The Taoiseach addressed a gathering of Fianna Fáil's party faithful at Arbour Hill last Sunday, 25 April 2004, to mark the anniversary of the 1916 rising. There was another important anniversary last Sunday, the second anniversary of the publication of Fianna Fáil's manifesto for the last general election. Two years on, we know what has happened to the promises that were made. Despite the fanfare given to the document at the time, the anniversary of its publication has passed with little attention.

A deadline that was enshrined in the manifesto had a critical influence on the outcome of the 2002 election. I refer to the Government's promise to eliminate hospital waiting lists within two years. The deadline passed last Sunday while the Taoiseach spoke at Arbour Hill. I wish to remind him that his party stated two years ago that in Government it would "permanently end waiting lists in our hospitals within two years through a combination of bed capacity, primary care, secondary care and targeted reform initiatives". Two years on, that promise has come to naught. The statistics show that some 27,000 people are on hospital waiting lists. People are suffering, in pain, in discomfort and in anguish as they wait for an opportunity to be treated or for particular procedures to be carried out on their behalf.

Given that such an important milestone has been passed in the term of this Dáil, it would be appropriate for the Taoiseach to apologise to the people for the Government's failure to live up to promises that were made two years ago. Will he consider the fact that the manifesto launched two years ago contained a commitment to extend medical card eligibility to a further 200,000 people? Statistics in this morning's newspapers show that 20,000 fewer people are in possession of medical cards than was the case two years ago, when Fianna Fáil launched its general election manifesto. That equates to 1,735 fewer people with medical cards in my health board area today compared to 2002.

Will the Taoiseach consider apologising to the broad electorate for making commitments which, with hindsight, he had no intention of delivering on? More importantly, what measures will he bring forward to address the needs of those on hospital waiting lists? I refer to those who are suffering. What steps will he take to help those who face the dreadful choice each week of providing for the needs of their families or bringing their children to their local GPs? I refer to those who are on the margins, beyond the current qualifying limits for medical cards.

What about an apology from Deputy Ó Caoláin's side?

The Government's record over the last two years is disgraceful.

I am glad to report, two years on, that the Government has continued to provide substantial resources to the health system. The projected figures for hospital activity show a likely increase of one third in such activity over the lifetime of the Government. Almost 1 million people have received in-patient treatment and been discharged. Over 10,000 people have been treated under the hospital services fund.

In the last full year, between September 2002 and September 2003, there has been a reduction of 42% in the number of adults waiting more than 12 months for in-patient treatment. In the same period, there has been a reduction of 39% in the number of children waiting for more than six months. Waiting times for adults and children have been halved from a year to six months. Approximately 75% of the actions in the framework as set out in the reform programme have been commenced in the first year.

We have provided the promised capital and revenue resources regarding bed capacity. Additional beds have been opened in many of the health board areas. Some 568 extra beds have been opened in the Eastern Regional Health Authority area alone. Funding has been put in place to support the commission of over 700 beds under this initiative. Ten primary care teams, one for each health board, have been approved while out-of-hours co-ops have been extended.

In respect of staffing, we are now just short of 100,000 people and the number of staff is continuing to increase. I do not need to provide details of the medical, dental and paramedical facilities. The Government's investment of over €500 million in the implementation of the national cancer strategy has had an enormous effect. We have established cardiac surgery centres in Galway, Cork and St. James's Hospital, to complement the existing centre at the Mater Hospital. We have provided enormous resources to the areas of mental health and disability. We have not eliminated waiting lists, but we have been doing a good job on them.

The Government will not even publish the figures.

Approximately one third of the population has access to a medical card.

What about the problems in St. James's Hospital last Monday at 9.15 p.m?

Deputy Ó Caoláin raised the issue of medical cards.

We are still trying to——

The number of people——

Last Monday night at 9.15 p.m.——

There is no point in me trying to speak because the Members opposite do not want to hear my answers.

——there were 16 people on trolleys and chairs at St. James's Hospital.

The Deputy should let the Taoiseach answer.

They could not even find trolleys, so some of the people had to be put on chairs.

Deputy McGrath, you are not the leader of the Sinn Féin Party.

Sometimes he pretends to be the leader.

Only Deputy Ó Caoláin and the Taoiseach are entitled to make a contribution.

After the Government's first two years in power——

I ask the Deputy to resume his seat and to stay quiet.

