This Government has spoken many times in the past ten years about the delivery of a world-class health service. It was the Government's number one commitment before the last election and has turned out to be the number one hoax from Fianna Fáil and the Progressive Democrats. This has been the case for ten years, billions of euro have been spent by three Ministers for Health and Children, and the service is absolutely appalling in some circumstances.

At Our Lady of Lourdes Hospital in Drogheda the midwife staffing levels are far below what they should be. Mr. Patrick Kinder, the head of the maternity task force there, said this showed the extent of serious risk to women in the north east who are forced to rely on the services of this hospital. Women attending the maternity unit there must wait until the fifth month or 20th week of pregnancy before seeing an obstetrician. No expectant mother, particularly a young mother with a first pregnancy, should be forced to wait 20 weeks to see an obstetrician when she should have that appointment within 12 to 14 weeks.

That level of "world-class service" is not unique to Drogheda. I received an e-mail from a woman in my county about her experience in Mayo General Hospital in February. She spent three days on a trolley in the accident and emergency unit. To judge from what she told me, her experience was not an isolated incident. Despite the efforts of the fantastic staff to whom she refers, she said the overcrowding was reminiscent of a Third World service and not what should be expected in modern Ireland.

She wrote an eyewitness account on her trolley according to which on Sunday, 25 February she had no pillow and her blanket had a blood-type stain. There was no ladies toilet available, only the gents was working. There was no visible security. On Monday, 26 February a lady with pleurisy was placed opposite an entrance-exit door which opened onto the casualty waiting area. At times one could hear the wind whistling through. There was no place to have a shower. Trolleys blocked areas which bore a sign stating "keep clear at all times".

On Tuesday, 27 February the toilets were absolutely filthy. She said she could not begin to describe the nauseating stench. The patients' trolleys were taken and they were given chairs. When they asked why they were told the trolleys were needed for the day care patients.

That is the lady's summary of the world class health service the Government promised to deliver: more than 30 on trolleys, with no privacy, washing facilities, hot food or visible security. As an elderly woman was escorted down the public corridor her nappy fell off. What does the Taoiseach say to the people who must put up with this standard of care? What does the Taoiseach say to expectant mothers who must wait 20 weeks to see an obstetrician? Is that what the Taoiseach meant when he said his Government, comprising members from Fianna Fáil and the Progressive Democrats, including the absent Minister for Health and Children, would deliver a world-class health service to the people?

God help us.

On the general question about a world-class health service, we have made real progress in the health service. We have over 100,000 dedicated professionals treating over 1 million patients in our public hospitals alone. There are 38,000 new staff, including 2,700 medical dental personnel and 9,000 nurses. Some 8,700 specialists were recruited in the past ten years and almost 1,000 consultant posts were created. Since I became Taoiseach, the numbers on hospital waiting lists have more than halved. In the past year, accident and emergency waiting lists have almost halved and, because of good practice and resources, 60% of hospitals have nobody at all waiting in accident and emergency units for more than six hours. The Irish taxpayer is funding the increase in spending from €4 billion to €15 billion, as Deputy Kenny correctly stated.

It is hard for Deputy Kenny to analyse the system on the basis of one letter and I could quote letters written by very satisfied people. I take the Deputy at his word regarding the letter he quoted, notwithstanding all the great staff. The letter stated nobody was cleaning or looking after the toilets, food or anything. The Deputy will be aware that there are several hundred staff in the hospital in question, employed at a cost of tens of millions of euro. Perhaps the day referred to was a bad day and the staff were elsewhere.

The Taoiseach should not twist it.

Every day is a bad day.

However, the Deputy cannot assert that all those things are true while acknowledging all the staff are great.

On the antenatal outpatient clinic at Our Lady of Lourdes Hospital, the HSE has confirmed that, because of the increased number of births therein, it has been very hard pressed to get the waiting list in line. There is no doubt that this is a real problem and I will not defend the fact that people are waiting for 20 weeks, if they are doing so. The HSE said it has a problem related to people having to wait a number of weeks for a routine appointment and this is certainly not good enough.

Management at the hospital already said it is trying to address these issues and that it has recently approved 22 new midwife posts, two specialist nurse posts and three new consultant anaesthetist posts with a view to improving its services. It has also confirmed that a new 25-bay emergency department is being developed at the hospital and it is to be opened early next year. Two new floors are also being built above the emergency department to provide more space. Obviously these are needed and the resources have been provided therein.

We are spending almost €500 million on the capital programme this year, as we have done in the past few years. Ireland and Norway are on top of the list of countries investing money in the capital programmes pertaining to their health systems. Obviously our system needs this investment and there is no doubt about this.

I have answered the Deputy's question on accident and emergency figures. The accident and emergency figures continue to be well over 50% down, as they have been the whole winter. We are now in what we consider the 24th week of the winter and there was one difficult week in which reductions of over 50% were not achieved. Even Deputy Kenny, from his position, will have to acknowledge this represents a big improvement in a year. It is still not good enough and that is why we are investing the resources I have outlined. I hope a big improvement will be made over the next year when all the facilities come on line. The Government continues to put in place the resources and staff and continues to make the necessary improvements and seek reform. This is the correct approach.

