Very soon more than 3,000 people will leave the health service. Before the previous general election the Taoiseach made a big deal about the health service and reform, and also about the principle of a universal health service which many of us were prepared to support. Many people have genuine concerns about losing top quality people from front-line services, especially those in accident and emergency units, those involved in surgery, top class nurses and other quality health service staff. There are grave concerns about patient safety. Even the Minister for Health, Deputy Reilly, accepted publicly that operations would be cancelled or delayed.

Will patients suffer because of the retirements and what will the Taoiseach do about it? Will the waiting lists get even longer? Last week a senior citizen who is an amputee had his home help hours cut. What does the Taoiseach say to his family on this appalling situation? Is it true that acute hospitals will lose 330 staff, services for the elderly will lose 150 staff, the primary care area will lose 125 and mental health services will have 114 departures? How can they cope with this situation?

Who are the transition teams? What do they do and what it their remit? How can the Government say it can run the health service in the next few weeks given the huge loss of quality people? Does he not accept that it will lead to chaos in the health service?

The Government has set out its plan for the development and introduction of a universal health insurance system which will apply at the end of the Government's term of office. The Minister will publish a White Paper and there will be detailed consultations. The end result will be a better health system for everyone based on the need of the patient as distinct from his or her income.

That is precisely the reason for having competent transition teams to manage the exodus from the public sector in general. I have read out the figures. According to the latest figures, a total of 263 will leave the health service. That means approximately 1,433 left in 2011. What it means is that responsibility will be devolved to local planners in each hospital who will know how it is that they intend to deliver services depending on the numbers that leave in any particular hospital or in any particular sector in each hospital. Clearly, it is not equal across the board and it is not equal either in terms of the category of persons who leave. In that sense I noted the comment this morning from the representative of the INMO, Mr. Doran, on its view of focusing on the objective of giving best patient care and attention at all times. It is true that the end of the month will test the flexibility of the Croke Park agreement. In that sense, everything from redeployment to all of the other issues that apply in this regard, such as rosters and various categories of service provided, must be brought into play. It is clear that given the scale and challenge of providing continuing quality health care, it is necessary to have teams in place to deal with any situation that might arise, be it in health or any of the other sectors.

I cannot comment on the individual who is an amputee, to whom Deputy Finian McGrath referred, and whose home help service has been cut, but suffice it to say that care in the community such as home care packages is central to the delivery of health services by the Minister for Health. Community care, including home help, is critical. I have heard of reductions in home help hours in a number of cases in various parts of the country. A decision was obviously made by a manager in the HSE at whatever level. I would like such people being able to respond accurately and clarify why such decisions were made, but I do not have the details of the particular person to whom Deputy Finian McGrath mentioned.

The Taoiseach mentioned local planners. How can one realistically run an overcrowded accident and emergency department, for example, which is already under major pressure and stress, with fewer people? How can local planners deal with those issues on the ground? Can one carry out the same number of operations with fewer specialised nurses or doctors? That is a serious issue for many families and patients in the State.

Hear, hear.

How, for example, can a disability service CEO provide the same emergency respite service with fewer hours and staff? For example, St. Michael's House has seen its staffing reduce by 123 under the Croke Park agreement, yet it has to cope with the situation. Will these wonderful transition teams turn up at Beaumont Hospital's accident and emergency department on a Saturday night and immediately whisk all of the patients on chairs and trolleys into beds? Does the Taoiseach now accept that within the next three weeks there could be a crisis in the health service? How will he sort it out with 3,000 fewer staff?

The Deputy is aware that 1,433 staff left the health service in 2011. Transition teams are not going to turn up in Beaumont Hospital or any other hospital in the middle of the night and do what he suggests. There are local managers in each hospital who know who will leave the service by the end of the month and they will make arrangements with the HSE, working with staff and the unions, to see to it that cover is provided.

The has Minister stated it may be necessary to delay some elective surgery cases. That may well be the case. There has been a 10% increase in general admissions to hospitals. This may well be because of the change in the weather or respiratory problems in older people. As the Deputy is aware, the numbers fluctuate from time to time, depending on what the issue might be, but I want him to understand it is virtually impossible to know what situation might apply in an individual hospital at any one time. The important thing we need to do is to manage the system in the best interests of patients. That is why there is a need for very clear lines of command and responses from the Department of Health, the HSE, regional directors and hospital managers who have responsibility at the end of the line for their hospital. This takes into account the co-operation of staff and trade unions in order that patients who need attention will receive it. That is why there will be a continuous focus and intensity on the part of all of the teams between here and the end of the month in order that there will not be the crisis or catastrophe that some predict. We are all interested in matters of health, which are about patient care and patients receiving attention.

It is not possible to do what the Deputy says, given the extent of the reduction in numbers, but it is possible to see the benefits of having very strong primary care and community care systems. In Deputy Dara Calleary's town I had the privilege of opening a modern primary care centre that takes many people away from the necessity of having to go to an accident and emergency department in the first place to have minor ailments treated. This eases the pressure on accident and emergency departments.

I did not see the Taoiseach there on Sunday.

Was the Deputy there? He is a member of Fianna Fáil.

The Minister of State was not there either.

As a frequent visitor to observe what happens there, I am sure the Deputy is well aware that many of the patients do not need to go to an accident and emergency department with minor ailments in the first place and could be treated in a primary care centre, the provision of which we support strongly.