Ivana Bacik (Dublin Bay South, Labour)
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I raise the incredibly volatile and concerning situation in the Middle East. As we were coming into the Chamber, we heard reports Israeli troops are, as we speak, firing on three UNIFIL positions in Lebanon. We understand from reports that one of those is the base at Naquora, that there are injured UN peacekeepers and that UNIFIL is to issue a statement very soon. No Irish peacekeepers are affected, as far as we know, but all of us must send thoughts to the troops now under fire. They are UN peacekeepers fulfilling a really important and valuable mission. Our thoughts are with our own peacekeepers in southern Lebanon and their families, who are desperately worried as matters develop. We hope everyone will be safe, as far as possible, but it seems the UN is under attack from Israel.

I have already thanked the Tánaiste and want to put on record my thanks for the briefing he gave to me and other Opposition party leaders on the situation facing Irish peacekeepers in Lebanon on Tuesday. Since that briefing, which we all found useful and constructive, we were relieved to see the most immediate danger to our troops in their positions had receded, but news is breaking of Israeli attacks on the UN today.

I want to put on the record my deep appreciation and that of the Labour Party for the invaluable work being done by our peacekeepers in Lebanon. We know how dangerous that work is and today's developments illustrate that starkly. I know the Tánaiste will continue to keep us and, much more importantly, the families of our troops updated on developments as they unfold.

This is yet another example of Israel's continuing spreading of mayhem, war, destruction and civilian deaths and casualties across the region, in Gaza, where genocidal actions by Israel have led to over 40,000 deaths, also now in Lebanon and there are reports from Syria too. Today in Gaza, 28 people were killed and 54 injured in an airstrike on Rafida school, where people were sheltering from the brutal bombardment. It is outrageous that Israel continues to act with apparent impunity, targeting civilians and now, it seems, firing on peacekeepers. There have already been unprecedented levels of death among UN aid workers, children and journalists under fire from Israel.

The Taoiseach is in Washington this week. He has said that President Biden had a conversation of substance with Netanyahu, yet Israel continues this outrageous and illegal action. What can we in Ireland do? Let us go further than we have gone. We welcome the recognition of the State of Palestine and the Tánaiste's efforts at EU level, but we have legal opinions stating the occupied territories Bill can be passed into law to create a meaningful set of sanctions against a state that is now a terror state, it seems. It is acting with disregard for the international rules of war and the rules around protection of peacekeepers. It is unacceptable. I know the Tánaiste and all in this House share that view as our troops face this outrageous danger. What are we doing about it? Can the Tánaiste say we will act to pass the occupied territories Bill? The Tánaiste will have all of our support in doing so. His party and the Green Party, up to 2020, wanted to see that Bill passed.

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy sincerely for raising the issue and for her comments. I do not have an update on the report I received as I arrived in the Chamber of firing on UNIFIL positions. I expect to get a comprehensive report on that, which I will share with people generally.

It illustrates the high-risk and dangerous environment peacekeepers now operate within and the need for an immediate ceasefire in Lebanon between Hezbollah and Israel. That has to happen immediately. Israel is not listening, even to its allies, in terms of progressing its agenda of, it seems to me, all-out war in the region. We have seen what has happened in Gaza, where 70% of all buildings have been levelled, 40,000 people have been killed and the population is now experiencing forms of famine and lack of access to proper nutrition. Children have had no access to schools for 12 months, from the beginning of this war with the Hamas attack on 7 October, which was a heinous crime as well. It is unacceptable.

I said earlier in the House that the nature of destructive warfare today, where an entire community, from education to health, gets destroyed in the name of attacking various opponent military targets, is a clear breach of international humanitarian law. There is no doubt about that. Ireland has pursued this through the international courts. It has supported and made submissions to the international courts. The advisory opinion is important, including in the context of the occupied territories Bill. We await further advices from the Attorney General, which I expect we will get shortly, in respect of both the Bill and the impact of the ICJ.

