On 12 April 2005, the Taoiseach made one of his greatest understatements when he said that "accident and emergency facilities are not up to scratch". He was right. On that day, the Irish Nurses Organisation estimated there were 350 patients on trolleys or chairs in our hospitals. Apart from stating the blindingly obvious, the Taoiseach also expressed confidence at that time that the Tánaiste's much-vaunted €70 million programme would deliver improvements. The Tánaiste told us in 2004 that we would see improvements by March 2005. In January 2005, she told us there would be significant improvements by the end of that year. She now seems to have abandoned any work on accident and emergency units, deciding instead to focus her energies elsewhere.

The facts indicate that this problem is getting worse. There were 392 people on trolleys and chairs in accident and emergency departments yesterday. There were 218 people in similar circumstances on the same day in 2005, which was considered at the time to be a crisis. It is incredible that there were 75 people on trolleys and chairs at Tallaght Hospital yesterday. Today's The Irish Times reports that patients are calling a corridor in the hospital “the Mary Harney suite”. Yesterday, there were 22 people on trolleys and chairs at the Mater Hospital, 25 at Beaumont Hospital, 28 at St. James’s Hospital, 26 at Cavan General Hospital, 25 at Letterkenny General Hospital and 37 at two hospitals in Cork. Does the Taoiseach have any idea of the discomfort and indignity being suffered by such people on a daily basis, as a consequence of the Government’s incompetence? Every time we raise this matter, we are given the same old answers —“we are doing something about it”, “we are working on it”, “things will get better soon”, “it is the patients’ fault”, “it is the nurses’ fault” or “it is the doctors’ fault”. Nobody on the Government side takes any blame or responsibility for it.

Does the Taoiseach accept that while the number of people attending accident and emergency departments has hardly changed since 1998, the number of people on trolleys and chairs is increasing? Even though we have trebled our expenditure on the health service, the problems in accident and emergency units are going from bad to worse. Will the Taoiseach admit that the Tánaiste's disjointed and incremental plan has failed, that no system of comprehensive response to this crisis has been put in place and that the key stakeholders have not been consulted? Can the Taoiseach offer any explanation of why this problem is continuing to get worse, nine years after his Government took office? Can he indicate to the House the solid action the Government proposes to take to deal with this atrocious situation in a positive manner?

Deputy Kenny cannot deny that huge improvements have taken place since 12 April 2005. New facilities have been opened, for example.

Where?

When?

A new accident and emergency department has been opened at St. Vincent's University Hospital.

What about Beaumont Hospital?

New wards have been opened at James Connolly Memorial Hospital and Mater Misericordiae University Hospital.

The Government has been making promises for ten years.

The development of an extension to the accident and emergency unit at St. James's Hospital has almost been completed. It is scheduled to open in the next few months. A new admissions facility at Mater Misericordiae University Hospital's accident and emergency department opened in December and is now up and running. All of these new facilities have opened. It is not true to say the Tánaiste's ten-point plan has delivered nothing, a year on, because the facilities I have mentioned have opened and are in daily operation. It is true, however, to say there are people on waiting lists and on trolleys in a number of hospitals because the figures are published every day and every week.

The Taoiseach cannot deny that.

A wide-ranging approach has been adopted by the Health Service Executive to try to improve access to accident and emergency services.

It is not working.

Senior management officials from the HSE have been working on the accident and emergency difficulties since they took office last year.

The Taoiseach has been in office for nine years.

The officials have improved patient flow through accident and emergency departments and reduced waiting times.

An election will solve it.

They have freed up acute beds by providing appropriate long-term care for patients outside the acute hospitals system. Their action plan has focused in particular on patients in acute hospitals who have completed the acute phase of their treatment and are ready to be discharged. Some 1,500 patients have been facilitated to leave acute hospitals since the date mentioned by Deputy Kenny.

The Taoiseach has not admitted that there is a problem.

We announced a range of measures, including the provision of high-dependency beds, intermediate care beds in private nursing homes, additional beds in public nursing homes and home care packages, in the last budget.

Those measures have not been implemented. There are cutbacks everywhere.

The measures have allowed approximately 1,500 people to leave acute hospitals. We accept that some difficulties remain.

That is right.

We hear about them every day.

The Taoiseach should resign.

It is not acceptable to refuse to acknowledge that significant resources are being invested in the health system by the Department of Health and Children and the Health Service Executive, under the guidance of the Tánaiste. It is well-known in the hospitals system that officials in the HSE and the Department are working every day to improve the system. A number of priority projects, most of which are ongoing, have not yet been completed under the ten-point plan. If I had time I would outline to the House the current status of each of those projects.

