Yesterday evening I invited the Taoiseach to visit Beaumont Hospital, which is in a state of crisis. The Taoiseach declined to take up that offer but I went out myself. In the accident and emergency unit last night, it was perfectly obvious that porters, nurses, doctors and consultants are doing everything they can to make life somewhat comfortable for patients. There were approximately 50 patients in the accident and emergency unit. All cubicles were filled, on both sides of that unit. All of those patients were assessed for admission and all were too sick to go home, but no beds were available in the hospital.

The first problem the Taoiseach does not seem to appreciate is that there is a problem in north Dublin as far as long-stay beds are concerned. There are between 80 and 100 people in that hospital who should be in long-stay beds elsewhere. The only commitment that has been broken here has been by his Government.

I know what is wrong out there, I know the solution to the problem and I know what the Taoiseach could do about it, but he does not seem to want to do it. The solution, which the Taoiseach appreciates, is that he must deal with the issue of long-stay beds. Since Leas Cross and Sutton were taken out of commission, they are down by 140 beds. The Government made two specific commitments. The first was to provide a medical admissions unit at Beaumont Hospital. It has not happened. Second, his Government, in a state of national emergency, said it would provide 100 beds at St. Joseph's in Raheny and 200 beds in St. Mary's in the Phoenix Park. The Government has not provided them. This problem will continue in Beaumont Hospital until that aspect is addressed.

Will the Taoiseach take responsibility for this because those who are supposed to have responsibility for it are doing very little about it? Those beds have not appeared, and will not appear, and this problem will continue until he sorts it out.

It is a disgrace.

One 78 year old woman had been sitting on a hard chair for 24 hours. She was assessed as being too sick to go home, but there was no place available in the hospital. It is the responsibility of the Taoiseach's Government to provide those units and beds. I see hotels being built on 24-hour shifts around the country, but regarding the most important buildings of all, hospitals, where people have no place at the inn, the Government has broken its commitments. What will the Taoiseach do about it?

Ten years of doing nothing.

Accept the reality. We need more beds.

The Taoiseach without interruption.

Ten wasted years.

It is disgraceful. Beaumont Hospital is a disgrace, but we have been saying this to him for the past five or six years.

Deputy McGrath, you will have to leave the House. There will be no delays this morning.

Yesterday, I stated that four of the 52 acute hospitals were having difficulties this week and I acknowledged the work the staff have been doing with the substantial additional resources, beds and facilities they have been given to make an enormous improvement on the waiting list this winter. They have brought down the length of stay in accident and emergency departments by over 50%. I also acknowledged that Beaumont Hospital and three of the other 52 acute hospitals are having difficulties at present and I stated that the senior people in the HSE, who have been working on the winter initiative and the accident and emergency departments generally, have been working with them. I appreciate that fact.

After Leas Cross and some of the other difficulties in north Dublin, a number of points were raised by the HSE where they required additional facilities. St. Joseph's, Raheny, is in use. As Deputy Kenny would have found out, approximately a year ago I visited the wards they opened at that time and it is in operation. They have introduced a number of other facilities.

There is a difficulty in four or five areas, mainly but not only in north Dublin. The bed numbers are down. Several times in the year they have patients who, in the normal course, could go home but it is just not possible for them to do so given their circumstances. Generally, such patients are elderly people who would be on their own. That is a risk that cannot be taken and, therefore, they need step-down facilities.

The HSE, in Dublin and around the country, does all it can to provide step-down beds, in both nursing homes——

Tell them to do something.

The HSE does its utmost all over the country to provide step-down facilities and is continuing to do so.

In reply to Deputy Kenny, not the Labour Party,——

Let the Taoiseach answer.

The Taoiseach without interruption.

There is loads of money and 50 beds would solve the problem.

Deputy McGrath, you will have to leave if you do not behave.

In reply to Deputy Kenny, in 2007 the HSE is providing 360 extra beds by way of contracts with the private sector — it is not a question of 50 beds. Of these, 220 are in the greater Dublin area, 100 in the south and 40 in the western region. It is not a question of 50 beds.

Beaumont Hospital.

It is not a question of 50 beds in Beaumont Hospital.

The Taoiseach should talk to the staff. I talked to them over the weekend.

One should talk to the people who know the position. Public capacity has been increased by some 446 beds. It is not, therefore, a question of 50 beds.

The HSE is very aware of the problems at Beaumont Hospital and has been working with it to try to increase capacity. As I stated yesterday, to try to avoid the problems experienced by the accident and emergency staff, the out-of-hours doctors systems and rapid access clinic in Smithfield have been opened. The latter is directly helping north Dublin. The facilities in James Connolly Memorial Hospital associated with the hospital-in-the-home concept have been put into operation and the community intervention teams are in place. All of these measures are directly designed to help the people to whom Deputy Kenny is referring. The schemes are working well and were not in operation 12 months ago. This does not mean that from time to time there will be no difficulties in some hospitals. These difficulties must be managed and will not all be solved overnight.

Ten years.

