett has taken of "insufficient funds", I must be clear that the Government's amendment does not suggest that within the Exchequer there are insufficient funds. Obviously, that would not be true. The point the Government is making is that within the parameters of Building Momentum there is not the level of flexibility that would be required to fully address pay parity. That is why these talks are needed and why they have been complex. It is important to provide clarity to the House and, more important, to the people affected, the workers themselves. The point we are making is that within Building Momentum, the 1% increase is insufficient. That agreement does not carry sufficient flexibility for full pay parity of 8% and hence, we need these talks.

As previously mentioned, the MLSA and health management have been engaged in talks in recent months with the aim of finding a way to advance the claim through the sectoral bargaining process. The HSE has provided the MLSA with the cost of its outstanding claim for pay parity with clinical biochemists and it is substantially more than the bargaining fund available, which is the point made in our amendment. Several options for moving medical scientists to the biochemist scale were explored during these talks, including some that would partially resolve the claim within the agreement. To date, no proposal has been identified which satisfactorily resolves the claim within the terms set out under Building Momentum. Any options that were put on the table have been taken seriously and respectfully by both sides and were discussed, costed and verified in good faith by the HSE and the Departments of Health and Public Expenditure and Reform.

Section 5 of Building Momentum sets out the principles regarding resolution of disputes and ensuring industrial peace is maintained within the lifetime of the agreement. Should an issue remain unresolved following discussions at local level, it can be referred to the public service agreement group. This group is the oversight body for Building Momentum and is comprised of trade union and Civil Service representatives with an independent chair. The group recommended that the matter we are discussing today be immediately referred to the WRC and that industrial peace be maintained in the meantime. Following this recommendation, health management met the MLSA under the auspices of the WRC on 17 May, but, unfortunately, no resolution was reached. While the MLSA agreed to engage at the WRC, it did not lift its industrial action. We all recognise the significant disruption caused by these strike days and the impact they have had on patients. I recognise unconditionally that not one medical scientist who has stood on a picket line wants to be there and there is not one medical scientist who does not understand the implications of being there. I fully appreciate and acknowledge that medical scientists are doing this as a last resort. They have been engaging for two decades now on this issue.

The Government also acknowledges that current price pressures are a source of concern for public service workers, including medical scientists, and right across the board. Nevertheless, Government must manage the public finances in a way that addresses the multiple challenges facing the economy and the Exchequer, including the impact of rising inflation and the conflict in Ukraine. Since December 2021, almost €560 million worth of additional expenditure measures have been introduced to support citizens and businesses with increased costs, including an energy credit payment, an increase in the fuel allowance, a reduction in the threshold for the drugs payment scheme and a temporary 20% reduction in public service transport fares.

On 14 March, ICTU advised the Minister for Public Expenditure and Reform of its intention to seek a review of Building Momentum. The Minister has directed his officials to arrange entering into exploratory discussions with public service unions and representative staff associations on an agreed way forward on public service pay issues. These will be complex discussions against a difficult backdrop of the hangover effects of Covid, the disruptions, the increase in demand and its impact on consumer price inflation, the war in Ukraine and many other international issues that have been driving up prices. Discussions must be cognisant of the multiple challenges Ireland is currently facing, including increases in prices right across the board.

As set out in the Government amendment to this motion, the Department of Health must operate within the public service agreement, and all of the State's industrial relations institutions must be used to prevent further disruption to patients and to find an acceptable solution to this matter for all sides. I was pleased to hear the parties have accepted an invitation from the Labour Court for exploratory engagement. I believe the parties will be engaging in the coming hours. It is for the court to establish whether and how it might assist the parties in finding a resolution to the matters in dispute. I very much welcome the decision by the MLSA to lift its strike action and to attend this Labour Court engagement.

Health management, in conjunction with the Department of Public Expenditure and Reform, is committed to continuing to engage with the MLSA while acknowledging that all parties must continue to adhere to the provisions of the public service agreements. We will continue to make every effort to find a resolution to this issue.

I thank the Deputies again for tabling the motion. It is an important topic and it has been going on for too long. We can all accept that. We all understand the source of the claim for pay parity with the biochemists. A process is now under way. I hope we all agree that the best way for this to be resolved is through the established dispute resolution mechanisms. I very much welcome all sides going to the Labour Court today. It is my sincere hope an agreement can be found through the mechanisms of the Labour Court, the Workplace Relations Commission, if necessary, and through formal and informal talks. I hope an outcome that is satisfactory to all sides can be found. We all know strike action has a significant impact on patients. I reiterate that the work of the medical scientists is highly valued and acknowledged, and we want to find a settlement that works for all sides.

What is this dispute about? It is about equal pay for equal work. Medical scientists and biochemists do the same work in the same laboratories in the same public hospitals. More than 20 years ago, it was agreed there would be pay parity and, more than 20 years on, there is still no pay parity. Medical scientists are paid at least 8% less.

In the National Health Service in the UK, there is a grade of clinical scientist. It is a natural career progression for medical scientists to move to the grade of clinical scientist and to develop their career path. That is not available to medical scientists here although it could and should be. That is an important part of the issues in this dispute. It is no wonder there is a brain drain to the private sector, that 20% of posts have been left unfilled and that there has been an industrial dispute. The dispute has caused disruption, which is entirely the responsibility of those who have refused to deliver on pay parity, that is, the Government.

I heard the point the Minister made about his definition of insufficient funds and Building Momentum. However, people cannot help but look at this situation and see that the Government does not believe there are insufficient funds to give developers subsidies of up to €140,000 for building apartments. The Minister for Defence does not believe there are insufficient funds to increase defence funding in this State by up to €1 billion, primarily spending it on extra guns and weapons.

The injustice that has been done to these workers is illustrated well by the fact that some other laboratory workers, when they receive a promotion to the grade of medical scientist, do not receive a pay increase but instead receive a pay cut. That is a bizarre situation. The Tánaiste receives a salary of €195,000 per annum. The Taoiseach receives a salary of €211,000 per annum. How would a Tánaiste feel if he or she were to receive a promotion to the post of Taoiseach and receive a pay cut? Of course that would never happen. The political establishment would never allow it to be the case. It is a double standard. It is allowed to happen in our public hospitals.

The example I just gave illustrates another part of the problem. Government politicians, who pay themselves enormous salaries, cannot begin to understand the problems of working people who are forced to live on a fraction of those wages. Many of the medical scientists who have taken to the picket lines last week and this week spend a big proportion of their salaries on paying rent to put a roof over their heads. Some of them to whom I spoke cannot even afford to do that. They have been to college and got degrees, and some have masters degrees, and yet some of them are still forced to live at home with their parents. It is a different world from the world of the Ministers who have perpetuated this injustice.

At least 70% of the State's 2,100 medical scientists are women. Is there a connection between this fact and the fact an injustice has taken place here? It is a fact there has not been equal pay for equal work for decades. The Minister, of course, will deny it but I cannot help thinking that such an injustice might not have been left to fester for quite so long if the majority of the workforce were not female. There is a long history of second-class citizenship for women in our health services. They have been treated as second-class citizens. I wonder is that being reflected, to some extent, in this situation.

The role performed by medical scientists is vital to our public health services. Never was this seen more clearly than in the course of the Covid-19 pandemic when they played a key role in the roll-out and implementation of the testing programme. This country could not have got through the pandemic in the way it did if not for these workers. That makes it all the more scandalous that they are being treated the way the Government is treating them. Their vital role is also shown by the strike. Without their labour, the public health service slowed to a virtual standstill last week and again yesterday. These workers got a taste of their own power on the picket lines. If the Labour Court does not deliver justice and pay parity, it is power that can and should be used again, if necessary. I hope the Minister is fully aware of that.

