——-or even come close. In my opinion and in the opinion of many people, they are working to extreme opposites and this is clearly the case.

Has the Taoiseach seen the report by the Nenagh Hospital Action Group? Has he taken on board the clear information that it indicates the importance of smaller hospitals in the provision of accident and emergency care? Has he taken on board the findings of that report? Does he recognise that the smaller hospitals, including Nenagh and Monaghan General Hospital and others around the State, have a critical role to play in the delivery of safe accident and emergency services? The Nenagh hospital was targeted by the Hanly report and the Hanly implementation group but this failed because his colleagues exercised themselves and it did not happen. Were it to have happened and if they had exercised themselves as well in the case of Monaghan General Hospital, then I warrant it would not have a closed accident and emergency unit today. As well as the 3,000 acute hospital beds that need to be provided and in the situation of a national emergency having been declared, will the Taoiseach now look seriously at ensuring the future not only of all the existing accident and emergency units but also those that have been reduced or closed and put them back up and running on an active footing, giving the service they have given so well in the past and taking the pressure off other hospital sites within the overall configuration of the 37 hospitals across this jurisdiction? That is the commitment we in County Monaghan need to hear from him and it is the commitment people in other parts of the country need to hear from him because it is only by taking measures such as those, rather than tinkering at the edges, that he will ensure we will make a real difference and that people will not have to languish on trolleys for excessive periods of time, not only hours, but days, in many cases. This is the Taoiseach's responsibility and I encourage him to take responsibility and to be accountable for it. There should be no more passing of responsibility to another political party or indeed to the HSE and Professor Brendan Drumm. Accountability ends with the Taoiseach as the overall steward of this Government.

If the Deputy is purporting that the hospital waiting lists have not changed I can state they have changed dramatically. The waiting time for 14 of the top 16 specialties is down to under four months whereas ten years ago it was several years. There have been significant improvements in waiting times. With the advent of the National Treatment Purchase Fund——

The waiting time is still seven years and it is five years at least for urology.

——we are giving top class quality services to people and as a result the waiting lists have decreased dramatically.

Medical cards.

The Deputy knows what the issues in Monaghan are. He knows some of the issues have been mentioned in other parts of his region on several other occasions. Whether Deputy Ó Caoláin likes it or whether I do not like it, the reality is that expert medical advice has been that what is required is a critical mass of proper services both in paramedical——

It is time to listen to alternative experts.

Allow the Taoiseach without interruption.

I have found to my expense that it is the case that when one pays for advice, there will always be another expert to give another view.

The Taoiseach should consider where their advice led him.

Please allow the Taoiseach without interruption. The Deputy went three minutes over his time.

I must listen to the physicians and to the Royal College of Surgeons in Ireland who make the statements on behalf of their practitioners in this country. In the interests of patient safety and health, we must listen to their views on Monaghan hospital and elsewhere. I remind the Deputy there has been significant political involvement in many of these decisions relating to his region. I also remind the Deputy that when his colleague, Bairbre de Brún, was Minister for Health for a short period in Northern Ireland, she ran into difficulties with what were historically the longest waiting lists ever experienced in Northern Ireland. If these issues could be easily resolved then we would all have easy solutions but that is not the case.

The Government is committed to dealing with this remaining area of the health service in an up-front manner. With regard to the Deputy's remarks about the Tánaiste, she has been the first Minister for Health and Children since attempts at reform were made in the 1960s, to try to tackle this difficult issue.

What about Micheál Martin?

Allow the Taoiseach without interruption.