While the Minister for Finance is preparing for the annual budget ritual this afternoon, people in the real world are continuing to suffer as a consequence of the failed policies of this Administration. Is the Taoiseach aware, despite all the hype and commitments made by the newly appointed Minister for Health and Children, that our accident and emergency units are still in crisis? The Minister visited New York recently to appraise herself of private hospital care in that city. Will the Taoiseach visit Tallaght Hospital with the Minister? Yesterday, some 59 patients at the hospital were kept on trolleys, reclining chairs and couches. An accident victim with suspected spinal injuries was kept on a spinal board in an ambulance because no trolley, let alone a bed, was available for that victim to be brought in for full triage attention. Will the Taoiseach join with me in commending those nurses who are at the coal-face of what is a health delivery system in chaos? These are the people we depend on most to expose the reality with which they and patients must contend daily. Statistics revealed yesterday by the Irish Nurses Organisation showed 175 patients kept on trolleys, reclining chairs and couches at different hospitals. The organisation described the ongoing crisis as almost akin to Third World conditions. It attributes this to either an underfunding of the health system or a misdirection of funding, which the Taoiseach will probably remind me is the largest ever provided.

Will the Taoiseach correct the record of the House where a number of weeks ago the Minister for Health and Children, in response to a question from another Deputy, indicated a bed was always a bed in terms of statistics? Documentation from her own Department shows couches, reclining chairs and trolleys have all been counted as beds in statistics offered by both the Minister and Taoiseach. The 59 patients on trolleys in Tallaght Hospital were most likely included in the statistics which showed an increase of 284 day beds over the past three years. Will the Taoiseach undertake to ensure statistics provided with regard to health services are accurate and honest and reflect reality, and are not couched in such a way as to misinform and confuse?

The Deputy asked about the Estimates process for this year and next year. The problems of accident and emergency departments are those experienced by the entire health service. Actions spelt out by the Tánaiste are designed as a package to take a whole system approach to improving patients' experience of health care, in particular A&E services. There will be an additional €70 million in current expenditure, a large part of which will go to staff, for which resources are required, mainly in nursing. Some actions are aimed at minimising the need for people to go to A&E by accessing care from medical professionals and nurses in stand-down facilities. Other actions are designed to free up hospital beds for people awaiting admission. The development and expansion of minor injury units, chest pain clinics and respiratory units in hospitals to relieve pressures in A&E departments, the provision of a second MRI centre in Beaumont Hospital, and the provision of acute medical and non-surgical units at Tallaght, St. Vincent's and Beaumont Hospitals were all announced ten days ago. High-dependency patients will be transferred to suitable private nursing home care. An increase in the number of private nursing home beds to alleviate pressures on acute hospitals is also underway. Negotiations are taking place with the private sector to meet the annual needs of 500 people for intermediate care for up to six weeks. These are older people awaiting discharge to nursing home care or a return to their own home with appropriate support. There is also a provision for more out-of-hours GP services in order to minimise the need for people to go to A&E departments. These are all the initiatives we have resourced, and they will take effect from now and through 2005.

With regard to the situation at Tallaght Hospital yesterday, I have been informed that management at the hospital cancelled elective operations in line with agreed policies to alleviate current pressures in A&E. The regional health authority reported the number of patients awaiting admission to the hospital this morning was 25. It had to work to get the figure down to that amount. A new medical unit at Tallaght Hospital is one of the initiatives which will help. Funding has been provided to facilitate short and medium term solutions to problems associated with A&E. There is no doubt pressures exist. Measures announced by the Tánaiste less than two weeks ago will hopefully help alleviate them.

The Taoiseach has not indicated whether he will visit Tallaght Hospital in conjunction with the Minister for Health and Children. I urge him to do so. Will the Taoiseach also instruct that statistics offered with regard to the health care system reflect the truthful position and the reality people experience? When we ask for statistics regarding bed provision, that is what we should get. A bed is a bed, not a trolley, a reclining chair or a couch. Is the Taoiseach aware that despite repeated questions to the Minister and the Department we are unable to establish the number of people seeking first consultation for elective surgery and procedures? Allegedly there are no statistics available from the Department showing the number of people trying to get on waiting lists. We have waiting list figures, but countless thousands of people are unable to get on waiting lists and therefore are not included in statistics. This is an absolute disgrace. The Taoiseach must face reality and reflect it. He must ensure Government spokespersons, in particular the Tánaiste and Minister for Health and Children, offer the real picture in truthful statistics that represent what nurses experience at the coal face and people suffer daily in hospitals.

I have visited Tallaght Hospital many times officially and privately to visit people. I am familiar with the hospital, and continue to visit. I know the Tánaiste is extremely familiar with the hospital for many reasons, both privately and officially.

There are about 1.25 million attendances at A&E departments each year, which is an enormous amount. We have provided for a large amount of staff and back-up facilities, but still there are major problems. Many of our initiatives this year and over the past few years are helping alleviate these, but they are not enough. There are issues with regard to stand down bed facilities. Many cities, in particular Dublin, do not have out of hours GP services, which means more pressure on A&E departments. The Tánaiste announced a range of measures to provide the service. Two issues are vitally important with regard to this problem. We have provided staff, nurses and resources, but hospitals fill up. Out of hours services are extremely important as is providing stand down beds. These are two key measures. On top of the resources provided every year for the past number of years, we have endeavoured to provide significant resources for these two areas. We also need the co-operation of GPs to help get the out of hours service up and running as quickly as possible.