Reference has been made to Building Momentum. There are different kinds of momentum. The Minister and the political establishment are aware of the fact this strike had built momentum. There was unity and solidarity on the picket lines. There was considerable support across the board from fellow workers in the hospitals. There was massive support from the public. You only had to stand on a picket line and listen to the sound of the horns blaring as cars passed. I have no doubt, despite all the sweet-talking we have heard today, that there are some in the Government and in the Department of Health who hope the Labour Court talks might be used to slow or break the momentum of this strike. We have seen it before. The Government is the master of this approach. It wants to spin out the dispute for weeks and weeks, letting the momentum of the strike fall off. The workers are then back to square one with perhaps a tiny bit more. They are left to start all over again. I say clearly to the workers in the Gallery and to the workers in the MLSA that if the strategy of the Department of Health and Government is to try to break the momentum of the strike by spinning out these talks for weeks and weeks, do not let them do it. The workers absolutely should go before the Labour Court to talk, negotiate and engage. They should see if justice and pay parity are on offer. However, if they are not on offer relatively quickly and the Government tries to spin out talks, I say to those workers not to let the Government break the momentum of the strike. The workers have power. It was used last week and this week, and can be used again. The Minister needs to be clear about that.

Every worker in this country deserves a pay increase. I hope a victory for the medical scientists will spur other workers to press for cost-of-living pay increases. The trade union movement as a whole must get behind the medical scientists and see a victory for them as a signal that justice for all workers through the protection of living standards in this inflation crisis needs to be fought for now. I will conclude by saying, victory to the medical scientists, equal pay for equal work, pay parity now, an injury to one is an injury to all, and a victory for the medical scientists will be a victory for every worker in this country.

I commend People Before Profit on tabling this motion. I welcome the medical scientists who are in the Public Gallery. I too was on the picket line yesterday with my colleague Deputy O'Rourke at St. James's Hospital, and many of my colleagues have been on picket lines throughout the State over recent weeks. We know this is a very long-standing issue that needs to be resolved.

I read the Minister's speech very carefully - we got a copy as he was making it - but it does not really tell us anything we do not know. He said he was aware of the ongoing, important and long-standing claims for pay parity. He acknowledged this goes back to the year 2000 and that pay parity was achieved then but was broken in 2001. He said that sectoral bargaining through Building Momentum is the way to resolve this issue. He went on to say medical scientists have been given their own bargaining unit and then outlined the constraint in that process, which is a 1% pay increase that we know will not achieve the objective of pay parity. He talked about engagement in talks over recent months. In fact, as we know, it goes back more than 20 years. He said several options have been put on the table over the past while. I do not know what those options are. Have any of them gone beyond 1%? That negotiation is ongoing between the organisations. He then went on to say "the parties have accepted an invitation from the Labour Court [yesterday] for exploratory engagement". We are far beyond "exploratory engagement". We know what the issues are. We do not need more exploratory talks. We need the HSE and the Department of Public Expenditure and Reform to come to the table with real, practical proposals that will resolve this issue.

I do not believe medical scientists will back down, nor should they. The principle of pay parity is something I hope the Minister supports and can resolve. I agree with previous speakers, and I have listened to the Taoiseach and others from the Government speak on this issue, that they have been almost Pontius Pilate-like in washing their hands of responsibility by stating this is something the industrial relations machinery of the State alone can resolve. Of course, they are the bodies that bring people together, but the paymaster here is the Government. It has the ability to resolve this issue, as does the Minister. They need to be creative, and if sectoral bargaining is not going to be the way to achieve the 8% pay parity, which is what is needed, they will have to look at options such as career pathways and recognition of the medical scientists grade, because this is not simply a pay increase issue but one of pay parity, which is different issue from my perspective. The Minister will have to be creative.

I very much hope, as the previous speaker said, these talks are not kicking the can down the road. We need this issue resolved. We all know how fundamentally important medical scientists are to every facet of healthcare. Consultants and doctors cannot do what they do without the support of medical scientists. I ask the Minister to resolve this issue as quickly as he can.

I thank the Deputies who tabled this motion because it gives us a very welcome opportunity. I also welcome the medical scientists who are in the Gallery watching this and those who are tuned in. I pay tribute to them for their patience and determination. It is patience because, as we know, this issue has been going on for decades. When an industrial dispute can be characterised in terms of decades, that shows the people with responsibility for its resolution have not been stepping up to the plate.

I well recall that in 2006 medical scientists were among the first to sign up for extended working hours under Towards 2016. There has been a lot of talk about working hours in the health service but when what might be called reform or more time spent away from families, whatever words you want to put on it, was proposed, they signed up to it. As we know, the Government of which the Minister's party was a part walked away from that wage agreement. It got the productivity and trousered that, but was off when it came to giving pay increases in response to that. The flexibility the medical scientists have shown is to be admired. Like my colleagues, I was on the picket line with them this week and last week. They will tell you about how the job, the hours, the demands and the pressures have changed. The only thing that has not changed is the pay. The only thing that has substantially changed is that the inequality between those with whom they seek parity is getting worse.

This dispute is fairly easy to resolve. I get a little concerned when I hear people are going to the Labour Court for exploratory talks. I venture to suggest there has been quite a substantial amount of talking about an issue that is relatively straightforward. I have some experience in industrial relations and sometimes things are genuinely very complicated but sometimes they are just about a straightforward pay equality claim. We need to separate the two. I am very hopeful a resolution will come out of the Labour Court. The person who is our current Tánaiste, when he was campaigning for the leadership of his party, cited that in some instances he wanted Labour Court recommendations to be made compulsory. I am very relieved he has not quite got around to that. We know it has not gone away. As I said at the time, I know a good, old-fashioned, Thatcherite, no-strike clause when I see one. That is in fact what it was.

The good news for the MLSA and its members is a recommendation will, it is hoped, come from the Labour Court. At that stage, they will have a chance to have their say because it will not be down to us as politicians to interfere in that part of the process. They will have a chance to ballot on whatever that recommendation is, to decide if it satisfies their very long-standing claim and if is something they can live with. At that stage, should they reject that recommendation, they know they will be back onto the picket line. I know from talking to them that if that is the place they have to go, they will, but they do not want to.

It is a tactic of the Government that has caused this delay and this dispute to be protracted. The Minister cannot walk into this Chamber and say this is a desperate situation that has been going on for 20 years, as if successive governments have not had a hand in this. It is a tactic. It was a tactic when I was on my tools, and it is a tactic now, to only send people to the debating or discussion forum of the Workplace Relations Commission, WRC, or the Labour Relations Commission as was, who do not have the capacity to resolve the dispute. People are sitting across the table with officials from the Minister's Department, who I know have done their best, and officials from the HSE who want to resolve it. They do not want to be running in and out. They have other work to be doing, as have the medical scientists. They are saying they want this resolved but then everyone looks around and says, "Who is here with the chequebook? Nobody." Everybody then goes home. It is an absolute tactic because it could not be happening as often as it is unless it was.

I sincerely hope the message has come from the Government, not specifically from the Minister's Department, but from the Department of Public Expenditure and Reform, that the resources will be there. Nobody is disputing this will require resources to settle. There is no point in people going to the Labour Court if the resources are not going to be there because otherwise we will just be back in the Chamber in a couple of weeks' time having the same debate. That does not do anyone any favours. It does not do the people in the Gallery, patients and the process of industrial relations any favours. In fact, it is disrespectful to the process of industrial relations to come to the Chamber, as the Minister, the Taoiseach and others have done, and say we must leave this up to the industrial relations mechanisms of the State, as if it is some sort of magic Aladdin's cave where we go in and come out with a resolution. There is no point in going to the WRC or any negotiating forum unless people are sitting across the table eyeballing the person with the chequebook. It is a waste of everybody's time otherwise.

