I will call Deputies in the order in which they submitted their questions to my office.
Private Notice Questions. - Threatened Strike by Nurses.
asked the Minister for Health and Children the contingency arrangements, if any, being put in place to provide health care and essential hospital services to those who require them should the nurses strike commence on Tuesday next, 19 October.
asked the Minister for Health and Children the steps that are being taken to provide emergency cover for hospital patients and others requiring medical care in view of the imminence of the national nursing strike and particularly having regard to the failure of the health services employers and the nursing unions to reach any agreement on the level of emergency cover; if, having regard to the consequences for patients of the failure to agree emergency cover, the Government will immediately reopen negotiations with the nursing unions with a view to concluding an agreement capable of averting the strike; and if he will make a statement on the matter.
(Dublin West) asked the Minister for Health and Children if agreement has been reached with the nursing unions regarding the provision of emergency cover during the forthcoming scheduled strike.
asked the Minister for Health and Children the contingency plans, if any, that are being put in place to provide health care and essential hospital services should the nurses' strike commence on 19 October next.
I wish to take these questions together.
The Health Service Employers Agency met yesterday with the Alliance of Nursing Unions to discuss the provision of emergency and essential nursing cover during the nurses' strike scheduled to commence on Tuesday next, 19 October. Some progress was made in arrangements for care in certain areas, for example, metabolic screening of new-born babies for PKU and other genetic disorders – the Guthrie or heel prick test – and care of terminally ill patients. I am very concerned, however, that there is no detailed agreed plan at national level with the nursing unions. In the absence of such an agreed plan it is still not possible for me to give the House an assurance on the level and extent of nursing care available in the event of a strike.
There was agreement on the following areas. In relation to metabolic screening, it was agreed by the unions that nurses would co-operate in the referral of new-born mothers to hospital for the Guthrie test. In default of attendance, cases would be referred. It was agreed that the unions will provide local management with details of emergency cover duty rosters to facilitate investi gation of critical instances, if any, which might arise.
Disagreement was recorded, however, in relation to the following matters which are a source of continued concern to me and to health service management. On the administration of intravenous drugs, the unions continue to refuse to facilitate a national protocol which would cover the administration of IV drugs as an essential task. It had been previously agreed, however, that this would be undertaken in emergency cases. I appeal to the unions not to create hardship for patients on this issue.
In relation to warfarin and diabetes clinics, it was indicated by the unions that the nurses would be withdrawing from these clinics.
In relation to pharmacy and drugs, the unions stated that emergency cover will not include the restocking of pharmaceutical supplies or cooperation with the continued administration of drugs to day care patients.
On communications, the unions would not agree to co-operate with the proposals to provide dedicated clinical care phone facilities. This would have assisted hospitals in providing a necessary facility for relatives and/or carers when inquiring for up to date information on the well-being of patients.
While health service management acknowledge that a certain amount of progress has been achieved through local discussions, there remains a gap between what is offered by the unions and the minimum requirements, as outlined by management on 30 September. The continued absence of a nationally agreed framework leaves an element of uncertainty regarding the provision of minimum care requirements at all locations for the duration of the strike. I share the concern of health service managers on this issue, as undoubtedly does the House.
I should remind the House that the HSEA document outlined the minimum cover necessary to ensure that lives are not put at risk for the duration of the strike. This document was compiled in consultation with a wide range of health care agencies, including senior nurse managers.
In the absence of national agreement, health agencies have made arrangements to inform patients or clients of the general deferral of admissions, clinics and the curtailment of other health services, as appropriate, within the terms of their own contingency plans and subject to consultation with medical and other staff, as required. Advertisements from health boards and the major hospitals are currently appearing in the newspapers informing the public of the effect of the planned strike on services.
The HSEA is meeting with the Irish Medical Organisation and with the Irish Hospital Consultants' Association this afternoon to discuss the situation in the light of yesterday's meeting. Previously, the Department had written to both organisations appraising them of the situation. Individual health agencies are also liaising with general practitioners concerning the effects of the strike.
In reply to Deputy Quinn's question as to whether the Government will reopen negotiations with the nursing unions with a view to averting the strike, I can only repeat what I have said in this House and in Seanad Éireann over the past two days, and what the Taoiseach said on Tuesday. The Government believes that the combination of the acceptance of the Labour Court findings regarding pay and allowances, the implementation of the report of the Commission on Nursing and the continuing discussions with public service unions about a new approach to public service pay determination provide enough scope to address the nursing issues, both pay and non-pay, in a reasonable way.
