For the third time today and, all too sadly, for the final time for the next ten weeks, the House asks the Taoiseach to indicate the immediate and effective measures he will take during the summer months to address the crisis in the health service. He must accept the facts. The Irish Nurses' Organisation has highlighted the drastic shortage in the number of nurses. There are some 700 vacancies and it is projected that this will increase to in excess of 2,000 within the next 18 months.

The crisis continues in accident and emergency departments, particularly those in Dublin with which the Taoiseach should be familiar. My colleague, Councillor Dessie Ellis, informed me about a man from his constituency who spent three days on a trolley in the Mater Hospital's accident and emergency department. On the day the man, who had suffered a stroke, obtained a bed, there were 29 patients on trolleys in the hospital. Some of these individuals had been on trolleys for five days at that juncture.

Yesterday and again today, four women from my constituency, including an expectant mother, are bringing a case before the High Court to challenge the decision to remove maternity services from Monaghan General Hospital. In addition to the closure of these services, accident and emergency services at the hospital have also been withdrawn. The Government has stood idly by and ignored Monaghan. The Taoiseach did not refer to it earlier in the context of the list of issues relating to hospitals that need to be addressed. Citizens are being obliged to resort to the courts in order to secure their basic right to access essential hospital services.

A report into the death of a nine year old child, Frances Sheridan of Cootehill, Cavan, was published recently. The girl in question was sent home from the accident and emergency department of Cavan General Hospital and the report to which I refer illustrates a litany of errors and system failures which must raise questions about the overall management of our hospital delivery systems.

The Deputy's time is concluded.

The report must invite a challenge to the ever-increasing control over the configuration of hospital services delivery by consultant interests.

I ask the Deputy to give way to the Taoiseach as his time is concluded.

Will the Taoiseach cease providing a litany of statistics and information about financial expenditure and refer to service delivery?

The Deputy must give way to the Taoiseach.

Will the Taoiseach respond in clear terms?

The Deputy asked me to respond in clear terms. He is aware of the details of the health reform programme. As a member of the health board in his area, he oversaw the changes that occurred there. I accept that these were obviously not to his satisfaction but he is aware of the position.

I will not provide a litany of statistics but I will state that there are 8,000 more nurses and 30,000 additional staff in the health services than was previously the case. These nurses are treating 1 million more people. The service is far better——

How does the Taoiseach propose to respond to the crisis?

I listened to the Deputy and I ask him to allow me to reply. These additional staff are serving many more people than was the case in the past. There are vacancies in the area of nursing but 8,000 more positions were created before the question of vacancies was ever addressed. A few years ago there were 2,500 vacancies but the Minister has reduced this figure to under 700. We should at least give credit where it is due.

There are over 700 vacancies.

The Deputy asked in particular about what we intend to do this summer in terms of increasing the number of beds. The Minister has given €17.6 million to the ERHA alone and he has also provided money to the other health boards. This funding has already resulted in the discharge of some 300 patients from a number of acute hospitals in the eastern region who were taking up the spare capacity to which Deputy Rabbitte referred. The numbers are being substantially reduced. That is the case in all areas.

I do not believe that the extra 30,000 staff or the additional billions of euro provided are not being used properly.

There is something wrong.

There are still problems in some areas, particularly in respect of accident and emergency services. I object to the view that hospital beds, capacities, facilities and the numbers of consultant, paramedical and medical staff have not increased to a position where they are now far more extensive than ever before. I accept that units have been completed which have not yet been opened. These will be opened.

When?

There are other units on which work has commenced. We are spending more than any other country on our capital programme for health and we will continue to do so.

Members should not try to indicate, as the Dáil session draws to a close, that nothing is happening. When the health Bill comes forward, I hope Members will support the Minister for Health and Children.

Deputy Ó Caoláin referred to consultants and others. As soon as we——

Face up to the consultants.

This morning, a section of the medical service is trying to suggest that we can roster people for duty from 9 a.m. to 5 p.m., five days a week. That is baloney and it is not acceptable. These are the issues we need to address.

The Government is baloney. That is the problem.

What the Taoiseach said is an admission of failure.

I am glad the Taoiseach has highlighted a matter on which we can agree in respect of the health services and the particular influence that continues to be exercised by the consultant representative offices. However, the Minister cannot, Macbeth-like, wash his hands of ultimate responsibility. That is what is actually happening.

We all recognise and acknowledge that there is more money being spent on the health services today than at any time in the past.

Deputy Ó Caoláin to continue, without interruption.

What is the Taoiseach going to do to address the specific areas in respect of which urgent action is required? We cannot allow the current position to obtain. Trundling out statistics time and again and offering only a defensive response will do nothing to meet the needs of people who are suffering. What is the Taoiseach going to do immediately to avert the possibility of there being some 2,000 nursing vacancies during the next months? He should be specific.

He stated that he would like to see the various units completed under the €400 million capital programme opened. However, he has not stated that he will not only support but will insist on the provision of €50 million for resources to ensure that the doors of these units are opened. Included in these units is that at St. James's Hospital which could cater for some 20,000 cases annually.

I ask the Deputy to give way to the Taoiseach as his time is up.

Will the Taoiseach give an assurance that this €50 million will be provided to the Minister to allow these units to be opened immediately?

Deputy Ó Caoláin should give way to the Taoiseach. There cannot be a separate Standing Order for the Deputy.

I would not expect there to be such a Standing Order. We are seeking real answers from the Taoiseach.

The Deputy inquired about the ERHA. I stated that additional staffing and resources have been provided and that several hundred cases have already been discharged as a result. The Minister is actively engaged in trying to recruit nurses. He has already reduced the number of vacancies from approximately 2,500 to 700.

As regards some of the new units, it is not merely a question of opening the doors. The Minister has been continually providing resources. The units will be opened but they must be equipped, commissioned and staffed.

The equipment is already in place at Blanchardstown.

Will the Taoiseach provide the Minister with the necessary funding?

The Minister is engaged in progressing this matter and he has been provided with enormous funding under the capital programme.

There are now over 50 emergency medicine consultant posts. Those occupying them are providing substantial assistance in terms of providing service in accident and emergency departments. We accept that in some areas we must provide more step-down beds to resolve the issue. I said that at the very start to Deputy Kenny. I hope in the months ahead we will be able to complete that process.

The backbenchers are getting very uneasy. They could be about to stampede.