I very much hope the Minister will use his good offices to prevail on the Minister for Public Expenditure and Reform to ensure this dispute is resolved and make that clear by ensuring officials from all relevant Departments and agencies are represented at the Labour Court, so the message goes out the Government is minded to settle this dispute and does not want to see medical scientists back on the picket line.

I have been involved in more than one dispute, and the Minister should believe me when I say the members watch these disputes very closely. They watch the body language and see what it means for a potential resolution to their own disputes. They see when the Government is serious and when it plays for time. With the greatest of respect, 20 years is enough playing for time. I sincerely hope the tactic, which is what it is, of sending only half a team to ensure a dispute is not resolved will be suspended and that real and genuine efforts will be made to settle this long-running dispute, which we all want to see settled.

I thank People Before Profit-Solidarity for tabling the motion and commend the MLSA executive and officials on the leadership they have shown. We had some of the team in the audiovisual room last Tuesday, before the first day of strike action. Most of all, I commend medical scientists from right around the country on the resolve they have shown. Others have talked about the fundamental issues at play here, including pay parity, the 20-year claim and the expert review. The present Taoiseach was the Minister responsible at the time. Others have pointed to the addition of insult to injury among laboratory aides. I do not think there is a medical scientist in the country who would deny laboratory aides the wage they get. It is a recognition of the valuable contribution they make. It is, however, a further indication of the contradiction within the system that the people to whom they are answerable get paid less than them.

I welcome the fact there is an engagement at the Labour Court but, as my colleagues have said, it must be a meaningful one and must come with an understanding of the issues and a willingness and an ability to find solutions. I implore the Minister to engage with the Minister, Deputy McGrath, and the Department of Public Expenditure and Reform to find those solutions and to be creative. There is huge opportunity to be creative here and it needs to extend beyond 1%.

I will touch on two major issues. I worked as a medical scientist and, looking now from the outside in, I wish to reflect on my experience of that profession and to touch on two issues: dedication and excellence.

Many Members have talked about dedication. This is a 24-7, 365-day service, including Christmas Day, New Year's Day and bank holidays, whether 3 o'clock in the morning or 3 o'clock in the evening, and harsh winters, including those of 2013 and 2017. Some colleagues mentioned staff working 15 days straight during Covid. At times, including during Storm Ophelia, medical scientists have not left the building for up to a week without thinking twice about it, such is their level of dedication. It is mainly women who do this work, including during Covid. Where was the support for childcare at that time? It was not there. That was another example. When I started work as a medical scientist, some of my colleagues had lived with the marriage bar. I think it is no coincidence we are in this position with a profession dominated by women.

I wish to touch on the issue of excellence. We do not see it in very many places. In medical science there is a culture of excellence driven by the staff's dedication and commitment, which has not been for reward, because the Government has introduced a glass ceiling for them. As colleagues have said, they are an essential part of practically every clinical decision. They have degrees, including masters degrees. Some have multiple masters degrees, PhDs, FRCPaths and MRCPaths. The internal journal is called Converse. I remember reading an article in it about colleagues who had done MRCPaths and PhDs and who talked about their experience. They obtained those qualifications for personal development and to contribute to and to improve the profession, not for personal gain, because the Government has introduced a glass ceiling. There is huge opportunity there in respect of advance practice if the Government has the creativity to realise that opportunity.

This is pioneering science, not off-the-shelf stuff. In many cases staff build these assays from the ground up. We have seen during Covid-19, in practically every lab, staff do their own basic science, pure science, building the assays, including the most high-tech of molecular science, from the ground up. These are fully accredited laboratories. It was the Joint Commission when I started; now it is INAB 15189. There is an obligation on transfusion labs. The other labs do it because they want to maintain the highest standards. The recruitment and retention crisis the Government has created is putting those standards under pressure. There is a spectacular opportunity here. These are the best of public services. We should be putting them up in lights and rewarding them, and that is what the Minister needs to do.

Gabhaim buíochas leis na Teachtaí as an deis an rún fíorthábhachtach seo a chur os comhair na Dála. Déileálann sé le rud an-mhífhéaráilte atá ag dul ar aghaidh le blianta fada. I thank the Deputies on my right for bringing forward this very important motion. I also welcome the medical scientists who are here today and who are witnessing this discussion. I commend them on their strength and on standing up for what is right. I hope the Minister and his Government will also stand up for what is right.

As the Minister will know, the MLSA represents 2,100 medical scientists. Something the Taoiseach said struck me yesterday during Leaders' Questions, so I will give a little background to this. Prior to this industrial action, the MLSA had just one official strike in its 61 years of existence. That was back in 1968, a year of great global upheaval. There was the Prague Spring, student protests all over the world and so on. The limited action the MLSA took that year was therefore hardly out of step with mainstream current events. The Government of the day was a Fianna Fáil one with Jack Lynch as Taoiseach, and a fair deal was reached with the union. I hope we will see a fair deal and a recognition of these workers again now.

I wish to comment on something the Taoiseach said yesterday, which was that the medical scientists should engage in the process. It is very clear the medical scientists have always been willing to engage in every single process and that they have been extremely patient and conciliatory, but they have been left with no other option. It is now more than two decades since the report of the expert group on medical laboratory technician and technologist grades. As part of that, the Health Service Executive and the Department of Health agreed to recommend pay parity between biochemists and medical scientists, but that was undone only months after it seemingly being resolved. The first public service benchmarking process ended up tying those grades to different markers, so there has been ample time to sort this and it is extremely unfair. As others have mentioned, medical scientists find themselves working in medical laboratories alongside clinical biochemists and medical laboratory aides, yet such a significant pay differential exists despite them conducting similar work. It is an incredible source of frustration to them, as it should be, that they are not getting that same wage or a higher one. I could ask the Minister how that is fair. It is completely unfair. I wonder how it was ever allowed to come to pass. Medical scientists essentially perform the same function as clinical biochemists but have completely different pay scales and are paid on average 8% less for the work they do. They also have fewer career development opportunities and less support for education and training. We know that workers are facing burnout.

One thing that has been quite interesting in the media coverage over recent days - it is found whenever there is strike action - is that everybody suddenly has come out and said we cannot do anything if we do not have these workers. That is why those workers are there. They perform an extremely important function. Those of us who, unlike an Teachta O'Rourke, did not come from this background might not know all the intricacies of the work they have been doing. It is, however, very clear from the media coverage we have heard over recent days that people from various hospitals have come out and talked about the extremely important work being done. They have been, as I said, extremely patient but they need to be listened to at this point.

It is incredibly frustrating. They have met with the Department of Health but the Department of Public Expenditure and Reform has not engaged. As my colleague Deputy O'Reilly said, you need to make sure that the finances are there. There has to be action from the Government here and now. We know the extremely important work being done by the medical scientists. We need to ensure the money is there to make sure they get fair pay and equity. I urge the Minister to speak to his Cabinet colleagues and put the pressure on the Government to make sure there is fairness here. We know the incredible work that has been done. We all stood up and clapped for front-line workers during the pandemic. Now we need to follow that up with action.

I thank People Before Profit-Solidarity for bringing forward this debate. It was submitted last week. It could have been resolved last Thursday or Friday and this matter might have been recent history but the proposers knew that would not be the case, as we all did. Even if it had been resolved, the proposers know that brining it forward also relates to wider issues in how the State engages with workers. I acknowledge that and I welcome the workers to the Visitors Gallery today.

