I am glad to welcome the Taoiseach and his motley crew back into this arena. No matter what way the Taoiseach looks at it, the health service is in crisis and the Government still does not appear to understand what it should do to sort that out. Every day, on average, 250 people lie on trolleys in hospital corridors while 29,000 are waiting to see consultants and 40,000 operations have been cancelled. Earlier, St. James's Hospital, which is one of the best and busiest in the country, had to cancel operations again because there are not sufficient intensive care beds and patients who are sick are being cared for in high dependency beds following the cancellation of serious operations. After ten years of this carry on from the Government parties who have always talked about their plans, two words sum them up — wasting and waiting. They have wasted the people's money and when they are sick, they make them wait even longer. For some, unfortunately, that is the last thing they do.

The Government's response is absolute silence while the HSE's response is to ask hospital management to explain why these difficulties have resurfaced at this time. When one talks to somebody who has prepared for a serious operation and who finds it has been postponed, one can understand the depth of feeling and anger. The fundamental issue, which has not been addressed by the Government parties over the past ten years, is bed capacity. In 2001, 3,000 additional beds were promised together with an end to waiting lists by 2004. These were false promises and these commitments have not been, and will not be, honoured. What would the Taoiseach like to say to the 20 people whose operations were cancelled earlier or the 29,000 people who are waiting to see consultants or the 40,000 whose operations have been cancelled? What will the Government do about this?

Deputy Kenny asked me three questions. Our figures differ a little. On his first question regarding patient waiting times, the HSE, which has responsibility for all 50 hospitals, continues to report significant improvements in the numbers of patients awaiting admission compared to the same period in previous years. The average number of patients awaiting admission during the December to January period was more than 50% lower than the equivalent period 12 months ago. I would have thought that was worthy of acknowledgement. Obviously, the lower it gets, the better, but we would like to acknowledge the efforts being made by the HSE. The average number awaiting admission in January up to last night was 111, whereas the average number for admission during the same period last year was 259. January's 57% reduction follows October at minus 34%, November at minus 32% and December at minus 53%. The HSE also hopes to reduce the over 24-hours category, which is now down to 4% of patients, to 12 hours over the next few months. I think that is important.

The second point Deputy Kenny made was that 40,000 operations were cancelled. I do not think any operations were cancelled, although some were postponed.

Either way, they did not take place.

Figures released by the HSE show that in the first six months of last year, 10,368 operations were postponed, not cancelled. That figure represents 2% of the total number of 527,000 patients who were treated in acute hospitals in the first six months of last year. While it always regrettable to postpone operations, they are postponed for a variety of reasons, including emergency cases resulting from road traffic accidents and other priorities being taken over elective cases, infection control and the availability of medical and nursing personnel. Operations are also postponed for medical and social reasons at the request of patients.

The third question raised by Deputy Kenny referred to St. James's Hospital. The bed numbers in St. James's have increased significantly by a total of 140 beds under the bed capacity initiative in new units developed over the past few years. The HSE informs me that it is aware of the pressure on the intensive care unit capacity in St. James's and it has entered discussions with management on that issue to help rather than, as Deputy Kenny said, to hinder. The HSE has offered its full support in terms of assisting fast-track post-acute patients in other settings in order to free up intensive care unit beds. It has also begun discussions with the hospital with a view to increasing high dependency capacity and advises that intensive care unit capacity has been increased from nine to 14 beds over the past few years. A national bed capacity review is currently being conducted, which will include the assessment of critical care beds. The critical carers society will be an important participant in that exercise.

I do not agree with the Taoiseach and am not inclined to give great credence to his statements about reductions in waiting times in accident and emergency units. He is well aware that a deliberate massaging of the figures is taking place. People are being moved from accident and emergency units to elective beds in which people were supposed to be recovering from operations. However, their operations have been cancelled. The Government and the Taoiseach made more than one promise that 29,000 patients would be removed from waiting lists by 2004. What happened to those broken promises?

Dublin hospitals operate at between 1% and 4% spare capacity, even though the best operational standards recommend 15% spare capacity. That means a hospital such as Beaumont has between six and 18 beds available if a crisis occurs. Last night, I visited a number of patients in that hospital. What this Government has permitted to happen in Beaumont and other hospitals is incredible. With between 1% and 4% spare capacity, Dublin hospitals are literally operating on a knife edge.