I appeal once again to the Nursing Alliance to call off the threatened all-out strike and to pursue their case in the context of the forthcoming discussions between the Government and the social partners on a new national programme to succeed Partnership 2000.
Is the Minister aware that the general public are aghast at the Minister's failure to attempt any constructive dialogue of any nature with the nursing unions? Will he acknowledge and recognise that the activity and effort being put into trying to agree contingency arrangements is extraordinary in the context of the Minister's own failure to engage in such dialogue? Is the Minister aware that this morning the Oireachtas Joint Committee on Health and Children unanimously, across party lines, agreed that a letter should go to the Minister and the unions asking that constructive dialogue take place? Will the Minister now, before a strike occurs, commence a process to facilitate the resolution of this dispute instead of continuing to adopt an attitude whereby he regards a dispute as inevitable, and both he and his colleagues, in what they say, inflame the situation to a greater degree and create more difficulties than we need have at this stage?
At no stage have I sought to inflame the situation, only to outline the Government position. The Government has put forward an alternative strategy for the Nursing Alliance which need not involve any hardship to the public and which at the same time allows them to pursue, as they see it, legitimate grievances that they would contend still exist after the Labour Court series of recommendations, without providing a prescriptive outcome. I refute the claim that the Government is not offering an alternative to what is being proposed by the Nursing Alliance.
On the question of the use of the word "inevitable", it is one that has been used by the Nursing Alliance leadership, not by the Government. The Government does not seek a confrontation or a strike, nor does it believe it is necessary in the context of the alternative strategy it has outlined to the Nursing Alliance as providing an alternative approach which need not provide the effect on services which is envisaged should the strike go ahead.
In relation to the efforts that have been made, I stated before in the House, and again this evening, that since 30 September we have put to the Nursing Alliance a proposed contingency plan for emergency and other essential care during the threatened nurses' strike. We would require a national framework for the assurance that the House seeks to be given unconditionally. It should be said that as a result of yesterday's meeting, and the report from the various areas, it is clear that the gaps which existed are closing considerably. I acknowledge that much progress has been made in local discussions between management and unions in addressing the issues which we would like to see the Nursing Alliance agree to but, unfortunately, thus far the Nursing Alliance has not been open to including an agreement with the health service management on a national framework which would give the assurance that the House seeks. However, considerable progress has been made at local level and the lines remain open between the HSEA and the Nursing Alliance to see what further efforts can be made to close already closing gaps between the level of cover being sought and the level of cover this is proposed to be given. In fairness to the Nursing Alliance, there is no indication of non-acceptance, to put it that way, in relation to the staffing of critical care areas that one would expect should be covered because an emergency is an emergency and critical care is critical care, no matter on what side of the table one is sitting, even in the event of a strike being contemplated.
As I said in my reply, considerable progress is being made at local level. However, as I have said from the outset, it appears the problem with the local arrangements is that they would not provide us with the level of certainty and uniformity which the public feels entitled to expect if this strike took place.
The Minister said in his reply that advertisements outlining the available cover were placed in the newspapers by the various health boards. Has he seen the banner headline of the Evening Herald, which states “Operation Shutdown” and which is the message that will be conveyed to the public? There is a fear across this city and the wider country that because of the failure so far of the negotiators on behalf of the health service employers, the Department of Health and Children and the nursing unions to arrive at an agreed level of care, beyond what the Minister has already outlined, there will be a serious crisis next Tuesday. In light of the failure so far, according to the report the Minister has just given us, will he reconsider the hard-line stance the Government has adopted from the very beginning and see if there is a way in which negotiations can be opened up along the lines, for example, outlined by Tom Hayes on the radio earlier? This dispute will have to be settled at some stage. Can it be settled in advance of the inevitable deaths that will take place rather than afterwards?
The foundation of language is important here. This morning the Nursing Alliance, personified by Mr. Des Kavanagh, the General Secretary of the PNA, confirmed that there is no intention on its part to put lives at risk. We should accept that. There is always an understandable tendency to overstate a case for the purpose of making a point. However, one should accept the Nursing Alliance's intention in that respect, and there is no need for us to repeat it. That has been clarified by them and by us. The headline "Operation Shutdown" which the Deputy has just shown me does a grave injustice to nurses. Nurses are not intent on providing an operation shutdown.
