A nursing union that will announce a series of 24-hour strikes today has hit back at the Taoiseach for ruling out pay rises.
The 40,000-strong Irish Nurses and Midwives Organisation (INMO) will announce stoppages that could begin as early as the end of this month.
Taoiseach Leo Varadkar warned any extra funds available would be used to protect jobs that are most vulnerable if the UK crashes out of the EU in March - not wage hikes.
And Finance Minister Paschal Donohoe claimed nurses' demands for increases on top of pay rises due under an existing pay deal threatened to take the State back to the "bad old days" and was "unsustainable".
Health Minister Simon Harris said the last thing the health service needed was a strike. He called for talks but warned "we can't just pick and choose bits of the public sector agreement that we like".
But the INMO and Psychiatric Nurses Association (PNA) warned they will forge ahead with strikes unless ministers discuss their grievances.
INMO general secretary Phil Ní Sheaghdha said the strike could be averted, but it would take direct engagement from ministers.
"The first step is for the Government to acknowledge that we have a problem," she said.
She said uncompetitive wages made it impossible to recruit enough nurses and midwives and the HSE only received one application for every four posts. She claimed the unions' demands could be dealt with within the existing pay deal. The unions want rises to bring nurses' wages in line with other staff, including occupational therapists.
However, ministers claim granting them would be a breach of the deal. They are also likely to fear knock-on claims.
The Public Service Pay Commission found no recruitment crisis among nurses and recommended increases for specialised grades. But a Government offer worth €20m was rejected.
General secretary of the PNA Peter Hughes said nobody in Government had disputed the worsening recruitment and retention issue. He said vacancies in psychiatric nursing had increased 40pc in the past year.
More than 7,000 support staff in major hospitals will begin balloting on strike action at the end of the month.