As others have noted, the dispute is not complex. In the context of industrial relations this case is relatively simple. We have said it has been going on for 20 years but it has been going on for much longer because what happened in 2021 did not just drop out of the sky. It was the result of more than 20 years of campaigning. When I was on the picket yesterday, I spoke to medical scientists who work in Temple Street hospital. They said that when they came out of Kevin Street college, the union was fighting for two things: the move to the Mater hospital and pay parity with the biochemists. That was in the 1970s. They came out of Kevin Street with their bench experience while the biochemists came out with their degrees, and that is where this all began. This goes back many decades. It is not just 20 years. That is obviously a huge amount of time but this goes back almost 50 years.

The Taoiseach said a number of times yesterday, in a rather patronising way, that the union and workers should engage with the full apparatus of labour relations machinery in the State. That is what they have been doing for years. They have been the good girls and boys in class. They have been engaging through their union with the Government for many years and it has got them nowhere until some months ago when they pulled back from industrial action to go back to the WRC.

Industrial action has been suspended and it gives us a moment's pause to speak about what has got us here rather than doing so in the white heat of the picket. Deputy O'Rourke's experience as a medical scientist is important to bring to the Dáil. The Republic has around 32,600 clinical scientists working in 43 publicly funded hospital labs. The services provided by medical scientists are vital to the functioning of the healthcare service, from blood transfusion and transplantation science to medical genetics, molecular diagnostics, haematology, microbiology, virology, cellular pathology, point-of-care testing, immunology, endocrinology and clinical chemistry. As one medical scientist told me on the picket line at Beaumont Hospital last week, they do a lot more than just Covid testing. Covid was a double-edged sword. Yes, it put a lot of the spotlight on the vital role they play, but it is only a small fraction of the vast array of highly complex functions they perform and the unseen front line of our health service. Medical scientists are highly educated and skilled individuals with level 8 degrees and have had specific multidisciplinary medical training to work in a clinical diagnostic laboratory setting. Over 70% of medical scientists have masters degrees or other postgraduate qualifications, including PhDs. They work alongside clinical scientists and biochemists. Biochemists make up 2% of Ireland's clinical scientists and medical scientists 98%. The Association of Clinical Biochemists in Ireland has had far more success in developing and delivering advanced and extended practice roles for the 2% of clinical scientists in Irish laboratories whom it represents than has its counterpart body which represents the remaining 98% of clinical scientists in this country.

Entry level criteria are similar for both professions, although medical scientists must complete one of three Academy of Clinical Sciences and Laboratory Medicine, ASCLM, approved biomedical science degrees where the syllabus is tailored toward the needs of a clinical laboratory to be considered qualified while biochemists can enter their profession with any science degree and little bench experience. Crucial to this dispute is that medical scientists and biochemists have markedly different career pathways, markedly different opportunities for career progression, markedly different reporting structures and markedly different pay scales despite having very similar responsibilities and despite there being no difference in the quality or scope of services delivered by laboratories that employ biochemists and those that do not.

At the top of his or her profession a publicly employed medical scientist can expect to earn only 60% of the wage of a publicly employed biochemist at the top of his or her profession. Biochemists across all grades are better paid and have far more opportunities for progression than their medical scientist counterparts. Over a 40-year career in the public service, a biochemist can expect to out-earn a medical scientist by as much as €1.5 million. The markedly different conditions of employment between medical scientists and biochemists are discriminatory. Medical scientists seek a unified career structure, equal opportunities for career advancement, equal pay for equal levels of responsibility, and equal pay for equal work. Put simply, they seek equality.

In addition to the disparity with their clinical scientist colleagues, medical scientists now earn a lower starting wage than colleagues who report to them. Medical scientists will stress the importance of lab aides to the health service. This is another anomaly that needs to be resolved.

Like many others, I want to highlight the work of medical scientists in responding to the Covid-19 pandemic and providing new diagnostic services for a new virus expertly, rapidly and on a nationwide basis during a global pandemic. As I said, it shone an overdue spotlight on the work that is done by medical scientists and its excellence, the word used by Deputy O'Rourke.

Yesterday the Taoiseach spoke grandly of the plans for expanding the number of medical scientists we have and a recruitment plan, but it is not an expansion but rather a refilling of staff. It is replacement of staff because we are struggling to retain medical scientists in publicly funded laboratories throughout the country. There are more vacancies in labs than there are graduates to fill them. That has been the case for some time. It does not take a lot to realise there has to be a breaking point. That has now been reached. The two days of strike action and today's suspended industrial action are testament to that.

The shortage of staff has led to outsourcing much of our testing capacity in the country to the US and the UK. We only have to look at the cervical cancer scandal to see what happens when we outsource such a vital service away from the excellence we know and trust in this country to somewhere where we do not have the same levels of trust. People in this country have been let down to the extent of losing their lives as a result. That is not an exaggeration or hyperbole. It is a fact.

I will conclude by expressing my admiration for the resolve of the medical scientists. Anyone who has spoken to them over the days of their industrial action so far can see there is a continuity, steeliness and determination not only to see this through but to get back to work. However, they will not get back to work unless there is meaningful engagement with the Department of Public Expenditure and Reform at the table and they can get what they deserve and is their right, which is true equality.

I thank People Before Profit-Solidarity for bringing forward the motion. It is very timely and important. It deals with a group of people who are absolutely critical to our health service. They work behind the scenes in a very quiet way. In many ways they have been too quiet in recent years. They have now reached breaking point.

It is important to note at the start that since the inclusion of the motion on the Dáil schedule, strike action for today was averted with the intervention of the Labour Court. That is a very positive development. However, it should never have come to this. Medical scientists have been extremely patient and have exhausted all avenues to resolve this dispute before resorting to industrial action.

This is a failure of the Government in my view.

I met a substantial number of medical scientists at Beaumont hospital yesterday. I got a sense of their utter frustration and annoyance with the way they have been treated. They are highly qualified people who want to work in the public health system but because of the disrespect that has been shown by the Government over many years, they are finding it increasingly difficult to do that. It is becoming a much more difficult job owing to serious recruitment problems. There is also a very deep sense of disrespect on the part of medical scientists. We should not be treating any of our healthcare workers like that.

It has been over two decades since an expert group report recommended pay parity for medical scientists with their colleagues in biochemistry and yet their pay remains approximately 8% less. It is difficult to fathom how successive governments have failed to implement this recommendation from 20 years ago when the current Taoiseach was Minister for Health and Children. That recommendation was accepted by the Department of Health and the HSE. It is even more difficult to fathom how a procedural error in 2002 seems to be the cause of this long-standing dispute.

Once again, it would appear that an unnecessary level of bureaucracy was the stumbling block. We have had more than 20 years to correct this situation, but successive Ministers have sat on their hands and allowed this issue to reach a crisis point. This strike action has not only brought this dispute to public attention but it has also shown us the importance of medical scientists. They are essential front-line workers and without them the delicate fabric of our health service would fall apart. Why is that? It is because the health service operates on the basis that if you produce it, they will test it. That is a critical role that is played and a key cog in the operation of the public health service.

Routine tests such as those for Covid and those of blood and urine samples, to name but a few, cannot be processed without them, in effect causing havoc in public hospitals, emergency departments and GP surgeries throughout the country. As a result of one day's strike action, approximately 14,000 procedures were cancelled in hospitals last week. Of course, much more work in the health service was delayed, deferred or could not happen as a result of the strike action. While emergency cover was offered, this only amounted to out-of-hours or Christmas Day levels of service. This was nowhere near the level needed to keep routine hospital and GP services even ticking over, never mind tackling our unacceptably long waiting lists.