There will be difficulties in some of the hospitals on some days and there is no point running around to whichever hospital has a difficulty trying to highlight it. The HSE and the staff are doing their utmost to address the problem.

Please allow Deputy Kenny to speak without interruption.

Our job is to listen to people on the ground.

The Taoiseach's last reply smacks of the Tánaiste's observation that the crisis in St. James's Hospital was manufactured by people in white coats looking concerned. The point is I know there is a problem because I was at Beaumont Hospital last night. The Taoiseach was not and is removing himself from the problem but it will not go away. Doctors in the accident and emergency unit told me that they must assess patients, irrespective of their circumstances, in a state of indignity and without privacy. The problem will not go away, unless the Taoiseach deals with it. He can mention all the figures and statistics he likes and tell me the HSE knows about the matter, but he must realise that he is the Leader of the Government, whose job it is to ensure it is resolved. The problem epitomises the failure of Fianna Fáil and the Progressive Democrats after ten years.

Hear, hear.

The problem will not go away.

It is time for the Government to go away.

Whether the Taoiseach likes it, a commitment was made to put in place a medical admissions unit, 100 beds at St. Joseph's Hospital in Fairview and 200 at St. Mary's Hospital in the Phoenix Park. The medical admissions unit has not been provided. When we get into government in a few months, I would like to call in those who are supposed to be responsible for the delivery of these beds. Why does the Government not fast-track those two hospital building projects, if not them all, in the critical infrastructure Bill? Why does the Taoiseach not call in the architects and HSE representatives and ask why nothing is happening, in spite of his having made a commitment to the people to provide the beds mentioned at St. Joseph's Hospital and St. Mary's Hospital?

What is happening in Beaumont Hospital is not a one night stand. It is happening every night and on the Taoiseach's watch. Neither he nor the Government seems to appreciate the scale of frustration, indignity and collapse over which he presides. This is the problem and it will not go away. Will he take personal responsibility to ensure the commitments made by his Government are honoured? If there were a serious accident in the Dublin Port tunnel — God forbid — or on his beloved M50, for which he paid €600 million yesterday, Beaumont hosptial would certainly not be able to cope.

On the problem of long-stay beds in north County Dublin, will the Taoiseach take responsibility for delivering or fast-tracking the 100 beds mentioned at St. Joseph's Hospital in Fairview, 200 beds at St. Mary's Hospital and the medical admissions unit at Beaumont Hospital? Will he answer these questions rather than listing statistics that go on forever?

I will answer them.

He should.

First, St. Joseph's Hospital is in Raheny, not Fairview.

It is a wonder the Taoiseach knows the difference.

Is he sure it was not Beaumont Hospital? He knows he has not delivered——

I ask Members on both sides of the House to allow the Taoiseach to contribute without interruption.

I will answer the question because that is the easy part; however, it does not solve the problem. The 100 beds in St. Joseph's Hospital are being commissioned and will be ready this year. There is no problem about this. The St. Mary's Hospital development is under way. The people dealing with these tasks will complete them.

When?

This year.

In 2007.

On St. Joseph's Hospital, the work is happening but it will not solve the whole problem.

No, but it would solve the exit problem.

I do not need to do anything in respect of the two commissions; both are under way and being fast-tracked, with many other schemes. I would love to be able to tell Deputy Kenny that the completion of the two jobs will solve all the problems. That is the point. Given the age profile and population structure in the catchment area of the Dublin teaching hospitals——

What about the medical admissions unit?

Practically every night an average of 100 patients could be discharged but, because of their family circumstances, they are not. They really require a step-down facility.

Consider the third step the HSE is taking. As the Deputy knows, there are ongoing talks about Leas Cross and efforts are being made to recommission the beds. That will probably happen this year also. The institution will be under different management and have different structures.

We should be under a different Government.

The HSE is also in discussions with other current and prospective private nursing home providers with a view to securing beds to allow additional discharges from hospitals. Most are private but one cannot be certain about them because they are not in the hands of the State. It should be noted that, in respect of addressing the problem of delayed discharges in acute hospitals, approximately 1,088 older patients have been subject to placement to date. I am afraid we are talking about many people and dealing with 50, 60 or 70 will not solve the problem. Looking at the figures, I do not know whether 200 beds at St. Mary's Hospital, mainly for the geriatric unit, and 100 beds in Raheny will solve it either.

What about the medical admissions unit?

The medical admissions unit was among the ten points listed. As I understand it, most of those issues are on track.

There is not a sign of them. That is a Bertie answer.

There is no great difficulty with any of them. Bearing in mind the difficulties, it still seems that in terms of bed capacity which is being examined by the HSE, it will be necessary to build a step-down facility either in north or west Dublin, the two areas experiencing acute difficulties. The age profile of the population in question which lives in some of the most densely populated areas in the entire country is such that additional facilities are required. Although all the proposed developments will be completed this year, in addition to the developments of 2006 and 2005, four of the 52 hospitals will still face constant difficulties. Two of them are located in north Dublin.