Tá tuairisc amuigh inniu a léiríonn arís go bhfuil ár gcórás sláinte ina bpraiseach. Is annamh a bhíonn seachtain ann nuair nach gcloiseann muid drochscéal faoin tseirbhís sláinte atá ar fáil do mhuintir an Stáit. The Taoiseach is probably aware that significant concerns were raised about overcrowding in the State's hospital emergency departments in a letter from the Irish Emergency Medicine Trainees' Association. These are senior doctors operating in emergency units and they are deeply concerned that trolley numbers remain extremely high. In the past two weeks, trolley numbers have exceeded 300 a day. The association also claims that the recommendations on overcrowding in the May 2012 HIQA report on Tallaght hospital are being ignored by senior hospital consultants. This is a scandal if it is accurate. Over a year after the HIQA report, severe overcrowding remains and patient safety is obviously a risk. Quality of care is being compromised. The letter states: "The appalling conditions that our patients endure in [emergency departments] should not go unchallenged." These are not my words nor the words of an Opposition or Sinn Féin spokesperson but the words of professionals.

We also learned from the Irish Nurses and Midwives Organisation that 394 patients are on trolleys today in emergency units and wards across the State, of which 308 are in emergency units. Meanwhile, the head of the HSE has said bluntly that the money allocated for the health service will not be enough to deliver the services required. What passes for a public health system is crumbling before our eyes and under the watch of this Government. Will the Taoiseach commit to providing the necessary funding to the 2014 HSE service plan and will he commit to reversing the disastrous health cuts that the Minister for Health is responsible for?

Deputy Gerry Adams's comments about the edifice of the health service crumbling are an insult to those who work in front-line services in every hospital across the country. Anyone who has had the opportunity to sit in an emergency unit can see the work done by people in challenging positions.

They have been sitting there for three days.

Deputy Adams should not tell us it is crumbling. Deputy Adams, above all people, decided to fly off to other pastures to have his treatment carried out, and good luck to him.

Deputy Adams went to America, with or without a visa.

The number of patients on trolleys in hospitals was 40% lower in the first two weeks of this year compared to two years ago. The number of patients counted on trolleys was one third lower last year compared to 2011. That amounts to 30,000 fewer patients waiting on trolleys. Since we began to count such things in hospitals, why is it that we always had a spike in numbers waiting in January? It was not until the Minister for Health, Deputy Reilly, set up the special delivery unit that it became apparent that in many hospitals professional personnel went away for a week or ten days in January and cover was not made available to keep things moving through. This year is no exception, and higher numbers of elderly people are being admitted to hospital.

Deputy Adams's figures are not correct. At 8 o'clock this morning, 21 January 2014, the number of people on trolleys was 341 and at 2 p.m. it was 210. It is still too many, but the impact made by the Minister, Deputy Reilly, in deliberately dealing with this has brought about substantial improvements in respect of the number of patients on trolleys.

Deputy Adams's comment about HIQA will be investigated to see if the recommendations are being implemented. We will report to the House on that.

I thank the Taoiseach profoundly for his concern about my personal health. He repeats it ad nauseam every time I ask a question about health services.

Why has Deputy Adams no confidence in the Irish system?

It is very touching but it is also none of his business.

Deputy Adams is speaking out of both sides of his mouth.

Members should stay quiet.

The people who work in the health service have my utmost respect and admiration because they work under dreadful conditions, and only for their confidence, their love of the job they do and their commitment, we would be in a worse position. The Taoiseach ignored the question. I am pleased that he will investigate the claim that the HIQA Tallaght report of 2012 is being ignored. I look forward to a report from the Taoiseach.

In terms of front-line services, the Government lurches from one debacle to another. Last week it was Deputy Phil Hogan and this week it is Deputy James Reilly again, and he will be back again with controversy after debacle. The health service was already at breaking point before the HSE service plan. Some €4 billion has been taken out of the health service since 2008. Fianna Fáil, Fine Gael and the Labour Party, a cosy consensus for cuts, all worked at that.

The Deputy is out of time.

Thousands of citizens faced the loss of discretionary medical cards this year, including seriously ill children and children with disabilities. Prescription charges have been trebled by the Minister, who condemned them when he was in opposition.

It is an amazing figure. Some 375,000 citizens are on outpatient waiting lists, and that is why I say the sense of a public health service is crumbling on the Taoiseach's watch.

Maybe the Deputy will ask a question.

People want and will demand a radical change in direction in the Government's health policy. Against the background of bonuses, back-handers-----

The Deputy is way over his time. Will he please put a supplementary question?

-----and all of that, will the Taoiseach please listen to what patients and professionals are saying, and will he change the direction of his Government's health policy?

The Deputy's personal health is none of my business but what is my business is that he is the elected leader of his party and he is here in the House, and properly so. He is making comments to the effect that the health service is crumbling and the people who work in it, despite their competence and love of the issues involved, are not good enough for the Deputy.

Is the Taoiseach-----

It is unfair.

That is not it. It is an unfair system.

Actions speak louder than words.

It is not a fair system.

The Deputy can see my concern for his well-being and health.

It is well-----

Is the health service good enough for the Taoiseach?

He is not in the public health care system.

He will not wait months for an operation.

I see-----

Deputies should quieten down.

With regard to the waiting list issue mentioned by the Deputy, later this week the Minister will publish figures and even the Deputy will be surprised at the extent of the improvement in terms of persons having to wait for very long periods for attention in Irish hospitals. I hope that when the figures are published this week, the Deputy will appreciate the professional staff involved who have made very significant improvements in the length people must wait over very long periods. The Minister will follow that through over a period with being able to determine just why waiting lists are so long in some cases and not so long in others. Patients are entitled to have information about that issue as well.

I do not accept the Deputy's weekly assertions that the health service is crumbling. It is a challenging period, as the chief executive of the HSE has said quite clearly. Every year is challenging in health and the money allocated this year is very far short of what was allocated during a previous time, when money was so flúirseach that an end to all national emergencies was declared, and yet the service did not measure up to what is being delivered now, having extracted costs, with people delivering so much more in front-line services. There is a belief in being able to deliver in patient care.

Thank you.

The Deputy mentioned medical cards and the Government made a decision this year to give free GP cards to those under five. The Minister of State at the Department of Health, Deputy White, is dealing with this, and the parents of 240,000 children will benefit. We are moving to a point where every person in the country will be entitled to GP coverage, as we approach the time to introduce universal health insurance from 2016.

There is major restructuring going on and it is in the interest of extracting costs but not lessening the quality of service. It is about patient care and seeing that it can be delivered. The group system introduced by the Minister for Health, Deputy Reilly, is far more effective within the regions, where hospitals exist so that they can give the best for all the services to the patients, which must be the first priority.