Is the Taoiseach aware that the management at Dublin hospitals must now resort to desperate measures to cut costs? I refer him to a confidential memorandum circulated by the chief executive of one Dublin hospital to senior staff stipulating that he is required to cut his costs by 10%, or €20 million. His senior staff are engaged in discussions with the EHRA to consider how this money will be saved and the following measures are proposed: the capping of cancer and dialysis treatment, which will place people's lives at serious risk; the closing down of the night dialysis shift, which will deprive patients of life-saving care; the closure of 35 more beds from April, which is the equivalent of a full ward; and major savings by eliminating the use of certain medical devices, thereby running the risk of increasing the mortality rate after certain treatments.

Is the Taoiseach aware that the hospital has been forced to consider additional cost-saving measures, including returning patients to the hospital from step-down facilities in nursing homes, thereby filling hospital beds with people who do not require treatment? Is he also aware of this confidential memorandum and that, to the best of my knowledge, it is being replicated in two other Dublin hospitals?

I am aware that under their financial and service arrangements and in compliance with the terms of the 1996 Act, all hospitals must have ensured by January this year that their service requirements are within their cost allocations for 2003. They have all complied. I am not aware of the so-called confidential internal document to which the Deputy refers. If it was confidential and internal it would not have found its way to the Deputy.

There is little in the document that is confidential for Fianna Fáil.

All hospitals work on a confidential basis within the hospitals system and under the relevant sections in the Department of Health and Children. This is an annual exercise. The overall position is that 96,000 people are employed in the health service and there has been an enormous increase in all areas of staffing.

This is ridiculous.

Some 30,000 people are still on waiting lists.

Allow the Taoiseach to respond without interruption.

Over 700 additional beds have been provided and an additional €29 million in funding has been allocated to cancer treatment services. Total additional Government spending in this area is €131 million. This year, the Minister for Health and Children has provided additional resources to all areas of the health services, including consultants, nurses, paramedics and junior doctors.

Given the enormous increases in funding, those involved in providing health services must manage their resources. The allocation provided this year should be more than adequate in this regard. There have been huge increases on previous years. Those involved should address their difficulties in the normal way, through the EHRA and the Department, with whom they are in discussion. It will not help the position of those managers who seek to get advertisements for their dilemmas. I am sure they are dealing with the EHRA and the Department, and they should continue to do so. The manager in question does not need Deputy Rabbitte to help him.

I do not apologise for irritating the Taoiseach. Should he wish, I will provide him with a copy of the memorandum. The case is Beaumont Hospital. The Taoiseach's waffling does little for patients suffering from kidney failure or to address problems arising from the capping of expenditure on cancer treatment facilities.

This situation is unprecedented and it affects three hospitals. The Taoiseach has the audacity to blame the managers at a time when he has imposed a cap on their spending. At the same time he is sending the Minister for Defence to the marketplace to procure a fleet of jets. When he gets his bargain basement prices it would not be surprising if the Minister does not also get a helicopter for the Minister of State at the Department of Agriculture and Food, Deputy Treacy.

How can the Taoiseach justify his position when yesterday a patient discharged himself after spending five days on a trolley in a hospital? He was charged €200 for the privilege of not being attended to. This case illustrates the state of the health services, yet the Taoiseach blames the managers.

There is no basis whatsoever for any curtailment of cancer treatment procedures. That has been confirmed by the Department of Health and Children. This year it has provided €29 million in addition to an earlier allocation of €31 million for these services. It is cheap for somebody to seek to create a commotion by giving Deputy Rabbitte an internal report that is highly confidential. It is not the correct way to proceed.

Shame on the Taoiseach.

Yesterday, the Minister for Health and Children repeated his often stated acceptance that there are capacity constraints at Beaumont Hospital and all other major acute hospitals. Under the Government's bed capacity initiative, an additional 35 beds are being provided to Beaumont Hospital and the Department of Health and Children has been informed they will shortly be commissioned. It will help to alleviate some of the capacity constraints at the hospital.

Pressure on the acute hospital system increases over the winter months. In recent years, funding has been provided for the contracting of additional places in private nursing homes. A major €27 million refurbishment programme, initiated through the Department and funded through the EHRA, is currently under way at Beaumont Hospital, which will provide it with a greatly enhanced environment. I am pleased Deputy Rabbitte identified the hospital as it has given me the opportunity to inform the House of this new development.