Each day, during which the crisis in the health system is upon us, some 38 people do not receive vital and necessary procedures. This means that 38 families – parents, children and grandparents – will be denied the right to such procedures. By the time we reach 17 May, the first anniversary of the day the Government bought its way back to power, nearly 400 people will have been denied access to medical treatment. In a full year that will amount to almost 14,000 people.

The Taoiseach promised before the last election to end waiting lists within two years. What contribution to the ending of waiting lists will be made by the closure of a further 250 beds? Does the Taoiseach have confidence in the Minister for Health and Children's ability to deliver the effective world-class health service that was promised by the Government? I do not doubt that the Taoiseach's reply will include telephone numbers, such as the sum of €9 billion that is being spent on the health services. Will he deal with the human cost of cutbacks, however, as distinct from the economists' version which does not treat people as people, but as statistics? The Minister, Deputy Martin, seems to be keen to leave the Department of Health and Children without having to make a difficult decision. He blames everybody and anybody other than himself and his Government colleagues.

Increased charges have been levied across the country in relation to VHI costs and visits to accident and emergency departments. Is the Taoiseach happy that there is sufficient money in the system to deliver the service to which the Government committed itself two years ago? Is he confident that the person who is sitting beside him, the Minister for Health and Children, is capable of delivering the world-class service to which the Government committed itself, but in respect of which people are being denied vital procedures?

Hear, hear.

I will not give a litany of figures if Deputy Kenny does not wish me to do so. I share the view of everybody else who would like to see a world class health service in which people can be treated and patients can be looked after. The Government's objective continues to be to provide an efficient and top-class in-patient and out-patient service to all who require it. The Minister for Health and Children is doing his best and he has my confidence in that regard. While there are difficulties within the system, we should not forget that thousands of additional patients are being treated as in-patients and out-patients every year. The figures have increased substantially in recent years, but I will not recite them all again.

There are problems in some areas of the health service, particularly in the Dublin hospitals where 81 beds have been closed. There are fears that other beds will have to be closed if issues relating to the 2001 and 2002 budgets are not sorted out. As the Minister, Deputy Martin, said during Question Time, meetings between the ERHA and the Department of Health and Children are taking place today. There will be further meetings between the authority, the Department and the Dublin academic teaching hospitals after the weekend. It is hoped that they can resolve some of the issues, which arise from the fact that the hospitals overspent in 2001 and 2002. Under the 1996 legislation, the additional moneys that were spent are subtracted from the hospitals' funds for this year. This creates cash-flow and financial difficulties for the hospitals. Such difficulties do not exist in many other aspects of the health service. In conjunction with the ERHA, which is directly responsible and accountable in this area, the Minister is endeavouring to deal with the problems.

While I do not want to direct a barrage of figures at Deputy Kenny, it is only fair that I should point out that almost 400,000 in-patient and day cases are being treated in the ERHA area. This figure is much higher than the relevant figure some years ago. It is clear that if more resources were available, we would open more than the 709 beds that were opened this year. The Minister has kept to his commitment in that regard and has published the health strategy. The Cabinet is in the final weeks of dealing with the implementation of the strategy. Members of the Government have to grapple with difficult and complex areas and to come to a successful conclusion shortly. The position will not change overnight, but the Government's efforts will improve it into the future. The Minister is determined to deal with both of these separate issues, with my support and the support of the entire Cabinet.

The Taoiseach has said that the Minister for Health and Children is doing his best. If that is true, how can the increase of 87% in patient waiting lists at Beaumont Hospital since 1997 be explained? There has been an increase of 23% in the Mater Hospital and 108% in St. Vincent's University Hospital. How can these figures be explained? Are the Minister's best efforts good enough in this regard? How can one say to the six in ten adults who have been waiting for ENT surgery for more than a year that the hospitals over-spent last year? Would such an explanation suffice for the seven out of ten young children who have been waiting for more than six months for similar operations? How can one tell the 50% of young children who have been waiting for more than six months for vital cardiac surgery that they cannot and will not be treated until next year because the hospitals over-spent last year? How can one say to such people that the Minister is doing his best?

The Taoiseach, who is in charge of the Government, said last year that waiting lists would be eliminated within two years. About 29,000 people are on waiting lists at present, a figure that will rise. The impact of the closure of a further 250 beds will exacerbate the problem. As a Dubliner, the Taoiseach is aware that even Ken Doherty could not come from that far behind.