Last week the HSE chief executive, Paul Reid, told the Joint Committee on Health that the plans to cut these waiting lists by one fifth this year were under challenge. One of the reasons highlighted was legacy issues and this pay dispute is undoubtedly one of those legacy issues. In fact, it is a microcosm of one of the root problems in our health service - the difficulties with recruitment and retention.

People are fleeing the public health service, or refusing to enter it, in the pursuit of better pay, improved working conditions and better work-life balance. This is a common thread across healthcare professions from nurses to consultants to medical scientists and so many others. Unless we address these concerns which have reached a tipping point because of Covid, we will continue to face staff shortages and even industrial action. We know that 20% of medical scientists' posts are unfilled in public hospitals. For example, ten medical scientists left last year and they have still not been replaced. Who must shoulder that burden? It is the remaining medical scientists as is so often the case but there are difficulties with recruitment. It is already a pressurised job but where posts remain unfilled that stress and pressure only increases.

To add insult to injury, laboratory aides who report to medical scientists earn more than them meaning that people take a pay cut for getting a promotion. You simply could not make it up. Is it any wonder that our medical science graduates are bypassing the public health system and being swallowed up by the private sector, particularly in the pharmaceutical sector? Of course, it is patients who suffer most from this brain drain. The Government along with every political party signed up to Sláintecare, which is all about enhancing patient experience in a strong public health system with well-respected public health workers throughout the system. However, this will never become a reality unless we deal with the deterioration in job quality and pay disparity in healthcare professionals.

As we speak, tens of thousands of patients are anxiously awaiting new dates for cancelled appointments with many having already waited months or even years in some cases. The HSE and the Departments of Health and Public Expenditure and Reform must put a meaningful proposal on the table to prevent a repeat of this. While I am glad to see that the apparatus of the State is being utilised, a sincere and meaningful proposal must be put on the table to address medical scientists' legitimate concerns; it cannot be more of the same. Without this it is difficult to see how further strike action can be averted and this would have very far-reaching implications for patients and the public health system at large.

How can the Government ever expect to honour its commitments to repatriate CervicalCheck samples if it cannot recruit or retain staff? It is ludicrous that we are still outsourcing to private laboratories at enormous financial cost and potential risk to patients while doing little to attract the staff needed to build up our own capacity. This, along with the overriding need of patients, must be the impetus for an early resolution. Positive platitudes about front-line workers will no longer cut it. Our healthcare professionals deserve better. They will not stick around unless they are respected, not just by words but by action over their pay and conditions.

As Deputies, we are frequently contacted by patients or their families about the latest medicine for a specific illness that can transform the life of a patient. They are looking for approval under the drug reimbursement scheme. This is all part of the rapidly expanding area of healthcare known as personalised medicine. This means that medical care is based on the patients' own genes and specific disease. We know that genes are the information that tells cells in the body how to grow and develop. For example, many cancers affect or involve specific genes.

Through investment in health research, we can target treatments towards these genes in an approach known as precision medicine. This can be more effective at treating or managing the disease with far fewer side effects than other types of treatment leading to more successful and quicker recovery which is far better for the patient, reducing the overall long-term cost of the delivery of our healthcare.

This type of precision medicine is built on two key elements. The first is technology. Identifying specific genes and how they are expressed through an illness encompasses the whole field of genomics which plays an important role in the diagnosis and treatment of diseases, including cancers and rare diseases, enabling more efficient and accurate diagnosis and improving treatment selection. Genomics is driving precision medicine to improve clinical outcomes for individuals impacted by illnesses and their families. However, we can only use genetic information to develop tests for cancer and other diseases, and to prevent them, if we make the investment.

Although the Government made a commitment in 2020 to develop a national genomics and genetic medicine programme, this key area of healthcare in Ireland lacks clear funding and a structure to deliver this type of innovative technology for patients.

The second area is people. The days of the doctor examining the patient and then sitting at the end of the bed outlining a battery of broad treatments that will be administered to the patient in the hope of hitting the right one for that specific illness are, thankfully, confined to history. Instead, the doctor's treatment plan today is based on laboratory results from an ever-increasing and far more targeted range of tests that can facilitate the precision healthcare I just mentioned.

Just as technology has become more precise, however, so too has the importance of laboratory staff who are now more likely to be the decision makers when it comes to a person's treatment, care and, most importantly, recovery, than the doctor at the end of the bed. This is only set to increase in importance. Today, more than 80% of laboratory medical scientists are educated to master's level, with many having a second master's degree, PhD or another professional doctorate. Patients see first-hand how vital the role they play is and they have seen it very clearly over the last two days of work stoppages.

A carer who is in chronic pain contacted me last night. Her procedure was cancelled last January and then again on three subsequent occasions. She was given a further date this week. Again, it was cancelled because of the industrial action. In this particular instance, this carer has had to source an alternative carer on five separate occasions so far this year so that she could have that procedure. She told me last night that she understands the reason why the laboratory staff are taking the action they are taking. She supports them in having fairer pay and career development opportunities, but she also wanted to outline the impact this is having, not just on her, but on the person for whom she is providing care. As I said, she continues to suffer pain, inconvenience and stress and has done so over the past six months. The uncertainty this industrial action is bringing about is making it impossible for her to plan in advance.

There is huge frustration out there among medical scientists at the moment. After spending five years in college and having gained professional recognition for their qualification, upon graduation, medical scientists actually supervise and are responsible for medical laboratory aids, but bizarrely, their starting pay scale is lower than the people they are actually supervising. Once medical scientists are registered with CORU, the first reality check they receive is a pay cut. The second more depressing hit comes when they discover that if they decide to stay for any length of time in the public service, they will work alongside their biochemist colleagues who are performing the same duties, but they will not receive the same pay or career opportunities. Biochemist colleagues with the same qualifications but with less experience operate at consultant level whereas senior medical scientists operate at chief medical scientist level, which is the final level of progression for them. To add insult to injury, this pay parity anomaly was rectified 20 years ago and was then rescinded.

Medical scientists stepped up to the plate during the pandemic and the cyberattack, taking on additional duties and working additional hours, even though the workforce was seriously understaffed prior to Covid-19. The refusal by the HSE, Department of Health and Department of Public Expenditure and Reform to move on these issues has been a clear slap in the face to these particular staff members.

This situation whereby these staff are now leaving in droves is a missed opportunity to develop this profession and the whole area of medical science. It is a missed opportunity to bring about the type of precision healthcare we need in this country that ensures people are given the most appropriate treatment and discharged back into the community as quickly as possible or alternatively, that they are treated in their own home or community. The investment in the laboratory services and laboratory staff is key to achieving these objectives. It is imperative that we address as a matter of urgency the severe recruitment and retention problem we have in the service today.

I thank Deputy Naughten. I apologise again for bypassing him earlier.

Medical scientists carry out critical diagnostic testing of patients sampled in acute hospitals, including urgent testing for Covid-19 and everything else. They have played their part. This dispute and issue was settled 20 years ago and then, for some reason, some people in the HSE decided to overturn it and now we have this problem again. I welcome the fact that the pickets were withdrawn today and that there is room for talks because picketing is the last word, especially in the congested and failed health system we have and of which the Minister of State is in charge. It is failing people every minute and hour of every day. This vital component, the very important diagnostic people, are being mistreated in this way and are fleeing the service, leaving a bigger mess behind.

There is no problem getting money for Mr. Paul Reid or Mr. Robert Watt, or hiring a taxi for God knows how much out in Dubai and booking flights or anything else. It is no problem for anything else; the Government throws money at it. When it comes to looking after the most important key front-line people, however, the Government will not look after them. It has failed to look after them for years. It is time to pony up here. It is time that the Government listened to and, above all, respected them. I still do not know if many of the people on the front line who were promised the €1,000 got it in a big blaze of glory. The Government is good at announcements but it is not good at looking after its staff. That is the difference with the HSE. It should be disbanded forthwith and regional operations set up to look after the people. Molaim na daoine a bhíonn ag obair go crua ann.