That is the newspaper's analysis.
The newspaper's analysis is not in keeping with the discussions that have taken place between health service management and the Nursing Alliance. It is a most—
The Minister is causing the shutdown, not the nurses.
Sorry, Deputy Stagg, I wish to answer the question.
The Minister, without interruption.
The Minister should not try to shift the blame on to the nurses.
Please, Deputy Stagg, we want an orderly Question Time.
Where there is inaccuracy, let us clear it up. It is inaccurate, given the level of progress that has been made at local level in discussions regarding the need to provide the minimum emergency cover outlined in the document of 30 September. While I acknowledge that it appears to be the case thus far that the Nursing Alliance is not open to agree a framework at national level, significant progress is being made at local level. As I have said, it is my strong view that it is very difficult to guarantee uniformity and certainty where we are dependent on local arrangements. However, progress has been made at local discussions to deal substantively with the issues which are a cause of concern to all parties. At this stage, I am prepared to acknowledge, as I think every Member of the House should be, that all sides have similar definitions of what emergencies consist of. As I said, we are making significant progress. There are areas of disagreement but the lines remain open and the local discussions continue.
(Dublin West): Does the Minister agree that one cannot understand the impending strike and the problems that it springs from without understanding that a grave injustice was done to the health services, including the nurses, and vulnerable patients in the 1980s? Savage cutbacks were inflicted by successive Governments while super wealthy people were stashing away in Ansbacher accounts and other offshore accounts hundreds of millions of pounds that should have gone to the tax fund and, therefore, to the health services.
A question, please.
(Dublin West): Does the Minister agree, in view of that, that the health services still suffer those after-effects, and that major investment is needed to correct those difficulties that date from that time? Does he agree that a staff nurse with a third level qualification, under the commission—
The Deputy must ask a question relevant to the discussion, which I understand is on emergency services—
(Dublin West): It is wider than that.
—during the forthcoming threatened strike. The Deputy's question was to ask the Minister for Health and Children if agreement has been reached with the nursing unions regarding the provision of emergency cover during the forthcoming scheduled strike. In fairness to other Deputies who wish to submit a supplementary, it is important that we confine ourselves to the issue before us and that the Deputy asks a question of the Minister to elicit information.
(Dublin West): This is my last, brief question. You were not here, a Leas-Cheann Comhairle, this morning when the Ceann Comhairle said that the generality of the problem could be put to the Minister. That was actually said, as you will see on the record—
I am dealing with the question the Deputy submitted to the Minister.
(Dublin West): Does the Minister agree it is a major problem that a staff nurse with a third level qualification is not on the same level of remuneration as other professionals with a similar degree, such as dieticians—
The Deputy is moving away from the subject matter of the question.
In regard to the substance of the Deputy's first question, it is asking a bit much of the Labour Court to deal with all the issues he outlined. That could all have been dealt with on the basis of a restructured claim that had a limit of 5.5 per cent from the PCW. We have enough problems with the specifics of this issue without bringing everything else into it. To that extent, other issues are absolutely irrelevant.
The question of arbitration in relation to the merits or demerits of the claims that were processed has been dealt with by the established industrial relations machinery. The Government has made clear that it is not in a position to undermine the authority of the Labour Court or to depart from its recommendations. It has explained, calmly and uncontested, that it has done so on the basis of the wider implications for public sector pay of departing from those recommendations. That is not, in any way, to speak of what other ways these issues could be developed, on the basis of the alternative strategy the Government has outlined.
Therefore, in regard to the Private Notice Question tabled by the Deputy – people might question my objectivity but this is also the view of many objective observers, one of whom was mentioned by Deputy Quinn – it would be regarded as an outstanding negotiating and arbitrating success to emerge with an average 23 per cent increase, on the basis of a claim under a restructuring clause that allowed for 5.5 per cent.
Does the Minister agree that disputes are resolved by conciliation, not confrontation, and that he has chosen the latter option? Will he outline in detail the steps he will be taking between now and Tuesday to avert this strike action? Does he agree that successive Governments have taken nurses for granted in that they have seen nursing as a vocation rather than a job? Is it the case that the consultants wanted total control over deciding what constituted essential and emergency cover and that that is where the problem lies?
