Last week, bearing in mind that Deputy Bertie Ahern will not be Taoiseach for much longer, I raised with the Tánaiste the case of a 76 year old patient with Alzheimer's disease who was on a trolley in the Mater Hospital for four days. The Tánaiste dismissed my point as being facile and simplistic. I find this extraordinary if it is the new philosophy in Fianna Fáil. It is neither facile nor simplistic and the circumstances described are experienced by hundreds of patients in accident and emergency units every day.

I make no apology for bringing to Members' attention a case brought to the attention of Deputy James Reilly. Relevant lines of a letter sent by the mother of a 13 year old read:

Our 13 year old daughter suffers from depression and anxiety and last week took an overdose for the second time. We met with the medical team and they explained to us that she was at high risk of harming herself and needed to be hospitalised. They explained that she needed to be admitted to Warrenstown or St. John of God's. I cried but the worst was yet to come when they told us that we would have to wait four to six weeks for a bed. Today her mood is the lowest I have experienced yet. She needs to be hospitalised but there is still no bed available in Warrenstown or St. John of God's

That is neither facile nor simplistic. The family, one of hundreds, must live with those circumstances every minute of every day. Does the Taoiseach not feel a sense of guilt that, in spite of expenditure of €15 billion on the health system, a depressed 13 year old young girl with the potential to self-harm cannot be given a bed in a hospital for the next four to six weeks? We remember other tragic cases of people who had to wait for treatment and who are unfortunately no longer with us. How can a young girl so desperately in need of attention be left in circumstances on foot of which her distraught parents must refer her case to the Minister for Health and Children and Deputy James Reilly?

Is this not symptomatic of the circumstances in which the HSE is faced with a deficit of €300 million and in which the Minister for Health and Children is clearly and patently unable to deal with the crisis that is now spreading through the veins of the health system like wildfire? Is this not symptomatic of all the cutbacks that leave a 13 year old defenceless in circumstances in which the State is unable to come to her assistance? Can the Taoiseach indicate whether further cutbacks are coming down the line under the watch of the Minister for Health and Children through this monstrosity that has been created in the HSE?

A number of questions were raised by Deputy Kenny. On the case of Mrs. Margaret McEntee, which I think is the case to which he referred, I was very concerned by reports regarding the time which this lady spent in the accident and emergency unit of the Mater Hospital. The HSE advised that the patient presented to the hospital on 14 April and was admitted on 17 April. As I have said previously here that is outside of its own figures — even the figures it presents to us. Clearly it is an unacceptable situation. The hospital's patient liaison officer was in contact with the lady's family during the time and the hospital has conveyed its regret for the time she spent awaiting admission. That has not been the norm these past few years in the hospitals. They report through the health committee monthly on the totality of the position and that was way outside of its own guidelines and benchmarks on which it is improving all the time. The hospital is working closely with the HSE in seeking to manage and improve the flow of patients through the hospital and the accident and emergency department. The focus is on improving the internal processes where possible and on the provision of appropriate community support services. From the Minister's and the Government's perspective, improving the delivery of accident and emergency services will continue to be our top priority.

The daily average number of patients awaiting admissions in the month just gone was 107, compared with 105 a year a go, which is practically the same. The average daily figure for April to date is higher than the reported average for the same period of last year. There are many reasons for that. The colder weather has continued. Deputies will recall that April last year was a far warmer period and this affects the figures. If one looks at the figures, there is a huge difference between what they were in the first half of April last year and the first half this year. However, the HSE has put in place a framework to collect and deal with these issues and try to improve them. It has also taken on additional beds to try to improve the delayed discharges. I think it has 200 more beds than it had. It states in the figures it presented to us that there are far more delayed discharges than there were last year.

I should also mention the phased opening of St. Mary's. There are 100 beds which are opening at a rate of ten per week. That was scheduled to commence at the end of March. This timeline has been adjusted to take account of staff recruitment. It will start next week on 1 May. Some 70 beds in Cherry Orchard have also opened and 24 beds will open when the staff have been recruited, which is ongoing. These beds will be used mainly for older people who have completed the acute phase of their treatment and are at present in the hospitals. Some months ago I said I would keep the House updated on those figures. Those beds are now in the process of opening. Between the three of them there will be 170 beds in addition to the 200 that have been provided.

Obviously I do not have details on each individual case. However, I can tell Deputy Kenny that regarding the consultants' contract that has just been completed, 15 of those consultants' contracts are for those consultants who are involved in child adolescent services. This is a substantial number of consultants. There are also extra beds in St. Vincent's in Fairview, in St. Stephen's in Cork and in Galway. Obviously those consultant posts are now in the process of being advertised as part of the agreement with the consultants. Those posts will bring with them the additional beds in St. Anne's in Galway, St. Vincent's in Fairview and in St. Stephen's in Cork.