As a champion of Bantry General Hospital, I would like the Dáil to know that last Wednesday, there were no laboratory service available and as a result, hundreds of tests were either cancelled or not processed. When we factor in that laboratory services were also withdrawn from Cork University Hospital, CUH, Mercy University Hospital and South Infirmary Victoria University Hospital, the number of affected patients in our constituency likely numbered in their hundreds from just one day.

I have received many emails on this issue, one of which was from a medical scientist in the cytology laboratory in CUH. She has worked in CUH for 17 years. She and her colleagues were, regrettably, on strike this week because of a long-standing pay dispute. Biochemists in the public laboratories do the same work as biomedical scientists, yet they are paid 8% more. Two colleagues are basically working side by side and one is paid more. This was addressed and agreed upon 20 years ago but it was rescinded very shortly after.

Laboratories right across the country are at breaking point. They absorbed all the extra work generated by Covid-19 with absolutely no extra staffing or resources. Covid-19 laboratories were set up overnight, which took staff from all disciplines to cope with the emergency. The laboratories are not just about blood tests. They do vital work across blood science, cancer care, attendance at bronchoscopy procedures, fine needles, rapid access clinics, head and neck clinics and everything in between.

Even if the pay parity is addressed, we are still left with a huge shortage of graduates. They do their in-service training and run to the private sector. I do not blame them. Their working conditions are so stressful. They are all asking the same thing. They do not want us standing in the Dáil clapping but instead engaging in meaningful talks with them and their unions. The Ministers for Health and Public Expenditure and Reform and their Department heads now need to get into a room with the unions as soon as possible. This 20-plus year farce must end now.

I too am very glad to get an opportunity to speak on this very important matter. As has been pointed out to me, these medical students have gone through a five-year course and are highly trained with special skills.

They are vital to the running of hospitals like University Hospital Kerry in Tralee, where I am sorry to say that many appointments have been cancelled in recent days. That is not fair on the people who need procedures. I hope that they are being carried out today. I have friends and special people who have been waiting a long time and are hopeful that their procedures will go through today.

I am not blaming the current Minister, but the HSE. These people are being underpaid. Just look at the courses they had to take and the experience they needed to gain. Proper outcomes, and many lives, depend on them. We must see after them. At the heart of this situation is the increased cost of living. They are just fighting for a chance to live, put food on their tables and support their families.

The suspension of appointments is jeopardising outcomes for people who have been waiting a long time. I am pleased that talks are going ahead. They should have gone ahead long ago. Will the Government please rectify the situation? It should not be happening. I am blaming the HSE, not individual Ministers.

I welcome my Limerick office team and colleagues who are present today. The staff in our offices are important.

How can any hospital function without staff and pay parity? In University Hospital Limerick, UHL, there are seven laboratories that are struggling for laboratory staff. There is a national shortage of medical scientists, so why not ensure remuneration accordingly? In 2020, 130 posts were unfilled. UHL requires medical scientists in seven departments, including biochemistry, microbiology, histology, haematology, the blood bank and the public health lab.

The main reason for the dispute is that biochemists are paid 8% more than medical scientists. Medical scientists have significant responsibilities and are more aware of the significance of the disruptions that a strike causes for their primary focus, namely, the patient. They carry out identical work with the same responsibilities. They have fewer promotional and career development opportunities and less support for training and education. They have a genuine grievance with the fact that other public sector health workers have seen significant pay increases when they have not.

I thank the medical science professionals who carry out such critical diagnostic testing of patient samples. I thank them for the excellent work that they do up and down the country, including in Kerry and in Cork University Hospital. I also thank the MLSA, the trade union representing medical scientists.

There is a significant national shortage of medical scientists across the public health service, with up to 130 posts unfilled even before the additional pressures of the pandemic arose in 2020. The reasons for this are inferior pay and conditions, poor career structures and limited opportunities for promotion.

The HSE has gone straight into combat mode and warned that the strikes will lead to the cancellation of many inpatient and day case elective procedures. The HSE is trying to blame those who are striking for these issues when the reality is that the real blame rests firmly with the Minister, previous Ministers, the HSE and the Department of Health.

At the heart of this dispute is the fundamental matter of equal pay for equal work. I have been spoken to by many people in Kerry who have been engaged in this excellent work for all of their lives. They are upset at what I would call being forced out to strike. They did not want to be standing out there and marching. It is wrong to have allowed this situation to come about. I plead with the Minister and his Department to listen to the union representing them as well as to them. They are sincere, highly intelligent and qualified people.

I salute the medical scientists in the Public Gallery today and all of those who were on the picket line yesterday and last week. I thank People Before Profit for tabling this important Private Members’ motion in the Dáil.

The intervention by the Labour Court is to be welcomed, given the key role that medical scientists play in the delivery of our healthcare, but the HSE and the Department of Public Expenditure and Reform have to move to take responsibility for the situation and resolve it. The Labour Court cannot be used to continue stalling. The HSE and the Department must engage in meaningful negotiations. After all, this claim dates back more than 20 years to 2001. At the time, the claim by the MLSA was conceded by the expert group report, by what is now the HSE, by the Department of Health and by the then Minister for Health and Children, the current Taoiseach. However, it was unintentionally overturned by a benchmarking process in 2002.

I was disappointed with the Minister’s reply when I raised the issue last week. Like the HSE and the Department of Public Expenditure and Reform, he is washing his hands of this legitimate claim from these workers. He is using the public service agreement, Building Momentum, which restricts any pay increase to 1%. This is not a pay claim, though. It is an historical pay parity claim. The Minister has also used Building Momentum to criticise these workers for going on strike, saying that their action last week was contrary to the MLSA’s commitment under that agreement. The fact that 21 years of frustration has only now resulted in very limited strike action shows the commitment of medical scientists to doing their jobs and providing a crucial service for people’s health. It is the height of hypocrisy to laud health service staff as heroes on the one hand and, on the other, to treat these essential workers and others in this manner.

I will briefly refer to an email that I received from a medical scientist of 17 years, all of which she has spent working in the public service. Her working week consists of 37 routine hours and, currently, at least another 24 hours of rostered night and weekend duty. These extra hours are not voluntary, but a mandatory roster consisting of 15 medical scientists providing the emergency out-of-hours service. This mandatory overtime affects all of her life, including her health, home life and social activities. She writes that, although she is not as young as she used to be, she is working more hours than she ever did. This is because there are staff shortages in her lab, with no immediate prospect of those posts being filled. Every year, training in medical scientist graduates has been a core part of her role and something she used to enjoy, but it has become soul-destroying in recent years because she sees how the new graduates, after four to five years in college, view the crazy working arrangements and hours and vow to never work in the public system. All of this is in addition to the fact that she and her colleagues worked and trained through Covid and dealt with the HSE cyberattack and all of the additional work that they took on without resources.

This is intolerable. These conditions are the key factor in the recruitment and retention crisis across the health service, particularly as regards medical scientists. This situation cannot continue. Where there is a will, there is a way, and there is always a will and always a way. The Department has to be creative. Building Momentum cannot resolve this issue. As the Minister pointed out, it can only provide a 1% increase, so he must think outside the box. How will he deliver the other 7% that is needed as well as career progression within the grade?

