The Taoiseach will be aware from his staff, who read newspapers, watch television and listen to radio, of the horror stories that unfold every day in regard to health, horror stories involving people who are old, sick or have a disability – for instance, the 74 year old woman who spent 16 days as an in-patient on a trolley in Tallaght Hospital or the accident and emergency unit I visited recently where two suicidal psychiatric patients were under private security for two days.

Dublin hospital waiting lists are up 107% on the figure five years ago. We think the position is bad, but it gets worse every day. The latest insult is the disgraceful cutback in the number of hours available under the home help service scheme, which makes life bearable for many thousands of our citizens. In the North Eastern Health Board area alone there is a reduction of 85,000 home help hours this year. Is this not absolutely disgraceful and contemptible treatment of the vulnerable in our society who need that service? Is it right that in a country that has come through five of the strongest economic years we have ever enjoyed, people still wait four years for cataract or hip operations, seven years for orthodontic treatment and some years for cardiac treatment?

Is this not disgraceful treatment of the health services of our country? Is it not an indication of a complete lack of leadership and of the ability to manage professionally a service that has let people down? We have heard all about task forces and reports on health. We had the Brennan report, the Prospectus report and the task force on medical staffing. Will the Taoiseach tell the House how much has been spent on these reports and on consultants' queries over recent years? Has a single initiative from any of these reports made the lives of our patients or the health delivery service to them any whit better in recent years?

Hear, hear.

The answer to the last question is "Yes". I could cite many areas, such as the cardiac and cancer areas, where we have seen enormous improvements overall. While funding in health is up by over 160% what is more important is that hospital activity is up almost one fifth. Waiting lists are down by about 14%. The number of people on waiting lists represented 3% of all discharges for acute hospitals last year. The number of people working in the consultancy service is up 26%. There have been enormous increases in resources in many of the health areas.

Of course there are pressures in hospitals. The Eastern Regional Health Authority is working closely with the hospitals mentioned by the Deputy, the five Dublin hospitals, St. Vincent's, the Mater, St. James's, Beaumont and Tallaght, on both the monitoring and evaluation of the activities, services and expenditure levels. There are problems, as the Deputy stated, which have been presented in recent days. The ERHA, with the individual hospitals and the Department of Health and Children, is looking at the service levels. There are hangover difficulties from last year where the service level component in the ERHA and the individual hospitals led to an overspend, which is being reduced this year, and this is creating some difficulties.

The ERHA has advised that the same total levels of services which it agreed with these hospitals last year would be provided for the hospitals this year. The authority has also said that additional money is available this year for cancer, cardiology and renal services. At a minimum there will be protection within the system for those services at the levels that were approved for last year. Provision is being made for the completion of major initiatives which commenced last year. There are an additional 300 acute beds at St. James's, St. Vincent's, St. Michael's, St. Joseph's Raheny and Naas. The Deputy asked about the position at Tallaght Hospital. The chief executive officer of the hospital met with the staff last Thursday. He is happy to meet them to resolve the industrial dispute in that particular hospital.

The Deputy asked about the North Eastern Health Board and the home help service. My information is that just three years ago the health board spent under €4 million on that service which represented about 10% of the budget for the elderly. This year some €8.2 million has been allocated to the home help service which represents 17% of the budget for the elderly. As can be seen from those figures there has been a dramatic increase. I do not know if I have answered all the questions the Deputy raised. He raised the issue of the Dublin hospitals, the services and reports.

In his last question he asked the cost of the reports. I do not have that figure but they are all being dealt with in trying to reform the system. We are spending €9 billion on the health service and some 96,000 people are working in it. It is the belief of most of people in the health service that we should look at structural reform of that area and that is what the Minister is engaged in.

This is the usual diatribe that is trotted out in response to every question. The single greatest failure of the Government in respect of health is that the bureaucracies are still as strong as ever and the services are not being delivered to the people. Last week, Deputy Olivia Mitchell asked the Minister for Health and Children to outline the budget for the 39 acute hospitals for 2003. The Minister responded by saying that level of detail was not available to him. Is there anybody in a major organisation, running major units, who does not know what is the available budget? Apparently the Minister for Health and Children is not told. How is it that the bill for taxis in the Louth-Meath area for acute hospitals for 2002 is €254,000? How is it that hours are being cut back? Is it because of the minimum wage paid to those who provide an essential home help service? The Taoiseach's response is typical of that from an accountant, it is an economic statistical response to a human problem. Give that answer to those who are lying on hospital trolleys today and to those who are lying at home in pain or in sickness waiting to be put on a list. In-patient and out-patient lists and figures are being combined and massaged. It is disgraceful that the Government is spending €9 billion of the people's money; it is like pouring it into a black hole as no effective service is being delivered. The bureaucracy is as strong as ever. Of the 24,000 employed in the health service, only 6,000 are nurses and doctors. That is an indictment and a failure of professional management and leadership of the health service.

Hear, hear.

Deputy Kenny will describe whatever I say as a diatribe.

He is right.

In one breath he says that all these reports are a waste of money and that we should not carry them out and in the next he says the problem lies in the administration of these areas and that we should do something about it. Unfortunately, Deputy Kenny cannot have it both ways.

No decisions are taken.

Deputy Kenny either wants reform or he does not.

Could we have a little less conversation and more action?

Whether Deputy Kenny likes it or not, the Government in 2003 is investing €9.2 billion in the health service, an increase of €970 million on last year's figure. It is an enormous amount and represents an increase of 162% in the past five or six years. The Deputy has asked the individual areas where the increased sums will be spent.

It is like pouring water into a leaking bucket.

Deputy Allen is not the leader of his party.

We are spending €116.7 million on acute hospitals.

It will not go away.

In the area of disabilities, autism, mental health and palliative care, we are spending an additional €41 million. On older people we are spending €15 million. In respect of child care we are spending an additional €7.7 million and we are spending money on primary care. These are not just figures. They represent additional money for additional staff for additional facilities for additional treatment in additional hospitals. That is the reality.

For additional problems.