There have been very serious revelations in The Irish Times today on the dysfunctionality and disconnect in the management of our health services. I note in particular the correspondence between the CEO of the HSE and the Secretary General of the Department of Health who, no doubt, was doing the bidding of the Minister for Health. The correspondence was on the HSE CEO's attempts to fill 253 vacant consultant posts nationally. It is now the case that 12% of consultant posts are vacant, which is causing a real crisis in the delivery of services to our people. The CEO was seeking a restoration of what was cut in 2012. The correspondence reveals that the figures produced in the budget to cut health by €600 million were never real. The HSE is at pains to point out in the correspondence that it never signed on for these figures or for Haddington Road notwithstanding that people claimed publicly that it did. It was then expected to deliver on the figures.

We had further revelations in the article in The Irish Times by Professor Donal O'Shea on last week's decision to stop surgery for obesity in St. Vincent's University Hospital and the dysfunctionality the decision involved. The decision will cost lives. These are people who are extremely obese and need the surgery which has been stopped. Professor O'Shea wrote aptly that leadership is absent and chaos reigns. Last week, we had the revelations on the community mental health service where patients are dying in the care of the HSE itself. We had stark revelations on the programme "This Week" on Sunday.

The foregoing reveals without any doubt that morale is extremely low within the health service. There is a complete absence of coherent management within the service and frontline services and the safety of patients are at risk, particularly in the context of the vacancies across the country in so many consultant posts. Does the Taoiseach accept that the figures produced in this year's budget were false and bore no relation to the reality of what could be achieved by the HSE? Does he still have confidence in the capacity of the Minister for Health, Deputy James Reilly, to manage our health services?

I do not accept the Deputy's assertions at all. In areas as significant as the Department of Health and the HSE, there will always be opportunities for differences of opinion to arise. I have no idea how letters between the Secretary General of the Department of Health and the CEO of the HSE found their way into to public domain. As Deputy Martin is well aware, things like this usually have a means to find their way into the public domain.

I point out to the Deputy that there were 29,000 fewer patients on trolleys last year compared to 2011. The number of adults waiting eight months or more for day-care surgery is down by 99%. I recall that was going to be ended way back in 2004. Consultants now see and discharge patients on a 24-7 basis, saving the State hundreds of millions of euro, an issue that was not tackled in previous years. The establishment of hospital groups represents the most fundamental reform in the health service in decades. With on average one new primary care centre being opened each month, we are moving to community care facilities which is important.

I saw the article this morning on obesity. I understand that surgery is necessary in a number of these cases. I understand that there was an allocation made for 20 such operations this year and that has been gone through. I do not accept the Deputy's assertion on mental health services. I dealt with this yesterday. The current Government is the first in decades to remove the entire mental health service from being the Cinderella of health services and to make it mainstream. We ring-fenced money for that purpose. I note that the suicides discussed yesterday, tragic though they are in every case, happened in the care of professionals who have been speaking out about these things. The Minister of State, Deputy Kathleen Lynch, has taken a particular interest in this matter and has been consistent in seeing that the best services are made available to the people who require them.

The HSE has pointed out to the Department of Health the establishment of a reference group to provide support to HSE members and the management negotiation team during the LRC engagement in the context of the MacCraith report, which was published. The Department of Health will continue to work to implement the recommendations of the MacCraith report. The current difficulties with recruitment and retention of doctors relate to a wide-ranging and long-standing set of issues. That was the context for the establishment of the strategic review of medical training and career structures chaired by Professor Brian MacCraith. The review group has issued two reports to date and the final one is expected by the end of the month. It is a fact of life that while these things remain unresolved and we await the further report before taking further action, many of the positions are being filled through applications by agencies. That imposes a higher cost on the taxpayer and public service. This is an issue which requires further attention and it will receive it.

The answer to the Deputy's final question on confidence in being able to sort this out is "Yes". The serious progress which has been made on the issues I have mentioned which were left lying around for years without attention speaks for itself.

The Government must deliver.

The Taoiseach might be clearer in expressing confidence in the Minister, Deputy Reilly.

Yes - "Y, E, S".