The ICJ places obligations on states in respect of the occupation, whereby nothing can be done that would in any way aid or support the Israeli occupation of Palestinian territories. In my view, this creates a new context in which we must look at this. We have already tabled this at the European Union Foreign Affairs Council meeting - the informal one held recently - where Josep Borrell, the high level representative, said that he has sought legal opinion as to the implications for the European Union in respect of the ICJ advisory opinion. Ireland supported that opinion through resolutions. We co-sponsored a resolution recently to have a follow-through at UN level on the implementation of that advisory opinion.

Ivana Bacik (Dublin Bay South, Labour)
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As the Tánaiste said, clearly the situation is unfolding. UNIFIL is due to give a statement shortly but the reports are extremely concerning. I agree that of course we need to see an immediate ceasefire. It is also true, as the Tánaiste said, that Israel is not listening to allies. It is not listening to anyone. That is the point. It is continuing to act because it believes it can do so with impunity. Netanyahu's Government has lost all sense of moral compass, international law and compliance. As a small state here in Ireland, where people share such outrage at Israel's actions, sometimes people can feel helpless and ask, "What can we do?" Certainly we have done some important things, such as the recognition of the State of Palestine, which was very important. We can, should and must go further, however. I take some encouragement from the Tánaiste's response. As he said, the ICJ opinion does change the situation. It does create a different and changed legal context in which it becomes even more imperative that we pass meaningful trade sanctions on Israel here from Ireland. The EU is Israel's biggest trade partner. This is how we can have an impact on Israeli policies through trade. Will the Tánaiste assure us that he is actively looking for ways to pass the Bill rather than reasons not to? Let us hope the Attorney General's opinion will give us a way forward.

Micheál Martin (Cork South Central, Fianna Fail)
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I can assure the Deputy that we will be supportive of anything that will assist in pushing back against the occupation of Palestinian territory and what is happening at the moment with the significant land grab in the north of the West Bank. With regard to the ICJ opinion, I already took action, instructing my Department and the military leadership not to procure from Israel any defensive equipment, drones or whatever. I had read somewhere, much to my surprise, that this was about to happen. I would regard any engagement with the defence industry in Israel as tantamount to supporting the occupation so I took that decision based on the ICJ advisory opinion. It is an opinion that people should read. I know Deputy Bacik has done so, given her expertise, to be fair. The opinion has significant implications for all European member states. Europe cannot ignore the implications of the ICJ advisory opinion any further.

Seán Ó Fearghaíl (Kildare South, Ceann Comhairle)
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I thank the Tánaiste. We move now to People Before Profit-Solidarity and Deputy Mick Barry.

Mick Barry (Cork North Central, Solidarity)
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I thank the Ceann Comhairle. What a cowardly and craven performance by the Taoiseach in Washington last night, by the way.

I wish to address what has happened in our health services on the Tánaiste's watch. Ten minutes from now, trade unionists will assemble at the gates of the Midland Regional Hospital, Tullamore and at Our Lady of Lourdes Hospital, Drogheda to protest against the recruitment cap imposed on the HSE and their hospitals by the Tánaiste's Government. Yesterday, workers protested at St. Luke's Hospital in Kilkenny and Connolly Hospital in Blanchardstown, where they were joined by my colleague, Councillor Ruth Coppinger.

Last Thursday, I joined with workers protesting at the gates of Cork University Hospital, CUH. I spoke to workers from the medical records department. They have just ten full-time staff where they should have had 24. I spoke to workers from the housekeeping team. Earlier this year, hospital management tried to stop members of this team from taking their annual leave but had to back down after an outcry. Nevertheless, the pay and numbers strategy still means that some members of this team have to clean three wards in a day. That is backbreaking. Outsourcing has to be stopped and these workers should get their grade 3. I spoke to nurses who pointed out that there are more than 2,000 nursing and midwifery vacancies being suppressed across the HSE. God knows how many posts are being suppressed across all grades. Perhaps the Tánaiste could tell us. I spoke to porters who told me that, in 20 years, they had not seen the workforce so burnt out and stressed out.

