Thousands of nurses have taken part in a nationwide strike over pay and conditions for the first time in 20 years.
More than 30,000 nurses from the Irish Nurses and Midwives Organisation (INMO) took to picket lines in freezing conditions outside hospitals across the country on Wednesday after talks aimed at resolving the issue failed.
Nurses are calling for a pay increase of about 12% and for the Health Service Executive (HSE) to take steps to deal with recruitment and retention issues.
But the Government has said it is not in the position to borrow hundreds of million of euro to fund pay increases for nurses.
The INMO has scheduled five more 24-hour stoppages, while the Psychiatric Nurses Association is due to initiate an overtime ban on Thursday.
The HSE said thousands of people have had appointments or services cancelled due to the strike.
Those with intellectual disabilities, the elderly and the young were among those affected.
Emergency and planned essential services were continuing while residential care was exempted from the trade union action over pay.
Cancer surgeries have gone ahead.
The health authority said it expected further disruption on Thursday because some who have stayed away from emergency departments on Wednesday may present then.
On a normal day around 3,000 people are seen in the country’s emergency departments and 750 of those are admitted as inpatients.
Liam Woods, deputy director general of operations in the HSE, said: “We are seeing delays and can expect further delays over the day.”
Minor injury units are closed, which places extra pressure on emergency departments.
Speaking in the Dail the Taoiseach said that while he could justify borrowing to save jobs post-Brexit or for capital projects, he could not for nurses.
Leo Varadkar said: “We’re not in a position to borrow hundreds of millions of euros to fund pay increases.
“I can justify borrowing hundreds of millions of euros for emergency measures to save jobs, if it comes to that in the next couple of weeks.
“I can justify borrowing that money for one off capital projects that will be with us for 40 or 50 years but I think borrowing money and funding pay increases with borrowed money is bad policy.”
Mr Varadkar added that he profoundly regretted the action and he was sorry for the disruption inconvenience caused to patients.
But the opposition accused the government of not making any genuine attempts to prevent the action.
Fianna Fail leader Micheal Martin said: “There’s been no proactive engagement from government in relation to this dispute with the nursing representatives.
“The belated 11th hour activity that we witnessed over the last number of days was far too little, far too late.”
Mr Martin accused the government of being in denial about the recruitment and retention issues within the health service, adding that agency nursing was costing 1.4 million per week and that the country was “haemorrhaging” nurses.
Mr Varadkar said he did not want to be put in a position where he would have to divert money that is earmarked for new medicines to pay for pay increases.
Bur Mr Martin said there was “no limit to the budget of the children’s hospital” and that it was wrong of the Taoiseach to suggest that if there was a deal reached with the nurses that it would be at the expense of medicines for patients.
Sinn Fein leader said the nurses were on the picket lines because of the government’s “absolute failure”, not just in relation to the pay issue, but also the recruitment and retention crisis.
Mary Lou McDonald said nurses did not want a strike but they had been forced into it.
“They feel failed, they feel let down, they feel they haven’t been listened to and they’ve been backed into a corner,” she said.
Ms McDonald added that Mr Varadkar had a duty as head of government to intervene in the matter rather than “pass the buck”.