Again, the Deputy's question related to the contingency plans that are being made, and I have outlined those to the House. His questions now are more extraneous, but I will deal with them. I reiterate that no confrontation has been sought by the Government in relation to this matter. The Government has abided by the procedures and honoured the commitments it was asked to honour under the established industrial relations machinery, which was set up to deal with cases such as this where parties in direct discussions cannot come to agreement. The failure of one side of the equation, the Nursing Alliance, to abide by those principles of social partnership resulted in a strike ballot being taken and notification of strike action has been forwarded. The reason there will be a strike is because Nursing Alliance has decided to use what I regard as a blunt weapon when other avenues are available which need not affect the public and which allow it advance its issues in a way consistent with the social partnership which has brought success to all parts of the country and all elements of the workforce, including nurses.
I call Deputy Shatter.
What about my question on consultants?
We will have an orderly Question Time. I have called Deputy Shatter.
I asked a question about consultants and the Minister has the answer. Is it the case that the consultants wanted total control over the definition of essential and emergency cover and that that is where the problem lay in dealing with contingency plans?
It is more comprehensive and complex than that. It must be asked what constitutes essential nursing cover. The Nursing Alliance has a legitimate view to express about that. Clearly the admittance to hospitals is a medical or clinical decision and the IMO has issued a circular to everyone suggesting that the protocols relating to that should continue and I believe they will.
Will the Minister acknowledge that the disruption this strike will cause not only may pose a threat to patients with critical illnesses but will cause huge difficulties for the wider community, such as patients waiting some years on the elective surgery waiting lists? We already know, as the Minister—
A question, please.
Is the Minister aware, and can he tell the House how many operations have to date been cancelled by hospitals because of this threatened strike? Is he aware, and can he tell the House how many residential homes to date have been in contact with relations of people who are intellectually or physically disabled requesting they bring their relations home this weekend? Is the Minister in a position to tell the House how many patients are so affected? Is he in a position to tell the House how many hospitals to date cancelled casualty department appointments dating back over many weeks for a variety of patients? Can the Minister tell the House exactly what he and his Department are doing to monitor the impact as of now of the proposed strike and what he will do next week to monitor the impact of a strike which would not have occurred had he engaged in constructive dialogue with the nursing unions?
Constructive dialogue has taken place for four years on this matter and the Labour Court has confirmed we have reached the culmination of that process. Obviously elective admissions will be affected by this proposed strike action. Regarding residential services for intellectually disabled and geriatric patients and so forth, local discussions have confirmed that personal care and the usual proper nursing care for those people in residential facilities will continue and that is welcome. Obviously day care services will be affected.
Why did relations of people in residential homes receive phone calls yesterday and today? Can the Minister indicate to the House if he knows how many elective surgeries involving serious areas of specialities such as orthopaedics and cardiac surgery have been cancelled to date throughout the country? Is he monitoring that and can he tell us what is the position to date? Has a calculation been done by his Department on what impact there will be on the waiting lists if this strike begins and continues for a number of days, if not weeks?
Obviously we will be able to assess that if and when the strike occurs and continues. I have candidly stated that elective admissions will be affected, as will waiting lists, as a result of a reduction in activity levels in the acute hospital system. All these procedures will be affected and that goes without saying. That is why we continue to appeal, even at this late stage, to the Nursing Alliance not to proceed with this strike and allow us proceed with the alternative strategy.
Does the enormity of that not indicate that the Minister should engage in dialogue?
Allow the Minister to speak without interruption.
Since the time the Deputy heard of phone calls being made to relatives about residential services, promises were made on those matters at the meeting yesterday and locally.
The Minister stated that the Government has not sought to be confrontational in this matter. Does he agree that phrases used by the Minister for Finance about industrial relations matters, such as "half-witted" and "half-brained", are provocative and bring about the type of confrontation—
We are straying from the subject matter of the question.
I am replying to a point made.
The Deputy is only allowed ask a question.
One is only allowed to ask a question stemming from the previous reply.
