Since the general election, we have seen the true value of Fianna Fáil policies, with hospital wards closed, operations cancelled, home help hours cut back, children's dental services cancelled, suicide prevention training cancelled and a ban on recruitment that has directly hit frontline services in the health area. However, there is one area in the health sector that has seen no recruitment ban and that is the Office of the Minister for Health and Children. Since 2002, the cost of special advisers to the Minister has risen from €206,000 to €666,000.

It is sinful.

Will the Taoiseach explain why this is so in the midst of the shambles over which he and the Minister for Health and Children preside? How can he justify the value for money this represents given what is falling down around us?

People cannot get four hours of home help.

Deputy Kenny continues in his attempt to attack the health service.

He continues whining.

Will the Taoiseach answer the question?

I will answer the question.

It is a case of Government and managerial incompetence.

It is regrettable that the enormous amount of good service, work in the community and all the other activities being carried out by the HSE are continually attacked in this House.

Will the Taoiseach tell that to the people of Longford-Westmeath?

The Taoiseach should take his head out of the sand.

Allow the Taoiseach to continue without interruption.

The people of Westmeath and every other county acknowledge the improvements in the health service while understanding the difficulties. I do not understand the question asked by Deputy Kenny.

The Taoiseach is making trouble for himself by not answering the question.

He says he is in favour of the reform programme, that he wants the discussions and negotiations with the consultants and the non-consultant hospital doctors concluded and that he wants to see us move towards implementing reduced working hours for nurses. We want to see the paramedical talks resumed, to conclude the agreement with pharmacists and to improve the hospital development programme. We want to do all these things with fewer staff.

Nothing has been done.

Nobody can agree on anything.

We either want the Minister for Health and Children to be given an opportunity to obtain best value for money within the €15 billion budget and with a staff of 120,000, and to reform the health system as we have been talking about, or we do not.

Will the Taoiseach answer the question?

As we know, when Deputy Kenny last saw the inside of a Department there were 55 advisers assigned to the various Departments whereas now there are only 34.

Where did the Taoiseach get that figure?

As with many other issues, the Taoiseach either does not understand or does not want to understand. I will ask the question again. Does an increase from €206,000 to €666,000 in the cost of special advisers in the Minister for Health and Children's office represent good value? If the Taoiseach did not understand the question the first time, I hope he does the second time. The Government calls to mind something Ronald Reagan said — it is like a baby's alimentary canal in that it has a huge appetite at one end and no responsibility at the other.

It is time we got to the bottom of it.

There is bureaucratic bungling. Ministers can wipe their hands of that until they have to explain to somebody why an operation is cancelled, dental treatment is cancelled, suicide prevention training is cancelled or it is not possible to obtain four hours of home help. The Taoiseach has admitted to me in this House that there is a bureaucratic bulge in the administrative section of the HSE. The Government recognises that it went the wrong way in setting up a structure that is overmanned and over-managed. I will ask the question again. Does the Taoiseach consider that the increase in costs to €666,000 in the Minister for Health and Children's office represents good value?

When will the Government start practising what it preaches? The Taoiseach preaches pay restraint but he is by far and away the highest paid world leader. He does not have a White House, he does not have the yachts, he does not have the aeroplanes——

Is that what Deputy Kenny wants?

——but he represents 4 million people as against 200 million in some cases and 80 million or 50 million in others. When will he practise the pay restraint that he preaches?

Hear, hear.

When will we see value for money in the €4 million that is now allocated to special advisers for Ministers whose salaries are on a range from €250,000 to €270,000 and €318,000 in the Taoiseach's case?

I answered the Deputy's question. The staff working for the Minister for Health and Children are working to their full capacity and to the best of their ability——

That is even worse.

I would hate to see where we would be if they were not working to their full capacity.

——and are doing an excellent job in helping the Minister to make the necessary reforms in the Department.

They are closing hospital wards.

Those in the HSE are working to bring in the reforms that are necessary. I do not accept this ongoing attack on the health service in which more than 1 million people a year are receiving treatment. Hospitals are doing their best and we are spending €500 million a year on the capital programme. In many cases, including in respect of maternity and children's cardiac surgery, figures are never quoted in this House because people just look through reports, as we saw yesterday, find the negative and attack the service. The health service is staffed by highly competent people doing their jobs in a highly competent way. We should be proud of them instead of always ridiculing them.

Does that include the Minister?

I am the first to admit where there are problems, difficulties and shortfalls and that we must set about addressing those.

The Taoiseach has had ten years to do so.

Do Opposition Members expect that the Minister for Health and Children and other Ministers can sit in their Departments with no staff and properly manage a budget of €52 billion? That is not possible. This Government is committed to getting the best possible return on all the resources——

What about staff?

——-to ensure taxpayers' money is used efficiently and effectively to give the very best service that we can.

Does the Taoiseach think that is happening?

Where we are seeking reform to do that, I would very much like if on some day of the year, for one minute, we would get some support to give a better service to the public, rather than the usual diatribe from the Opposition.

Professor Brendan Drumm is the real Minister for Health and Children.

The Government should be carrying out reform rather than talking about it.