What happened to the promise to end the waiting lists by 2004? Does the Taoiseach accept that the figures are being deliberately massaged to make the HSE and the Minister for Health and Children look good in terms of numbers on waiting lists and in accident and emergency units? Why does there appear to be no responsibility or accountability within the HSE? Surely, somebody should have asked every person working in that organisation to outline his or her job responsibilities but nobody seems to be able to determine that.

This is traditionally the night on which people leave out a piece of white cloth so that St. Brigid, if she is around, would keep sickness away. Maybe it is the case that the Government should turn that into a white flag and give up because it has failed abjectly and utterly on health and the people of this country will not forget that when they get their chance to vote within the next 20 weeks.

Hear, hear.

Deputy Kenny will continue to make those points but we are spending a lot of money in this country.

The Government is wasting money.

We are paying 140,000 people in our health service to work hard and they are working hard. Deputy Kenny is correct in that the spare capacity in most acute areas of the health service is very tight. That always has been the case and I would say it will continue to do so. As we increased bed numbers by 1,500 and used the National Treatment Purchase Fund——

The Government took away 3,000 beds and never put them back.

I am answering Deputy Kenny. We have used the National Treatment Purchase Fund to treat many of the people on waiting lists. Opposition Deputies should not try to paint the picture that the people who were on the waiting list five years ago are still waiting. There will always be people on waiting lists.

They cannot get onto the list.

As long as people——

As long as the Government is in power.

——are ill, people will be on waiting lists, so do not paint the picture that it is always the same people. A person may be in for an operation today and somebody else will be on the list tomorrow.

More will be on the list.

I am replying to the Deputy's leader. We have increased capacity in practically every hospital in the country. Last year, the HSE contracted from the private and nursing home sector more than 1,000 beds, concentrated particularly but not only in the Dublin area. This year, it plans to contract 360 beds with the private sector, more than 220 of which will be in Dublin, and it proposes to extend public capacity by 446 this year by building on what it did last year. Of course, it is already planning beds for next year. That will provide a total of nearly 800 long-stay beds during the course of this year, comprising 350 private and 446 public beds. Significant resources are being put into that and they are being used well. This comes in addition to projects such as the rapid access clinic, which is a new initiative and is now up and running to treat a large number of elderly people, the hospital in the home service, which is being used by teaching hospitals including Connolly and is a very good service, and the out-of-hours system, including the Dublin north doctor on call service in particular, for which the HSE deserves great credit. For almost a quarter of a century, there was no out-of-hours service by GPs in the Dublin area. I acknowledge the work done by GPs and we now have centres in Ashtown Gate, Coolock, Ballymun and North Strand which offer excellent services every night and on Saturdays and Sundays by the best qualified GPs. GP diagnostics and community intervention schemes have also been established and work is ongoing by the accident and emergency task force.

Deputy Kenny knows that the improvement of 57% in January is an enormous figure. I do not like to see anybody waiting for anything but it is impossible to reach a situation like that. However, they are working hard to reach it, which means at times that elective cases are not taken because if there is huge pressure on accident and emergency units and no free beds, hospitals will not admit elective patients. It is not perfect but that is the position.

It happens all the time.

I am answering Deputy Kenny. The Deputy can raise it the next day the Minister for Health and Children is taking questions. That is what they are doing, but they are still seeing more patients on an inpatient basis, more on an outpatient basis and more under the National Treatment Purchase Fund. I know it is a rising population, but they are getting more resources to do this and people need to acknowledge it.

There are fewer.

No, there are more.

The Taoiseach should look at the figures.

The Deputy is very good at figures. Normally if something is 30,000——

The Taoiseach should look at the figures for the Mater and Beaumont.

If something is normally 30,000 and it is now 34,000, how does the Deputy make out it is fewer?

There are fewer inpatients in Beaumont and the Mater than there were five years ago.

Allow the Taoiseach to conclude.

There are not. The number of inpatients, outpatients and patients being dealt with in our hospitals has gone up every year. Deputy Bruton knows that — he is excellent at figures.

All cataract operations are being dealt with through the NTPF in the Royal Victoria Eye and Ear Hospital.

The National Treatment Purchase Fund is being used effectively to take people off lists——

They are now in the Royal Victoria Eye and Ear Hospital.

——such as that for cataracts and to deal with them. That represents a massive improvement in the service.