Does the Minister intend to make available or to construct any type of framework within which talks could be resumed between now and Monday evening with a view to seeing if some form of resolution to this unwanted dispute which everyone wants averted could be brought about? Is he going to sit and do nothing and not attempt to contact the union leaders to see if some formula can be found between now and Monday evening? Is the Government's position that the Labour Court has made a decision and recommendation in arbitration and that that is the end of the matter?
I can only reiterate the Government's position. I have already done that and there is no point in my repeating it for fear that any other—
Would the Minister at this late stage, in light of the hardship which will undoubtedly be caused, consider requesting a meeting with the trade union leaders? They are in the House at present and there could be a meeting to see if there was a possibility.
Deputy Quinn was Minister for Finance at a time when what was on offer was a third of what is now on offer. Be that as it may, we all have our responsibilities and they change from time to time. The Government has stated that, if people are prepared to uphold the principles of social partnership, there is a means by which these issues can be continued to be addressed, but they cannot be addressed on the basis of a departure from the Labour Court recommendations. That is the Government's position and it is not a confrontational, absolutist or irredentist position.
Is it a final position?
It is one which provides the scope for the issues which the Nursing Alliance wishes to see addressed to be continued to be addressed in the appropriate fora which have been set out by Government, which include the Commission on Nursing, the question of a new pay determination system to be agreed through working with their public service union people, and a post-Partnership 2000 arrangement. That, coupled with acceptance of the Labour Court recommendation, provides an available level of scope which is unavailable when strike action is taken. That is the fact of the matter and it is an unarguable case. The Government is anxious that everyone would again dedicate themselves to the principles of social partnership, which have served all the social partners well, as the means by which we now do business in this country. We do not want—
However, the Minister refuses to meet the nurses in the meantime.
I know the Deputy may be a late convert to this, but that is the way we do business in modern Ireland. We have no intention of returning to a situation where sectional interests must be examined in isolation from the general parameters of possibility which exist. That is a fair and reasonable approach by the Government to this matter.
Would the Minister not accept that this is a recommendation from the Labour Court that we are talking about, that it is not mandatory, that it is not arbitration? The Cabinet had to meet before the Government decided whether it would accept the recommendation. Would he accept that there are many examples where recommendations are not accepted either by one side or the other, that in this case one side has not accepted the recommendation but that does not mean the end of collective bargaining, and that the Minister has the capacity and the freedom—
That is not relevant to the question on the Order Paper.
I want to raise an additional point. With due respect to the Minister, I can tell him that the key to ensuring that people will be looked after in care is the opening up of discussions between the Minister and the nursing unions. That is the way forward. Talk is always better than war.
Many of the elderly and the sick do not live in residential units and need care. Who is to decide what is an emergency case? Much of workload will land on the family doctor dealing with people who are in need of care who may not now be able to avail of nursing care in the community. If, in the view of the family doctor, that person becomes an emergency case, is that sufficient for him or her to receive treatment in hospital? We are getting very close to zero hour, and there are so many questions unanswered—
The Deputy should ask a brief question.
—that it is very disturbing to those who are most likely to need care and those who are trying to deliver care.
The general practitioner will assess the situation for patients in the community and that will be referred to in the assessment procedures in the hospital. The normal procedures in that respect will apply.
In relation to the Labour Court, it is true that we have a voluntary code of practice in industrial relations. We also have what is known as a best code of practice. I have stated time out of number that it was the Nursing Alliance who, at the time of the publication of the Commission on Nursing report, sought due process. Now I am being told by some in the Nursing Alliance that I keep quoting the Labour Court recommendation. The first people to suggest that the Labour Court could resolve this matter were the Nursing Alliance in relation to three pay related issues. I am simply saying that, on the basis of what were termed residual issues being dealt with in the Labour Court, on the basis of the Labour Court having dealt with this in as comprehensive a way as it has dealt with any other issue before it in industrial relations over the past four years, on the basis of the Chairman of the Labour Court confirming that this was the culmination of the process, and on the basis of the Industrial Relations Act, 1990, which refers to the Labour Court as a court of last resort in practice, the fact that we have a voluntary code of conduct does not mean that we walk away from the principles of social partnership that that represents.
Deputy O'Shea.
Just one last supplementary.
I have called Deputy O'Shea. I will call Deputy Shatter next. It is Deputy Wall.