On Tuesday, there were an incredible 98 patients on trolleys or chairs at CUH, the highest number since the INMO started collecting trolley numbers 18 years ago. If there are 98 patients on trolleys in CUH at the start of October, how many await us in the depths of winter? One of the hospitals that could take some of the pressure off CUH is Mallow General Hospital but Mallow hospital now has 34.5 full-time vacancies. Staff shortages in its lab services recently forced the cancellation of some surgical procedures. The gap has been plugged for now, with staff members from CUH who live in or near Mallow coming to the rescue. Once again, the picture we see is of a health service really struggling to get by and a workforce that is severely overstretched.

Mallow was just one of the towns that were threatened recently with a cut to their ambulance cover. I congratulate the ambulance staff, the people of Mallow and people across the Cork and Kerry region for pushing back against that cut. The threatened cut to ambulance cover was withdrawn under pressure but the original cutback by the HSE to National Ambulance Service funding remains in place. People are suspicious, rightly so in my opinion, that the cut in ambulance cover will remain withdrawn until after the general election but will be reintroduced then. I urge the people of Mallow to elect politicians who will fight ambulance cuts all the way, not politicians who would have them postponed rather than cancelled.

The Government's pay and numbers strategy is a disaster. It is a recruitment ban by another name. Will the Government lift it before the winter comes or will it just allow this dire situation to go from bad to worse?

Micheál Martin (Cork South Central, Fianna Fail)
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First of all I must point out to the Deputy that there are 28,000 more people working in our health service than there were at the beginning of 2020. That is a 23% increase. This includes some 9,375 nurses and midwives, 4,000 health and social care professionals and 3,330 additional doctors and dentists. At the moment, we are looking at 129,750 - approximately 130,000 -people now working within the HSE. This is excluding disability services, which have moved over to the Department of children. The budget is in and around €25.8 billion. We need perspective here. The Deputy creates a picture of cuts and pull back but that this does not stack up. The agreement reached by the Minister for public expenditure and the Minister for Health allowed for €1.5 billion in 2024, into the base, and €1.3 billion into the base for 2025. These are huge sums of resources allocated to our health services. That agreement allowed for the regularisation of 2,000 posts, for which the HSE had recruited but up to then had not been funded, and then a further 2,000 posts that were recruited temporarily to support services during the Covid-19 pandemic and which were still in place. The HSE had basically recruited 4,000 staff without funding being provided and that is all sorted now. In addition, provision has been made to recruit a further 4,200 staff in 2024, with 3,310 funded by the Department of Health and 900 by the Department of children. There is no ceiling. There is the provision now whereby decisions can be taken regionally on prioritisation and the allocation of resources. I do not believe it merits industrial action, but certainly engagement and dialogue.

We also have to raise the issue of working on outcomes, reforms and governance. We cannot keep on ignoring that. The resources are exponentially growing within health. We are committed not just to further recruitment, but also doubling the numbers in training in nursing and allied healthcare professions. The Minister for higher education and the Minister for Health have already announced significant funding for the colleges to increase the number of those in training. The argument being put forward by the Deputy is that the recruitment ceiling is a freeze by another name.

That could not be further from the truth. The health service has been funded to expand its numbers, both this year and next year. Funding has been allocated to enable that to happen.

Mick Barry (Cork North Central, Solidarity)
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The Tánaiste gave out a lot of statistics but he did not point to the fact that services have had to increase, and rightly so. He also did not point to the fact that there are big increases in the population. He also did not indicate how much of the new staffing is on the basis of hire of agency workers. These workers are more expensive and often have considerably less skill and experience in the particular hospital. The Tánaiste says he does not believe that it merits industrial action. He should listen to the nurses, porters, the staff in the medical records' offices and the housekeeping staff. In many cases, these people are the Tánaiste's constituents and they are telling me and they are telling the Tánaiste that they are over stretched, burnt out, stressed out and demoralised. A blanket of statistics cannot be placed over that to deny the real human experience.