The medical scientists will forgive me if I do not waste my four minutes thanking them. I stand in solidarity with them. I thank People Before Profit-Solidarity for tabling this motion. I am not sure how the Minister could not agree with it. It is the most basic motion that I have ever seen and makes three calls:

— ensure that DPER and the HSE agree to the long-standing pay parity award…

— begin a recruitment campaign...

— publish a plan.

Instead, we have a response from the Minister about hidden heroes. Medical scientists are not hidden to me, the rest of the Opposition or the hospital staff. They are certainly not hidden to the public who rely on them, including me, who gets her blood tested like everyone else. This is not to mention the 200,000 Covid tests that were carried out last year in Galway hospital alone. They are not hidden heroes. They are hard-working medical scientists who are asking for equality and pay parity. That is it.

The Minister’s speech should have dealt with the background to this. It contained a heading entitled “Background”, and I was full of hope that he would give us the background, analyse what had happened and tell us what he was going to do. Instead, there was nothing.

I have a report in front of me. It has 112 paragraphs and 64 difficult recommendations written by three men. Unfortunately, they did not number the recommendations 1, 2, 3, etc.

Notwithstanding that, the recommendations are clear when reading through it. It is now time. In May 1997, the Labour Relations Commission recommended the establishment of an expert group. That expert group was set up in 1997 following long delays since 1981, when all of these problems emerged. We then go forward to this report, in which the expert group actually apologises for its delay in producing it. I do not know why but it apologises for the length of time it took. There was more delay before we got this report in 2001. To add more confusion, within the report it is said that some of the recommendations should be implemented by 1 April 2000. The report was published in February 2001 but obviously there were interim reports and contact with the Department. Perhaps the date of 1 April 2000 is the hint that nobody was serious about this. Some of these recommendations were to be implemented by 1 April 2000 but that did not happen.

Let us fast-forward to more than 21 years later. We are all expected to grow up at 21 years of age. It is the age of maturity. What have we got? We have an answer that is positively insulting. I say that with the greatest respect for the Minister's role and not in any personal way. We cannot go on like this. The Minister must look at this report. What happened? Were any of those recommendations implemented? If so, will the Minister tell us? If not, will he tell us why not? Why was there no review between then and now? Why do medical scientists, whom I want to thank, have to give us all of this information and tell us how difficult it is to go on strike, which they do most reluctantly? Why does that have to happen? It raises the question of whether the structure in the Government is fit for purpose. In my opinion, it certainly is not. The Government has had any number of warnings that this was going to happen. I spent ten years of my life on a health forum and I watched the medical science laboratories being run down and their services being outsourced to private for-profit companies. While the medical scientists and all of their colleagues appealed for this not to be done, each Government, following the lead of the Progressive Democrats, said "No" and that privatisation was the way forward. We then had the scandal of the cervical smear tests. We have learned nothing.

The Minister should be telling us why the report has not been implemented, what needs to be done and what we are going to do to stop outsourcing and to recognise the fundamental role of medical scientists so that we can rely on them for their honesty, courage and hard work. I want to rely on them and I do. I certainly will not rely on the Government, unless it is going to change.

I thank all the speakers today for their considered thoughts on such an important matter. I reiterate what my colleague, the Minister, Deputy Stephen Donnelly, said about the value we must place on medical scientists in our healthcare service. I pay tribute to the dedication, professionalism and commitment of all medical scientists throughout the country. They worked tirelessly during the pandemic and their efforts in testing Covid-19 samples were, and still are, very significant. The Government recognises the extraordinary contribution made by those working in our health services, which is evidenced by the decision taken earlier this year to provide a pandemic bonus payment to Covid-exposed front-line workers.

The strike has led to serious disruptions across the sector, including the cancellation of urgent elective surgeries such as time-sensitive surgery for patients with cancers and other very serious conditions. I welcome the decision of the Medical Laboratory Scientists Association to lift its strike action and to attend today's exploratory engagement at the Labour Court. The Government recognises that all of the State's industrial relations machinery should be utilised to resolve the matter.

I acknowledge the extreme pressure that this cohort of staff has been under due to staff shortages. It is true that recruitment difficulties for this role exist. The current medical scientist workforce stood at 2,135 whole-time equivalents as of the end of March 2022, with 260 vacancies. It is important to note that there is a clearly defined grade structure with promotional opportunities for medical scientists within the HSE. While the number of basic grade medical scientists has indeed reduced since 2019, the numbers of senior and specialist grade medical scientists have increased. Overall, since 2019, there has been a 6% growth in the number of medical scientists employed by the HSE. Each hospital group is progressing recruitment on an ongoing basis and utilising strategies to attract and retain staff, which includes a focused approach on the attraction of new graduates to careers in the public healthcare service. The HSE plans to undertake a national recruitment campaign to promote the role of medical scientist both nationally and internationally. The focus of this recruitment drive will provide additional candidates for national vacancies across the system and for priority services.

In the context of recruitment and expansion, I will briefly reference Dr. Gabriel Scally's scoping inquiry into the CervicalCheck screening programme in 2018, which included the examination of the laboratory services used by the CervicalCheck programme. Arising from recommendations of Dr. Scally's report, a strategic decision was made in 2018 to develop a national cervical screening laboratory, NCSL. This is due to open in the coming weeks, building capacity and resilience into the public element of the laboratory services required for the national cervical screening programme in Ireland. It will enable the National Screening Service to reduce its dependency on third-party providers to meet the needs of the CervicalCheck programme. The new laboratory is designed to become the principal provider of cervical screening laboratory services for the National Screening Service over time. It will also serve as a national base for training, education and research purposes. Some €20 million has been committed for construction, fit-out and staffing of the NCSL. A workforce plan is currently being developed to address workforce resilience. This new laboratory will require trained medical scientists, along with many other trained professionals.

At present, qualification and registration to become a medical scientist involves a four-year programme at undergraduate level. There are currently 105 training places annually across the universities in Ireland to produce graduates for both the public and private sectors. In recent years, on average, over half of these graduates have joined the HSE. The HSE is leading a project to progress advanced practice in the health and social care professions in Ireland. It encompasses developing an overarching framework incorporating all the key considerations and factors, including an agreed definition and approach across the professions, core competencies, a planned approach to meeting educational requirements, governance and regulatory considerations which can inform policy development in this area. The work carried out as part this project aims to help address staffing shortages in the health services, including in the medical scientist profession, and to support retention of health and social care professionals who might otherwise be lost due to lack of opportunities for career progression in clinical roles. HSE projections for future years indicate a requirement for an additional supply of qualified graduates from the Irish labour market. This could be achieved through an increase in the number of undergraduates taken on the relevant colleague courses, a specific graduate entry programme or both.

I will briefly address the issues surrounding the current public service pay agreement, Building Momentum, and its impact on the MLSA's claim for pay parity between medical scientists and biochemists. As the Minister stated, the MLSA is part of the Irish Congress of Trade Unions. This means that it is bound by the terms of Building Momentum for the remainder of its lifetime. Under this agreement, sectoral bargaining provides that long-standing and outstanding claims can be fully or partially resolved using funding provided under the agreement. As advised, discussions have been ongoing for many months with the aim of finding a resolution to this matter. Unfortunately, the sectoral bargaining pot available to the MLSA is not sufficient to resolve the issue in full.

As an agreement could not be reached at local level, the MLSA was invited to attend a meeting of the public service agreement group on 31 March. At that point the MLSA called off strike action which had been scheduled for late March or early April. The suspension of the strike was welcomed by health management and the Department of Public Expenditure and Reform. On 31 March, the public service agreement group agreed that the MLSA and health management should return to local engagement to attempt to find a solution to the matter. All parties involved wanted to see a resolution to this matter and the parties were, therefore, given more time to find a solution. New, alternative proposals were considered but unfortunately none could successfully resolve the matter. As no agreement on resolving the claim could be reached at local level, the public service agreement group met again on 11 May to reconsider the MLSA's claim. It was at this point that it recommended that the matter be immediately referred to the WRC and that industrial peace be maintained in the meantime.