Has the Minister had discussions with the IMO on implementing a strategy for the elderly, mentally handicapped children and so on, who will be resident at home because of this strike? What is the situation in relation to that? Surely it cannot be, as Monday draws nearer, that there has not been consultation between the IMO and the Department to try to overcome the problem which will be created by the lack of a public nurse health team.
My understanding is that significant progress has been made on that issue. The IMO has forwarded to all its members a document which sets out what it expects its membership to do to assist in ensuring that proper patient care is available should the strike proceed. My understanding is that the procedures which have existed up to now will continue. I will clarify the specifics and get back to the Deputy for the sake of accuracy.
Is the Minister aware that many members of the general public looking in at what is happening perceive the Minister as mentally locked into the confrontational time warp of the 1970s? Would he not acknowledge that good industrial relations means that when disputes arise one engages in constructive dialogue? Would the Minister not agree that to find a way forward people will have to talk?
The Deputy is moving away from the subject matter of the question.
I am not, Sir. This is what the question is about.
The question is about emergency services. There are a number of Deputies offering. I would have liked to facilitate them all but time has overtaken us.
The Ceann Comhairle managed to interrupt in the way he traditionally does in this House on what is a most serious issue.
I resent that. The Chair's sole function is to ensure that Standing Orders are adhered to.
We are pursuing two issues, Sir. One is contingency arrangements and the other is strike resolution and avoidance. Deputy Quinn specifically included that in his question. The Chair may have come in half way through, but there are two issues before the House. Can I be allowed to resume what I was asking?
Would the Minister not agree that the only way this problem can be resolved is by talking? Will he stop giving this House lectures in industrial relations and indicate whether he will now open up a dialogue with the nursing unions? Is the Minister not aware that he does this before the strike occurs or he will inevitably have to do it afterward when great damage will have been done? Will he consider now opening up a dialogue so that procedures and frameworks can be found to avoid what will be a most damaging and life-threatening dispute?
I am sorry that when Deputy Shatter hears an opposing point of view he regards it as a lecture. Sometimes the state of knowledge of the Deputy in industrial relations requires instruction. We have had the most detailed and comprehensive examination of these issues within those structures which have the expertise to deal with them and which are agreed by everybody to be the means by which we should deal with these issues.
There have been disputes before in this country following Labour Court recommendations which have subsequently been resolved. The Minister knows that.
I would ask the Deputy to allow the Minister to continue without interruption.
In relation to the "sooner or later" argument which can have populist attraction without examination, sooner or later a recommitment to the principles of social partnership will have to be accepted by everybody. In the Government's view, those principles involve an ability to come up with a strategy which can keep the public isolated from this issue. The Government is putting forward a strategy which allows the Nursing Alliance to avoid involving the public in what is a pay and non-pay issue between the nursing unions and nursing management. That is precisely why we are continuing to ask people to give proper consideration, in a way in which perhaps the recommendation did not receive it, to the scope that is available in the strategy which the Taoiseach has outlined. It is a genuine and proper proposal which upholds the views and positions of everybody while allowing this matter to proceed in a non-confrontational way.
Does the Minister accept that important operations have been cancelled? I know that from relations of mine. Will the Minister be in a position next Tuesday at the emergency meeting of the health committee to give us fuller details on how many operations have been cancelled? I accept the Minister does not have that information right now, but will he be in a position to provide it next Tuesday?
If I receive any request from a committee of the House for information on the up-to-date situation so far as we can gauge it, that will be made available.
Has the Minister been in touch with the congress of trade unions to ask it to act as a third party? Has the congress been in touch with him? Has he had any discussions with the leaders of the congress of trade unions?
The answer in both cases is "no".
Are you talking to anyone?
What am I to say to the working mother who contacted me five minutes before I came into the House to say that she has been contacted by the psychiatric unit at Tallaght Hospital and asked to take her daughter home. Can the Minister, as Minister for Health and Children, tell me what am I to say to that woman?
Patients will not be discharged unless they are fit for discharge. The question of admittance or discharge from a hospital is a clinical, not a political decision.
I will take two final supplementary questions, one from Deputy O'Shea and one from Deputy Joe Higgins.
I understand there is no time limit on this matter.
Do you have a question, Deputy?
Yes. Other Deputies had a number of questions.
We have had 15 or 16 supplementary questions. I call Deputy O'Shea.