They are going nowhere.

They are continuing.

A previous Taoiseach described the current Taoiseach as the most cunning and devious of them all. It has been reported that a Government backbencher said yesterday that it is sometimes impossible to figure out what goes on in the Taoiseach's head. The Taoiseach's response is very far removed from the reality. When I visited the accident and emergency unit of the Mater Misericordiae University Hospital last week, the head nurse there gave me a graphic description of a serious assault on a ward sister.

Will the Taoiseach appoint a respected member of the health profession to call together the key stakeholders? These are the consultants, who should be discussing this instead of debating it on radio, the nurses, the general practitioners and those involved in successful experiments such as that in Kilkenny. They should be called together to produce short-term responses that can be delivered. Is the Taoiseach prepared to charge drunks extra for sleeping off their intoxication in wards with their hangers on? These people cause serious disruption to patients, doctors, nurses and the general public. Is he prepared to set up a number of helplines now? People should be able to know where they can get help when they need it. How many GPs are available any night on any weekend from Howth to Loughlinstown? Where do people get help when they want it? Why has the Government not been able to implement nursing home regulations that will allow for people to be discharged from hospitals to well regulated, well run nursing homes? Guidelines for this are being drawn up for a long time, yet nothing has happened.

This House is becoming irrelevant to people on trolleys today and tomorrow. They are not just on trolleys; people are also on chairs. I saw it myself last week in the accident and emergency unit in the Mater hospital. The place was cluttered and jammed and there was no room for any kind of movement at the weekend. The Taoiseach should visit some of those hospitals and see what is going on.

The Deputy's time has concluded.

Does the Taoiseach admit, despite all the verbosity, that he has failed to engage with the key stakeholders? Does he admit he has failed to put in place short-term proposals that will deal with the accident and emergency situation? How many minor injury units in public hospitals have been set up, as promised in the Tánaiste's programme? They have been set up in private hospitals, but not in public hospitals. The situation is getting worse every week and the Government has failed to deal with it. The Tánaiste and Minister for Health and Children is one year in office and she suddenly decided she will deal with the elderly. We have had three years of her waffle about dealing with this crisis, which is heaping indignity upon indignity on patient after patient all over this country. The facts are there and whatever the Taoiseach reads out from his well prepared brief, it is not relevant to the nurse who was seriously assaulted in the Mater hospital last week——

The Deputy should give way to the Taoiseach.

——or to the hundreds of patients lying on trolleys and chairs today.

We need more beds.

I am well aware of the difficulties for staff in accident and emergency units. Like Deputy Kenny, I was in the accident and emergency department in the Mater Hospital last Monday. I am sure he forgot to mention that a new 33 bed ward was just opened adjacent to the department to help people.

It was completely overcrowded.

It is 33 new beds. I hope we do not get to a situation when we open facilities in St. Vincent's Hospital, in Blanchardstown, in St. James's Hospital, and 33 beds in the Mater Hospital, that every bit——

What about all the facilities they are closing?

What about all the wards they are closing?

These are leaders' questions only.

I want to tell the truth.

When we fully staff the hospitals, take on 24 additional accident and emergency consultants, take 1,500 people out of acute beds and when we have an elderly day care package, I hope that is not considered to be nothing. The money is being spent on those facilities.

It is being spent on official travel expenses.

To try to claim that nothing is happening on these issues is incorrect. There are pressures and there is no doubt about that.

There are disasters.

We know that and we see it every day. We have introduced an initiative to create 1,000 new public beds by having the private sector build private hospitals on sites of public hospitals and that is helping. We put in funding for 900 inpatient beds in acute hospitals and that is having an effect. We put in facilities to improve patient flow and we obtained extra staff in almost every accident and emergency unit. Deputy Kenny is right that the initiative in Kilkenny is good. It is for that reason that the person who devised the Kilkenny unit has been taken out of there and has been put on the national service. That is part of what Deputy Kenny has accused me of not doing, namely, to co-ordinate the activity around the country to try to bring the same success in Kilkenny elsewhere. They are dedicated people in the HSE co-ordinating their efforts with accident and emergency departments every day.

The ten point plan is being implemented. I readily admit there are still difficulties as I hear that every day. However, there has been an enormous amount of activity in the last year and in the last number of years.

They are still not up to scratch.