I reiterate the extremely valued role of medical scientists within the health system. The Department is fully cognisant of the current recruitment challenges in the profession but, as stated, tangible campaigns and projects are under way to address the issue. We acknowledge the medical scientists' claim for pay parity. We acknowledge the significant impact of industrial action on patient care across the health system and we will continue to engage on the issue through the Labour Court.

The members of the MLSA in the Gallery are very welcome. They have come from the picket line to the Dáil. That is how democracy should be. We are delighted to have their issues aired here. I hope the debates will help MLSA members understand how the system works and better equip them to be able to argue against what they are hearing.

There is an idea in ecology of a keystone species, that is, a species that occupies a niche in the whole ecological system and when that species is damaged or removed it has profound effects on the entire environment and ecology. Members of the keystone species of the health service are in the Chamber watching this debate. If we fail to treat the scientific laboratory workers properly by failing to give them justice, fair play and equality, our health system will start to implode from the centre. Removing any group of workers or impeding them from operating in the system has a profound effect on all of us, right across the board. It is similar to the way the failure to retain psychiatric nurses in the Linn Dara CAMHS unit is having a profound effect on the most vulnerable in our society. Behind the scenes these unsung heroes, whom we have all acknowledged, are absolutely essential.

I first became aware of the MLSA and the work it does several years ago during the CervicalCheck scandal. I was hugely impressed by the evidence its members gave before the committee hearings into what happened in that crisis. It is worth remembering, because it tells us a great deal about the role of such workers, how political decisions based on ideology have a profound and negative effect on people's lives. In 2008, the MLSA and its members warned the State of the dangers of outsourcing the CervicalCheck programme on the basis of competitive lower costs. The heartbreaking result of that political decision, which is obvious to all of us, affected many women. What is less clear is that the result of that decision to contract out the testing capacity to the US also meant we lost university courses, qualified graduates and hundreds of skilled staff who had intended and hoped to work in our public health service.

The warnings of the MLSA and other workers on the front line of laboratory testing were ignored because of a political decision and philosophy. In many ways this dispute for the past 21 years is similar in that we are ignoring warnings from front-line workers about what is happening at the heart of our health service. We hear of great investments in the children's hospital, the national maternity hospital and the new testing facility at the Coombe. The figures are in the billions of euro and are mentioned as proof of the seriousness with which the Minister and the State take the provision of services. Who will work in these buildings? Who will ensure these shiny new buildings operate and people get the services they need? It will be workers, nurses and laboratory staff such as members of the MLSA. Without them we would have only very expensive shells. If we cannot retain and recruit workers and keep them in a public system, the chief goal of which is not profit but public service, it will not matter that we spend billions on buildings because we will not have workers to do the job.

The usual suspects tell us we cannot treat one group of workers differently from others in the health service. No doubt we will hear commentators warn about the need to be prudent with State money. I heard the same about nurses during their dispute some years ago. We need to remember when one group of workers, such as nurses or MLSA staff, is disrespected and treated badly it is not a victory for prudent management of the State coffers. It is not a win by saving the State purse a few shillings. It is a defeat for all of us who rely on and need public services and a defeat for workers everywhere.

It is deeply ironic that this week we have heard so much talk about whether it is time to remove the cap of €500,000 per year on top bankers' pay because it is restrictive. The poor créatúrs must live on that much, yet we are being urged to be realistic when it comes to how we treat our public sector workers. We need to retain the best banking talent, we are told. I say we need to retain the best scientific talent. I have read the Minister's remarks carefully and it is interesting that he mentioned the Building Momentum deal eight times. However, he goes on to explain that within a particular section of that agreement, there is a mechanism for increasing pay by only 1%. He also alluded to the fact the MLSA rejected that deal. I am not surprised. If it has had a claim of 8% for the past 20 years to bring its members' pay to parity and Building Momentum has a mechanism for only a 1% increase in pay, it is no surprise the MLSA rejected the deal. The Minister cannot keep referring to the deal over and over again without recognising it will not go anywhere in settling this dispute. That 98% of workers voted to take strike action is startling. They did not do that lightly. As the Minister of State outlined, they have called off their action again and again in order to facilitate talks. This issue is going nowhere unless the Minister and the Department of Public Expenditure and Reform sit at the table and try to find a solution. The Minister said the money is in the coffers but he is restricted by Building Momentum. In that case, he must find a way around those restrictions.

I will say a few words about the hopeful message in the Minister's remarks and his amendment regarding what will happen with the new testing centre at the Coombe and how it will provide a plan to address workforce resilience, development, training and all the rest of it. I received a reply from the HSE to a parliamentary question yesterday which indicates that when this new building opens we will continue to rely on a back-up from a second provider for several years. How many years that will be is not spelt out. It does not say two years or ten. We are still going to be outsourcing CervicalCheck until we bring the service up to standard. The Minister should not give false hope that the situation MLSA members are in will change because a new facility is to open in the Coombe. That is not the case.

The Minister also mentioned the conflict in Ukraine twice. When the scientists first faced this lack of parity 20 years ago there was a worse conflict taking place in Iraq. What does that have to do with the price of beans? I do not see why the Minister mentioned Ukraine.

The amendment also calls on the MLSA to call off its strike. That is disgraceful. Every Deputy with any self-respect and respect for these workers should vote against the Minister's amendment should it go to a vote tonight. It is outrageous.

Victory for these workers will be a victory for all workers because it will mean we can build a decent health service in the future by correcting the historical wrongs done to workers which are having profound and negative impacts on all the key services on which we all rely.

I thank all Members for their positive commentary on this important issue in the past two hours. I also thank the MLSA members in the Gallery for attending to hear what Teachtaí Dála from the Opposition and the Government are saying about their workplace. We again thank them for their continued work in their jobs.

I will cut to the chase.

If there was an anomaly in Deputies' pay it would not have taken 20 years to fix. It would have taken 20 minutes. Let us be honest that Deputies are overpaid and if this situation had involved them it would have been fixed. There are pay anomalies across the board in the public sector involving teachers, FEMPI cuts, workers in section 56 and 59 organisations and school secretaries. There are different sets of rules.

I want to go back to the historical context for this issue. It is 21 years since the recommendation was made. Since then there have been five general elections, numerous health Ministers, a financial crisis and a pandemic. The pandemic changed everything about public health. Medical scientists were and continue to be at the forefront of public health. They have been waiting in the wings for this issue of pay parity to be fixed. It is ludicrous. It is absolutely shambolic that medical laboratory scientists have been on the picket line in the past two weeks. It is ludicrous. Think about it. They are the very people who have been trying to save people. They are looking for a very small pay increase. The health budget is approximately €22 billion. I am guessing that if tomorrow they were given the 8% they seek it would be an absolute fraction of this. I guess it would cost less than €7 million or €8 million per year. It does not make sense.

With regard to the retention and recruitment of staff there is an existential crisis in the health service. As politicians we see it on a daily basis. Health staff are burned out. They love their jobs and they are absolutely passionate about their work but they tell us and their colleagues that at present the circumstances they are in are extremely difficult. Some are leaving the country because they are burned out. This is not sustainable. It will have an effect not only on the health service but on the workers who keep it going. I appeal to the Minister and other Ministers present to resolve this issue and give these workers the 8% increase they deserve.

Amendment put

In accordance with Standing Order 80(2), the division is postponed until the weekly division time at 8.30 p.m. today.

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