The Government will ignore this issue at its peril. These protests are gaining strength around the country. This is a snowball effect that is happening in the hospitals among the health service workers. Whether the election takes place in February or in November it looks to me like the Government is running smack into that mood among the health service workers. This will be a general election issue.

Micheál Martin (Cork South Central, Fianna Fail)
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I am not providing an umbrella of statistics. There is a fundamental issue here. The statistical data from the OECD shows that Ireland now has second-highest rate of practising nurses per 1,000 of population, among reported EU countries. However, let us put all that to one side. There is no doubt that health expenditure has increased exponentially. Yes, the population has grown as well and there is pressure on hospitals. I accept that. There are organisational and reform issues that we have to look at as well. We are more or less increasing health expenditure every year by €1.5 billion. We have to evaluate that spending. There has been a tremendous increase in life span over the past 20 years. There has been fantastic work done on cancer, cardiology, stroke treatment - where outcomes and survival rates have really improved. Equally, we have to look at some of the outcomes in terms of numbers of people treated and so on over the last number of years and the correlation of that with the inputs. This is a legitimate issue that we should put on the table. By this I am not referring to the people on the ground. HR management in the HSE needs to be looked at. A concern I have is that work has been delegated to regional executives in terms of the prioritisation of resources but that could lead to a post-code-lottery type of situation, which is something we must avoid.

Cathal Berry (Kildare South, Independent)
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I want to raise the issue of the situation in the Middle East, particularly as it pertains to our peace-keeping troops in south Lebanon. I commend the performance and the professionalism of our troops in and around outpost 652 over the last number of days. I shudder to think what would have occurred if our troops had given in to the intimidation and abandoned their position. It would have had a detrimental, domino effect across the entire blue line, with soldiers at the other two-dozen-odd posts looking over their shoulders. What occurred was the opposite, with the actions of our troops stiffening the resolve of the other posts and it reinforced the fact that there will be no more Srebenicas, not on our watch at least. They say that history can turn on the smallest of hinges and perhaps such a hinge is what occurred over the last few days at that outpost. I commend everyone involved in the operation.

I want to focus on the wider issue of the United Nations Interim force in Lebanon, UNIFIL and its viability. There has been some loose talk recently, some of it well intentioned, saying that UNIFIL should not be there and that we should somehow withdraw the 10,000 troops from 50 different nations at the stroke of a pen. I want to make three points about this. I suspect the Tánaiste probably agrees with me anyway. If there had been a UNIFIL-type buffer zone between Gaza and southern Israel 12 months ago, would the attack by Hamas have been allowed to take place? I suggest that it would have been highly unlikely. Even if the attack had happened, would the indiscriminate carpet bombing of Gaza have occurred if there had been a UNIFIL buffer zone in place on the Gaza border? This is also highly unlikely. I emphasise the fact that the attack by Hamas came from an area where there were no UNIFIL troops, not from an area where there were UNIFIL troops. I want to hammer home those points that, yes, we accept the imperfections of UNIFIL but for those people who do not appreciate the presence of UNIFIL troops, I can assure them that they will certainly not appreciate their absence if they are withdrawn.

I agree that the safety and security of our troops is our top priority and paramount in this. I want to raise two issues that are of secondary importance but are still important. The first is the logistical situation. Can the Tánaiste provide reassurance to the House that our troops have adequate supplies of water and food to sit this event out? Second, there is a planned, scheduled rotation in around five or six weeks' time where some 300 fresh troops from Ireland will be heading out to relieve the 300 battle-hardened troops there now. Does the Tánaiste envisage that this rotation will occur as planned, pending the operational situation?