There is no time limit under Standing Orders.
On a point of order, there is no time limit under Standing Orders.
There are many precedents for not allowing a question go beyond half an hour. This question has already lasted 40 minutes.
There is no Standing Order on that.
There is no Standing Order but there are long-standing precedents for questions not to go beyond half an hour.
We are dealing with the nurses strike and people's lives are involved. This is not an ordinary matter. This is the most important matter before the House in the past 15 years and it is being dealt with in a shameful manner.
If I cannot ask a question can I at least seek a point of information?
I call Deputy O'Shea.
Will the Minister inform the House of the urgent intervention he has made or intends making regarding the critical situation at Waterford Regional Hospital where there already is industrial action? The situation at the hospital is critical. Has the Minister done anything or does he intend to do anything today?
The industrial action the Deputy refers to in his locality relates to the notification of strike action from the Nursing Alliance. It is unauthorised industrial action and presumably will be deferred until such time as the instruction to go on strike takes place, should that happen. I reiterate once again the arrangements that need to be made to ensure minimum emergency cover is obtained by everybody throughout the country. It is strongly my view and that of my Department and hospital management that a national framework provides us with the best guarantee that this will happen. In the meantime, local arrangements have taken place.
There is already a problem with industrial action at the hospital. What is the Minister doing about that?
If there is industrial action—
The Minister is unaware of it.
The Minister without interruption.
Waterford is known for its ability to come up with strike action, but if there is—
I want that remark withdrawn.
I withdraw it.
The Minister is casting a slur on Waterford.
I withdraw it.
Deputy O'Shea, allow the Minister to continue without interruption.
Does the Minister know what has been happening at the hospital?
If there is industrial action in relation to the notification given by the Nursing Alliance it is unauthorised strike action.
It is not. The Minister does not know what is going on.
If the Deputy can tell me what is happening in Tullamore I will tell him what is happening in Waterford.
The Minister does not know what is going on.
The Minister does not know what is happening to critical services. He is a disgrace.
I call Deputy Joe Higgins.
(Dublin West): Does the Minister agree that in the course of their everyday care in the hospitals and other parts of the health service, nurses are most in touch on a continuous basis with patients, that they already make many crucial and life and death decisions about the medical conditions of patients and advise doctors and consultants accordingly? Given this, will he instruct the health services employers to agree to the position being adopted by the nursing unions' representative as to the role nurses will have in determining emergencies? Given that the public understands the role played by nurses, does he accept they have massive public support, that the public will not tolerate a prolonged strike because of its drastic effects and that, in view of this, he will have to accede to the legitimate demands of the nurses? Given this, why does he not settle the dispute now rather than let a strike take place? The Minister has not answered the question as to why he agrees there should be inequality between nurses with third level degrees and other professions with third level degrees in the health service who have vastly different remuneration levels.
Deputy O'Shea is a reputable Deputy and I apologise for any statement I made which was not warranted. I understand the dispute in Waterford is a local one and that the HSEA is involved in trying to resolve it.
With regard to the points raised by Deputy Joe Higgins, there are relativities involved in the present pay determination system which people in the present environment regard as providing a barrier to addressing issues in the long-term which will improve remuneration for increased responsibility and performance. That is the issue the Taoiseach raised with the social partners as long ago as June 1998 and upon which much work has been done. It is because we are in the era of social partnership that those issues can be addressed constructively with the view perhaps that they may form part of the basis of the discussions that will take place in relation to a post-Partnership 2000 agreement. That will be the means by which those traditional and historical difficulties can be resolved.
The Government is being inconsistent. Why are nurses being treated so differently from, for example, gardaí or train drivers? I presume it is not that they are a largely female workforce. Why is the Government adopting such a hard line position on the nurses dispute when there is an option to open discussions with the unions? Is the Department still of the view that this strike, if it happens, may last three weeks? How does the Minister envisage the ensuing scenario? How many deaths will occur? How many people will suffer? How can he square that with the core commitment made by the Government to tackle the waiting lists?
We discussed this earlier when Deputy Quinn made a comment. I take the word of the Nursing Alliance this morning that there is no intention to put patients' lives at risk during the strike. The progress made in discussions in recent days signifies that we are getting to the point where we can see that this can be achieved. We have different points of view as to how to guarantee or give assurances on that, but that is the current position. In view of this, to refer to questions in that manner does not do a service to the representatives of the nursing unions who seek to ensure that they deal properly with this issue and in accordance with the ethics of their profession.
