Today Irish nurses commenced their latest campaign to highlight the disgraceful scenes at accident and emergency departments around the country. At the Mater Hospital, Cork University Hospital and Roscommon General Hospital nurses were forced on to the streets to protest during their lunch break about the continuously bad situation in accident and emergency units. Their demands are not unreasonable. Like the rest of the people, they want an accident and emergency service that meets the needs of society. They want an end to hundreds of patients on trolleys in hospital corridors throughout the length and breadth of the country. Last week there were 404 patients on trolleys in hospitals throughout the country, today there are 350 patients on trolleys. Every few months the Government gives us a whole new raft of solutions to deal with the problem.

The Tánaiste, who has been in the Department of Health and Children for six months, building on the seven and a half years of prior service by the Government, has announced another ten-point plan, which is supposed to sort out this business. Will the Taoiseach give the House any reason to believe this plan will work where no others have worked? Will he give a definite timeframe as to when this ten-point plan will be implemented? Will he tell us what has happened to the accident and emergency agreement drawn up on the last occasion when the 2002 work stoppages took place to highlight the overcrowding in hospitals which has worsened since then? When will the additional acute and non-acute beds and primary care units promised by the Government in 2001 and 2002, which will only offer the long-term solution to this crisis, be provided? There are repeated incidences of people who leave their beds or trolleys in hospital corridors to use the toilet or to go outside for a smoke only to find when they return that their bed has been taken. This is truly disgraceful. In a country rolling in money it is sad to have the nurses of Ireland out on the streets again in an effort to deal with a problem to which the Government committed itself to solving over the past eight years.

As I have stated before, for one reason or another, accident and emergency facilities are not up to scratch but it is not the situation in all hospitals. New accident and emergency departments have been opened in hospitals such as St. James's Hospital and Blanchardstown but problems still exist in a number of hospitals.

Deputy Kenny asked me to state the present position. Approximately 3,300 people a day are treated in accident and emergency departments which is 1.2 million a year. The Tánaiste's ten point plan is a dedicated funding of an additional €80 million this year. The Government is confident that this plan has already achieved results in some hospitals but not in all. For example, the special home care packages to allow people to leave hospital are to help those who require better facilities at home and cannot leave hospital until these are provided. The first of the 500 step-down places are now being provided by the private sector. This is important as it releases acute beds in general hospitals. Nursing home places for long-term stay will soon be contracted. Several hundred beds need to be outsourced and this is under negotiation. Site visits to determine the suitability of facilities will be completed at the end of this week.

The GP out of hours service is operational in most parts of the country but not on the north side of Dublin. However, 150 north side GPs have now indicated they are prepared to work an out of hours co-operative and this will have an impact. It is the case that there is no GP service after 5 p.m. and people have no alternative but to go to accident and emergency units. Progress has been made in discussions with private hospitals to provide additional access to MRI and CT scans in order to reduce waiting times. This is important and it is happening now. The Health Service Executive is putting in place a permanent system of audit inspection for cleanliness in acute hospitals and which was previously identified by Tallaght, Beaumont and St. Vincent's hospitals. The new St. Vincent's Hospital will open shortly. Tallaght, Beaumont and St. Vincent's hospitals are working to install new acute medical units and a number of other medical initiatives are being taken. These units are being funded by the €80 million funding announced by the Tánaiste. Others are already in place as I announced previously.

I acknowledge the frustration of the nursing staff in hospitals in particular. The accident and emergency consultants are now in place but some further work remains to be done because the difficulty is that accident and emergency consultants leave at 6 p.m. and the busiest time is after 6 p.m. This is an industrial relations issue that will need to be negotiated. The Tánaiste is involved in this matter. It would be very helpful to the service if the accident and emergency consultants were in place. These are some of the issues.

The Taoiseach has not changed. He referred to the figure of 3,300 people. This is very much less than it was seven years ago. The position is that the Government is unable to deal now with a lesser number than there was seven years ago. The Department closed contracted beds 18 months ago and is now opening up contracted beds as if this was a brand new initiative. In those years the health budget has doubled but the Government is still unable to deal with this element of the crisis. Why is it that today I hear reports of businessmen ringing up radio stations offering money to buy prefab units for hospitals? People are phoning radio shows to give their views about how the problem should be sorted out. The Government is almost eight years in office and the situation is much worse than it was when it took office. The Taoiseach in his reply may refer to the ten point plan and the millions of euro.

What is the Taoiseach's personal view of how to deal with the hundreds of drunks who turn up every weekend in accident and emergency units, with nothing more wrong with them than that they are completely out of their minds with drink? They upset nurses, doctors and other patients who have rights that are being infringed. Has the Taoiseach a view as to how the drunken community in accident and emergency units at weekends should be treated and dealt with?

The numbers attending accident and emergency units have risen considerably over the past number of years.

That is not true. The Taoiseach should quote figures.

There are reasons for this. Like me, Deputy Bruton is also a representative of the north side of Dublin. In the past there was a very good GP out of hours service. However if several hundred doctors decide to stop work at 5.30 p.m., which they are entitled to do, there is no alternative for people but to go to the accident and emergency department. It was not so in the past because a few years ago every community on the north side had a clinic. It is to be welcomed that the GPs have decided to work an out of hours service.

It is accepted that several hundred people occupying acute beds cannot go home for one reason or another and alternative beds must be found for them, which is what we are doing. It is not a question that they were always there. Step-down beds are not available. People are living longer——

It is an admission of failure.

——and for one reason or another they cannot go home. In the past such people were able to go home but that is not the case now and step-down facilities must be used which puts much pressure on the system.

I will give my personal view in answer to Deputy Kenny's question about the drunks. The ambulance crews and those who bring such people to accident and emergency departments both at weekends and other times, have no alternative but to bring them. The difficulty is trying to provide separate facilities for them in accident and emergency units in order to protect old people and others who may never have been in an accident and emergency unit before. Some units are able to do this but most units cannot. This is particularly the case in the Mater Hospital in Dublin because the facilities are old and separation cannot be made. This creates much hardship for the staff and also for elderly patients who have never experienced such behaviour. However, these people cannot be denied treatment for many medical and legal reasons and this creates great pressure.