Overall, waiting lists are down 22% – that is the figure. In-patient waiting lists are not 29,000; they are 18,000.

That is because the Government changed the way in which they are calculated.

The Taoiseach is very selective when quoting figures.

The Government divided the figure in two by changing its method of calculating waiting lists.

Cardiac surgery, which was the huge difficulty—

The real figures are in the death notices.

I do not think that is the right thing to say.

It is correct.

It is not true.

I can provide plenty of examples.

Waiting lists for cardiac surgery have been halved all over the country, as a result of the extended facilities in Galway, St. James's Hospital and Cork. There has been an enormous reduction in waiting lists in most of the specialties.

Most people cannot get in.

They are the official figures.

They cannot get in.

There are more beds in the system that there ever were.

What country is the Taoiseach talking about?

Only 81 beds have been closed.

Only.

There is a potential problem.

Thanks a bundle.

Some 709 more were opened up.

The Taoiseach promised to end waiting lists.

The reality is that the Government is concerned—

It was not concerned when it was making promises last year.

—to ensure that it can keep the system at its best.

The Government is responsible.

We are keen to continue to resource it. We have put in a substantial amount of resources this year. It is not just about resources, as it is also about how we manage this for the future and how we deal with the difficulties that exist. That is what the Government is committed to do. One should not ignore the fact that tens of thousands of people are receiving quality services. There are ongoing difficulties in accident and emergency services. Many more people are being seen and helped throughout the range of in-patient and out-patient services and day care services. We have to try to build on the fact that the vast and overwhelming majority of patients are cured. That is what we are endeavouring to do in the health strategy, which has already been published. Within the strategy, we are trying to deal with the three reports which are before the Government, two of which have been completed and one of which has almost been completed. That is what we will do.

Little done, an awful lot to do.

How can the Taoiseach, as leader of this Government, say that there are more beds in the system than ever before? Was it not the man beside him, Deputy Martin, who published the document with such brouhaha and said that 3,000 additional beds were required? Was that not in the health strategy which is now in tatters like the reputation of the Minister? Is that not the reality?

What is the point of the Taoiseach stating to the House that there are more beds in the system? Does he pay any attention to the statement by the chief executives, one from the Mater Hospital in the Taoiseach's constituency, and consultants? They pointed out the implications of the closures announced this week which are equivalent to closing one acute hospital in Dublin. Some 14,000 treatments are delayed while people in the community are in pain waiting for access to a hospital bed.

Deputy Kenny reminded the Taoiseach of the anniversary of 17 May. Does the Taoiseach remember where he was one year ago yesterday? It goes without saying that he was not in the House, as he seldom is. The Taoiseach was in the lavish headquarters of the Fianna Fáil press office for the purposes of controlling the election where he announced, with the dauphin who sits beside him today, the document that committed to eliminating waiting lists within two years. Does he remember the promise to eliminate waiting lists within two years? The Taoiseach has failed to publish the figures for last December. When he said that he would cause waiting lists to be eliminated, did he simply mean that he would not publish the figures?

This is beyond a laughing matter. If the current Minister cannot do the job, the Taoiseach should try to find someone who can as he had to do in the area of transport. For five years, the Government had a Minister responsible for transport who could not make a decision and that is why we are in the current mess. Is the Taoiseach going to do the same with people's lives? These people, some with life-threatening illnesses, are not statistics; they are awaiting care. While they cannot get access to a hospital bed, the Taoiseach stands up in the House to say that there are more beds than ever in the system. What world are we living in? This is a real crisis for real people who need real doctors to attend to them.

Deputy Rabbitte probably does not want to hear that he was not in the House this time last year either as we were in the middle of a general election campaign. He did not have to be glib about that.

I said that while 81 beds were closed, 522 additional beds have been put into the system. Unless I have failed to count correctly, there are more beds in the system. I am merely giving a factual statistic, as I did with regard to waiting lists being down by 22%. I am simply providing a record of the figures.

I am not saying there are not people to be cared for or current difficulties in some hospitals, particularly the academic teaching hospitals which are spending almost €900 million – I think €872 million is the correct figure – and treating in excess of 380 in-patients and day cases, an increase on previous figures. However, neither Deputy Rabbitte nor anyone else should, when there is a substantially increased number of patients and beds compared to last year, create the perception that the service is worse than it was.