I am referring to comments attributed to the Secretary General of the Department.
The Minister, to conclude.
There is no time limit on this matter.
There is a time limit and there are precedents. I am concluding this question now. I said I would take no more.
On a point of order, Deputy Shatter, I and other Deputies sought to invoke Standing Order 31 but this was refused. This matter has been raised on a number of occasions this week. The scale of the issue is unprecedented. Members who wish to speak again on Partnership for Peace will be able to do so. We have approximately eight minutes left—
Fifty minutes of debate on this question have been allowed. That is sufficient for a Private Notice Question.
For whom?
All Private Members' business was devoted to the issue.
It is sufficient for a question. Six minutes are devoted to Priority Questions, so we are drawing this question to a conclusion and we are now moving on to read out the matters for the Adjournment.
On a point of order, a number of Deputies in the House have not had the opportunity to ask a question. As I understand it there is approximately five minutes before the Adjournment Debate.
Five minutes would not facilitate the number of Deputies offering.
Given that the House will not be considering another matter I ask you, Sir, to allow Deputies who have not had the opportunity to ask a supplementary question to be allowed to do so in the short time remaining.
Please allow time to Members who are offering. I have always found you to be reasonable in such matters.
My question will be brief.
Private Notice Questions did not proceed for one hour before.
The length of time the question lasts is a matter for the Chair and in my view it has gone on longer that a Private Notice Question should go on. I will now announce the Adjournment Matters.
On a point of order, we have not reached the time for the Dáil Adjournment.
I accept we have not reached the time but we are now moving on to the Adjournment.
It is outrageous for the Leas-Cheann Comhairle to chop the debate with five minutes remaining.
There is no question of chopping the debate.
Whatever argument there is in procedure for reverting to the PfP debate, there is no justification for the decision of the Leas-Cheann Comhairle to read out the Adjournment Matters five minutes in advance of the time and going straight to the Adjournment. It is a blatant breach of procedure.
Which is contrary to Standing Order—
Deputy Rabbitte, a half an hour would have been sufficient for any Private Notice Question.
(Interruptions).
It should have concluded at 4.20 p.m. we have already gone on another 20 minutes.
A Leas-Cheann Comhairle, you are making it up as you go along.
I am not making it up as I go along. If the Deputy will read the record, there is a long-standing precedent—
(Interruptions).
In the circumstances, I am calling for a quorum.
There is a quorum.
(Interruptions).
The Opposition side of the House is interested in this debate.
A Leas-Cheann Comhairle, I asked a question within your time. This is your personal time; nobody else has agreed to this particular timeframe. I asked a question within that timeframe and I did not receive an answer. I think I am entitled to that.
What was the question?
First, why are nurses being treated differently from the gardaí and train drivers and, second, is it still the Minister's view that this will last three weeks? How does he envisage this strike will impact on the health services?
If the strike goes ahead, the impact on the health services will be adverse. It will be a challenge to management to provide the sort of service everyone in this House would wish to see. It is a truism to say that the strike will have an adverse effect on the health services. No one seeks or wants this strike. There is no question of treating any sector differently from another sector. It is a question of abiding by the procedures, honouring the commitments and moving forward in a non-confrontational way, which is available to those who are seeking to go on strike. That is the Government's clear position. I believe it is a tenable and proper position, one which takes into the account the wider implications of this issue. There are wider implications, depending on how the matter is resolved. This is very clear and Opposition Deputies and parties committed to the social partnership model are skirting around that central problem because it does not suit them to face up to it. The Government did face up to this problem and I am doing the consistent thing as people—
(Interruptions).
In reply to Deputy Stagg—
We did not cause a nurses' strike. The Government will not talk to the nurses.
The difference between the February 1997 and the October 1999 situations is that in February there was an acceptance of a Labour Court recommendation; in 1999 there is the rejection of a recommendation, which was the culmination of the process.
(Interruptions).
Can I ask the Minister—
A point of order from Deputy Shatter.
On a point of order, Deputy Fitzgerald tried to ask a question five minutes ago and you denied her that right.
The question was answered.