We need a debate on the promissory note negotiations, a promissory note, the House will recall, which was created by Fianna Fáil and which the people cannot afford to pay.

I wish to put to the Taoiseach another question which I hope he will be able to answer clearly. Due to some intrepid work by journalists, who used freedom of information requests, we learned that hospital upgrades were fast-tracked by the Minister for Health, Deputy James Reilly, at the behest of the Minister for Public Expenditure and Reform, Deputy Brendan Howlin, and the Minister for the Environment, Community and Local Government, Deputy Phil Hogan, in their respective constituencies ahead of other hospitals upgrades and capital works in hospitals throughout the State.

No one in Sinn Féin begrudges the people of Kilkenny, Carlow or Wexford their hospital services. There are other priorities in the region, including the need for a palliative care centre for the south east. However, the Labour Party Minister for Public Expenditure and Reform, Deputy Brendan Howlin, authorised the €12 million budget for the Wexford hospital upgrade without reference to the HSE board, which was only informed of these decisions one month after they were announced by the Ministers. The Government has downgraded hospitals in Dundalk, Navan, Ennis, Nenagh and elsewhere and it has broken promises to restore accident and emergency services to hospitals in Roscommon and Monaghan.

The problem with the Government, like the Fianna Fáil Government before it, is that there is no real transparency in Fine Gael and Labour Party decisions. The Taoiseach will recall the famous programme for Government in which he committed to openness and transparency, but the decisions about these two hospitals, like the decisions of the Minister, Deputy Reilly, on primary care centres, were only revealed because journalists and Deputies asked questions. How long will the Taoiseach allow the Minister, Deputy Reilly, to act in breach of his commitments in the programme for Government and in complete conflict with the public interest?

If any other Government did it, there would be war.

These projects have been in the pipeline since 2006. Deputy Adams will be aware that it is now 2013.

Bring home the bacon.

The Wexford General Hospital accident and emergency unit operated out of a converted pharmacy. I do not know if Deputy Adams considers that suitable or whether he thinks it should continue in that situation. At St. Luke's General Hospital in Kilkenny, accident and emergency has operated from a portakabin since 2000. Any public representative will understand that these are major hospitals which have had commitments for support from everybody in getting on with the provision of these facilities, which are part of the restructuring of the health system to ensure that patients have the best facilities available to them for their treatment. In 2006, the then Minister for Health and Children stood over here and described the fact that people were waiting on trolleys as a national emergency and said the situation was unacceptable. It was. The party that was then in the majority, Fianna Fáil, said it would take urgent action, but both projects have languished on the capital programme since then.

Not true.

Clearly, since this Government was appointed, waiting times have reduced significantly, while critical hospital infrastructure has been prioritised.

The project in Wexford comprises an emergency department, including a maternity delivery suite and a theatre with necessary equipment, with a main entrance. The project is under construction and good progress is being made. Do not deny that to the people of Wexford. What we want is to see more of such developments as quickly as possible in the interests of patients. The project is expected to be completed in 2014. To date, €2.5 million has been expended.

When is the Limerick project commencing?

The St. Luke's hospital project comprises an emergency department, a medical assessment unit and a unit for day services, including endoscopy. Construction commenced in 2012 and the facilities are expected to be completed and operational by 2014. To the end of 2012, €1 million has been spent.

Deputy Adams should consider the outcome. Instead of having more reports, more capital programmes and more proposals sitting on shelves while nothing happens, it is about time we moved, with as much urgency as we can, to put blocks and concrete in place and make facilities available for the taxpayer - in this case, those in Kilkenny and Wexford who need these facilities, which have been operating out of portakabins since 2000 and 2002, respectively. These capital works were approved in the programme by the HSE and it is past time we got on with this. We must look at the outcome, which is of great benefit to the people of Wexford and Kilkenny.

That is disingenuous.

Deputy Mary Lou McDonald is shaking her head. If she does not want these facilities made available to patients in those counties, she should stand up and say so.

Of course the people of Wexford, Kilkenny and Carlow and every other county deserve the very best hospital services. The Taoiseach is being disingenuous. The question I asked was on the transparency and accountability of Government decisions. It is not long since the Taoiseach's predecessors were boasting about how ministerial office brought benefits to their own particular constituencies. It was seen as acceptable and reported as such. There used to be speculation in the media about the benefits a ministerial appointment would bring to a particular constituency. That is now seen as wrong and as bad politics. We have had the spectacle of a Labour Party Minister of State resigning over such politics while a serving Labour Party Minister engages in strokes. The Taoiseach's Minister for Health is central to it all. I admire the Taoiseach's loyalty to the Minister.

Deputy Adams was let down.

I am looking for the transparency and accountability referred to in the programme for Government. The Taoiseach has failed to provide a credible explanation as to why these hospitals, which obviously deserve to be upgraded, were fast-tracked. What were the criteria? What was the basis? Where is the record of the decisions? Why was the HSE not told until after the Ministers had made the announcements?

In the supplementary budget of 2009, the HSE's capital allocation was reduced by 32%. As a consequence, certain capital projects were deferred, or paused, as they like to call it in official terms. The Wexford and St. Luke's hospital projects were among those deferred. Despite the previous Minister's statement that urgent action was being taken and that the situation was unacceptable, the reality is that they were paused.

Like Dundalk.

In 2011, planning permission was in place for both locations and both projects had reached the detailed design stage. As it happens, in 2011, the Minister for Health, Deputy Reilly, made it crystal clear that his initial priority was to reduce the number of patients on trolleys, as set out in his policy on transforming the structure of health services delivery. As Deputies are aware, the Minister established the special development unit to tackle the scandalous situation at accident and emergency units throughout Ireland. In case Deputy Adams did not hear me the first time, I repeat that the medical assessment unit at St. Luke's hospital in Kilkenny has operated from a portakabin since 2000, while the emergency department at Wexford General Hospital has operated from a converted pharmacy.

I know that.

Deputy Mac Lochlainn may think that is acceptable. However, I am sure he was very happy to see the scale of investment in the accident and emergency unit at Letterkenny General Hospital, which the people up there were perfectly entitled to.

Free the portakabin two.

Instead of persisting in the witch hunt of the Minister for Health, Deputy Reilly, and other Ministers - I understand the politics of that-----

I am much more interested in the outcome, in terms of bricks and mortar, facilities, equipment and professional staff to give patients in Kilkenny and Wexford the very best level of attention.

The Minister is tougher than that.

A number of major hospital projects in the south were delivered under budget in 2011, and efficiencies were achieved. That enabled the Kilkenny project to be accelerated, while additional funding of €12 million was made available for the facilities in Wexford.

The Taoiseach is embarrassing himself.

I supported that in opposition and I support it now.

The Taoiseach supported Roscommon too.

No other projects have been delayed, omitted or withheld from the capital programme to accommodate these projects. Let us have a discussion about Roscommon some day if Deputies wish. I will tell the House about the increased activities that have taken place at that hospital.

The changes delivered have made Roscommon County Hospital a much busier place than it has been for very many years. What we need is to get on with these projects to provide facilities not only in Wexford and Kilkenny but in many other locations around the country.