Micheál Martin (Cork South Central, Fianna Fail)
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I thank the Deputy for raising this issue. I am in a position to report to the House that a statement will issue shortly from our Defence Forces, stating that all Irish troops in Lebanon are accounted for and well. This is a relief to us after the reports that had been circulating prior to this session of leader's questions starting. I also want to pay tribute to our soldiers in Lebanon and all of the peace-keepers in UNIFIL from 50 contributing countries, totalling some 10,000 in theatre, at the moment. They are doing the most noble activity of all, endeavouring to keep peace between warring parties. Our soldiers are professional, resilient and operating in a very challenging environment. I thank their families and loved ones who, far from the field, are understandably extremely anxious about the situation. We owe them a very significant degree of gratitude for their resilience in holding up in what is a very worrying time for them.

Regarding the mandate, both Israel and Lebanon sought the intervention of UNIFIL. There is a need in any post-war scenario that the mandate be respected by both sides in the future. The fulfilment of the mandate has to be an unrestricted one. The Deputy is correct to say that there have been imperfections, not so much in UNIFIL really because it is a chapter 6 mission. There are limitations to chapter 6 missions which are peace-keeping missions. Hezbollah has built up activity over the past year. It has fired about 10,000 rockets into Israel. That is a breach of UN Security Resolution 1701. Israel's incursion into Lebanon is a breach. The Deputy is correct. Our troops are there as the eyes and ears of the world-----

Mick Barry (Cork North Central, Solidarity)
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It is not an incursion; it is an invasion.

Micheál Martin (Cork South Central, Fianna Fail)
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-----to bear witness to what is happening and potentially, if diplomacy can triumph and get the war stopped, then UNIFIL could play a significant role in the restoration of peace. The Deputy raised some very important hypothetical questions about if a similar force had been in place in Gaza. There are no guarantees and we cannot be certain about any particular outcomes but already the Arab peace initiative envisages an international security presence as the optimal way of creating a post-war situation in Gaza that might have some substance in terms of dealing with Israeli security while also allowing the Palestinian Authority or others to run Gaza for the benefit of the Palestinians living there.

I will come back in on the issue of troop rotation.

Cathal Berry (Kildare South, Independent)
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I thank the Tánaiste for his response. I want to be associated with the views expressed by Deputy Ivana Bacik and her utter condemnation of the Israeli attacks on the three UN posts this morning. This was completely unacceptable.

When this last occurred in 2006, when there was a major escalation on the Lebanese-Israeli border, there was a negotiated solution after about five weeks. I encourage all parties to follow a similar pathway. The sooner that happens, the better. Perhaps the Tánaiste would like to use the last few moments to address logistics and to give us any assurance he can as regards the scheduled rotation in a few weeks' time.

Micheál Martin (Cork South Central, Fianna Fail)
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I spent two to two and half hours on Sunday morning listening to numerous presentations from our military leaders, the Chief of Staff, the deputy chief of staff and the director of operations, and the Defence Forces have advised that, despite recent media reports, there is both fresh food and contingency food packs available, certainly at UN position 2-45. The outpost has about 20 days' worth of food and water supplies because our Defence Forces leadership sensibly sent out forward supplies in August in anticipation of challenges ahead and altogether independent of the UN. We have provided those supplies, which have given us a buffer.

On the rotation, as the Deputy will know, the handover from the 124th UNIFIL battalion to the 125th battalion was to occur in two chalks on 13-14 November and 24-25 November. However, in light of the recent changes to the security environment, the UNIFIL force commander has decided to suspend rotations for October for safety reasons. He will review the situation at the end of the month. Planning continues for the November rotation. It is under active review, pending any UN direction in this regard. Engagement continues with all key stakeholders, including with the IDF, as regards the protection of Irish troops. As the Deputy will know from his experience, there are a range of channels as regards stopping fire to protect soldiers in what is a very challenging environment.