——there are 2,286 people with disabilities on waiting lists.

Deputy McGrath, I will ask you to leave the House if you interrupt once more.

It is a disgrace.

Listen to the facts.

I was about to speak about disabilities before I was interrupted.

The Taoiseach was talking about medical cards.

The Government has provided 1,700 additional residential places, which are mainly based in the community. Some 465 extra dedicated respite places have been provided in the past three years and 2,950 new day places have been developed. The number of persons with intellectual disability or autism who were resident in hospitals in May 2003 represented a significant decrease of 50%. I have given the facts. I was also asked about medical cards. We had a higher proportion of medical cards when unemployment was almost 20% in this country, but things have changed, thankfully.

Does the Taoiseach know how much it costs to go to a doctor?

He does not.

He does not have a clue what is going on.

He never indexed the thresholds.

I will conclude because Deputy Ó Caoláin will want to ask me more questions. He might take the opportunity to explain something to me. When I examined figures relating to when his party had control of the health service in Northern Ireland, I noticed that waiting lists increased dramatically during that time.

That is wonderful.

The people of Northern Ireland are waiting for an apology.

The Taoiseach is well aware that, regrettably, we do not have autonomous governance in the Six Counties.

I referred to when his party had power.

We have to endure the continual interference of his good friends at Westminster.

Some people have to endure knee replacements.

Knees and ankles are a speciality.

We might have a very different situation if he worked a little harder to bring about change in that regard.

Why does Sinn Féin not apologise to the people of Northern Ireland for its actions?

As usual, the Taoiseach has trundled out a list of figures and statistics and presented it as a reply. He has given no comfort to the 27,000 people who remain on hospital waiting lists. These people must "serve their sentence", in new Government-speak. Children must wait up to six months while adults wait 12 months to qualify for consideration for the treatment purchase fund. The Taoiseach has offered nothing in his reply to those people who are suffering. The word "suffering" must be repeated to him and the Minister for Health and Children, Deputy Martin.

The Taoiseach should not claim we are all so better off today that fewer people need medical cards. Has the Taoiseach any idea of the number of people every week presenting themselves at Deputies' clinics who are concerned that the threshold for medical card qualification is so shamelessly low? People are forced into real poverty when they cannot afford to make the choice to bring their children to a GP and get subsequent medical care, including prescriptions. Will the Taoiseach raise the medical card threshold to a realistic figure to address this suffering in society? That is the least he can do if he actually means his claim last Sunday of honouring the Proclamation's ideal of "cherishing all the children of the nation equally". The Taoiseach should take the advice I and every Member has given on this issue and put it into practice.

The Deputy is a hypocrite.

The Government is committed to extending the numbers of people with medical cards. Everybody over 70 years of age has already received a medical card. The number of people aged 70 years and over is rising because of our better health services.

Which means fewer people can get medical cards.

Allow the Taoiseach to speak without interruption.

One third of the population have medical cards. The Government is committed in the programme for Government to increasing this number. Deputy Ó Caoláin does not like the statistics.

It is the Taoiseach who does not like the facts.

The Taoiseach means the Government has reduced the number.

The Deputy cannot have his own time slot and then another. He cannot have it both ways.

That is what the Taoiseach is having.

Deputy Ó Caoláin allow the Taoiseach to continue without interruption.

I simply want to answer the Deputy's question. He speaks for two minutes when I have a minute.

What about the 1,000 medical cards promised in two years?

The Government also promised 2,000 extra gardaí.

Deputy Lynch, this is a question from the Sinn Féin Party.

My question is for the Irish people.

Deputy Ó Caoláin, I ask you to be silent. This is a democratic Parliament. The Deputy has submitted a question which he is entitled to do. The Taoiseach is entitled to give his answer.

Hear, hear.

If Sinn Féin wants democracy, we will give it democracy.

There will be no knee-capping then.

The Taoiseach to continue without interruption.

I will be brief if I am allowed the time. However, the Deputy obviously does not wish to give me that time. The Government has increased resources in the health sector. There are more staff, more facilities and buildings, and more community and health care workers to deal with the waiting lists. One needs the resources to create the staff. That is why 1 million people — 25% of the population — are receiving in-patient and out-patient treatment every year. The Government is putting significant resources into 20 projects in the State mainly in the staffing area. There are 100,000 people working in the health sector and the Government will continue with this commitment.