I am not endeavouring to give the perception that there are not people on waiting lists or that we do not need to do more in terms of numbers and resources to improve the position. That is the factual position and we should deal with it. That is why I stated that a lot of time was spent over the Easter break moving to the next stage of the health strategy, building on what was published in autumn 2001 and considering the reports to see what more can be done to better manage the funding of almost €10 billion, an enormous increase which Deputy Kenny acknowledged, which has been put into the system.

I acknowledge there are difficulties in the four hospitals because they went over their allocations and the service plans agreed with the ERHA in 2001 and 2002. As a result of the 1996 legislation on accountability, that is taken from their allocation in 2003.

What were they to do? Should they turn patients away and send them home?

That has created a difficulty for the hospitals. I have met and spoken with many of those concerned over the Easter break and I know of the difficulty. The Minister has been engaged in discussions with the hospitals and the ERHA is currently meeting with officials of the Department of Health and Children. The Dublin academic teaching hospitals, the ERHA and the Department of Health and Children are sitting down to see how they can deal with this situation.

However, let us not say a situation is being created where less people are being seen in hospitals. There is a problem as long as anybody is on a waiting list although I do not think I will ever reach the day where nobody is on a waiting list. Nonetheless, we should try to reduce waiting lists as much as possible, maximise the resources available and try to achieve the maximum throughput for those resources. That is what we are trying to do.

I wonder what is different today from one year ago. The Taoiseach now says that we will never get to the day when there will not be a waiting list. At the top of the treasury management building one year ago, there was no waiting list at all. How can the Taoiseach say that this applies only to the Dublin teaching hospitals? That is not the case. What about the James Connolly Memorial Hospital or the children's hospital in Crumlin where one of the wards is being closed?

What about Tralee?

Essential surgical beds are being taken out of the system. What, indeed, about Tralee?

This is not an abstract question. The Taoiseach says that there are more beds than ever in the system. He also claims to be an accountant. Is it correct that there are 522 additional beds?

There are.

Some 350 are blocked and 250 were closed this week.

They are not blocked.

If one adds 350 to 250, one gets 600 and that is more than 522. That is the reality.

And one million plus one million is two million.

The Government health strategy calculated that 3,000 additional beds were needed to bring us back to where we were when MacSharry and Haughey wreaked havoc between 1987 and 1989. Yet the Taoiseach comes to the House to say that there are more beds than ever in the system. How are those caring for relatives on waiting lists for God knows how long supposed to react to such a statement from the head of Government?

This is not an abstract question. We are talking about real people. A head consultant said last night that 14,000 treatments are delayed. It was the Taoiseach who published the health strategy, who rubbished everyone else's health policies this time last year, who said that Fianna Fáil had the money and the know-how, who appointed Deputy Martin as Minister, who is making a mess of things and who is the head of this Government. It is his job to answer these questions for the people.

I will not go into what I said about bed numbers as that is on the record. Deputy Rabbitte is correct that there were many difficulties in the 1980s, some caused by my party and some by the hospital closure programme brought in by the Deputy's present party. However, we should not get into that because doing so will not sort out problems or provide health care for anyone on a waiting list today.

As Deputy Rabbitte puts questions to me, it is only fair that I put back to him that it is the Government—

That is not so.

It is the Taoiseach's response we want.

The Taoiseach won the election on his promises.

Can I reply to Deputy Rabbitte?

The Taoiseach should shoulder the burden.

There is 162% more funding than a few years ago and waiting lists are down by 22%.

If the Government doctors the figures.

Hospital activity is up 17% and the hospital treatment fund is dealing with 4,000 patients. Deputy Rabbitte mentioned Tralee which has the lowest waiting list of any hospital in the country. There have also been new initiatives by the Minister for Health and Children in regard to Crumlin. It is not that we do not have problems but neither should we paint the health service as being in a hopeless position—

Once the Government got in.

A recent survey carried out by the health associations showed that 90% of those who received treatment in our hospitals were very satisfied and thankful for that service. We have problems in certain areas which must be managed.

The lotto winners are happy too.

We must implement a health strategy that brings us forward. Rather than just ranting about it, we will work to try to achieve that and provide a quality health service to people in an efficient way to allow them get into hospital for those necessary treatments.