The Taoiseach is probably correct in that he is on the run-in to being run out of office. When he visits hospitals, does he take the time to go down the corridors? We do not live in fantasy-land any more. Mr. Patrick Kinder, chairman of the taskforce dealing with Our Lady of Lourdes Hospital, does not live in fantasy-land and said the women of the north east are exposed to serious risk because they cannot see an obstetrician for 20 weeks once pregnant. That is a scandal. The lady who wrote to me from her trolley in Mayo General Hospital is not fantasising either.

In the past fortnight, I have been in St. Vincent's, Cavan, Mayo General, Galway Regional, Nenagh and Limerick hospitals, and in a number of others. In every one, people who built this nation are lying on hospital beds and trolleys with their medical problems exposed for all to see. A general practitioner in Kildare stated recently that 35 weeks elapsed between a screening test and a hysterectomy and that, in his opinion as a physician, the woman in question was essentially killed as a result. In Tralee Hospital last week, the consultants told me quite clearly that people are dying because of the endless waiting list for scope analysis and endoscopies. This is simply not acceptable.

I agree that when people get through the system and are treated in hospital, their care can be fabulous, but it is a scandal that the Government has, for ten years, failed to manage competently the accident and emergency system, thus causing all these problems.

The Deputy's time has concluded.

The general practitioner in Kildare is not fantasising, nor is the consultant in Tralee. It is not just a case of spending money on the system, but of reform, change and competent management, together with performance audits. These have not occurred under the Taoiseach's Government and that is why every Deputy in the House is getting endless streams of letters about the appalling circumstances that obtain daily in our hospitals. Is this the kind of world-class health system the Taoiseach and his absent Minister for Health and Children said they would deliver to the people?

The Deputy should give way to the Taoiseach.

By referring to a "world-class health service", was the Taoiseach referring to nappies falling off in public, elderly patients marching up and down in their underwear, filthy toilets and an endless series of waiting lists, including a waiting period of 20 weeks for expectant mothers?

The Deputy should give way.

As the consultant said, people die at the end of the line because they cannot have scopes in time.

I understand the agenda of the Deputy, who has visited all the hospitals in question. We are tracking each other in that I have been to most of them also. I have heard the negative comments but have also heard an endless number of positive ones. People who have been in for major cardiac surgery, heart and lung transplants, maternity care or other kinds of treatments, including people who believed they were on death's door, have said they were treated well. It is true that I have encountered problems and seen old buildings that in my non-professional view are past their sell-by dates and can never be addressed and that is why we are investing the resources.

There are 140,000 positions, including 100,000 full-time equivalents. There has been a great increase in the number of doctors, and the number of consultants has doubled. There are thousands of extra nurses and an additional €11 billion or €12 billion has been spent in a short period. Spending compares well pro rata against that of other countries and problems are being addressed.

I agree with Deputy Kenny that there are problem areas; there is no doubt about this. If the consultant in Tralee could use his influence to complete the consultants' contract, it would help to deal with some of the endoscopies. If he could put a word in with his union, in addition to talking to the Deputy and me, it would also help. The Deputy is correct that certain reforms are required. We are trying to make these reforms in the ongoing negotiations.

If, in any area of life, one goes around the country looking for problem cases, one may find them, but one must acknowledge that, according to independent surveys, the vast majority of the 1 million patients in our public hospitals last year were happy with the service. There are problems in accident and emergency wards, that is why we are building so many new units, why we are putting so many extra services into accident and emergency wards, why we are setting up primary care teams and injury clinics, why we have emergency consultants working in accident and emergency and why we have increased the staff in accident and emergency.

Many of the buildings are just not suitable for the necessary developments but there are construction programmes in every area. In Drogheda, there is an ambitious plan for the whole north east. The Teamwork Management Services report spelled out what is needed in that area. I admit the report points out that the present system, whereby five local hospitals in the north east deliver acute care and services for people with severe illnesses to a relatively small population, has exposed patients to increased risks and this must change.

Exposing them to greater risks.

I know there are Members of the House who believe we should hold on to all of those hospitals, something we cannot do. This plan, which is costly and which the Government supports, will ensure the north east will get a modern, integrated and safe hospital and patient services.

Deputy Kenny knows that whoever is in Government for the next number of years, that plan will be unveiled. It is right to do this. We want to protect small hospitals that are unable to provide the services while on the other we want to argue for better medical services. We will continue to implement a better health service. We are not world class in every area, we know that, but we continue to resource the health service and make our services top class in many areas. We should acknowledge that.

Does the Taoiseach know that 25% of medical patients in Drogheda Hospital spend their entire stay in the accident and emergency unit? This is what he holds up as a world-class service. This is no world-class service.

There is no provision for Deputy Connolly to ask a question. I ask the Deputy to resume his seat or he will have to leave the House. It is obvious to the Chair that is what he has in mind.