I remember three or four years ago, the Taoiseach spoke in very convincing terms about dramatically reforming the health service, money following the patient, the Dutch model and the fact that everybody would be treated on time and nobody would have to wait ever again. The figures published last Friday tell a different story. One in every eight patients on a hospital waiting list is in the queue for more than one year. That is 50,000 on an outpatient waiting list for more than one year, which is a 400% increase from January to now. In Tallaght hospital alone, close to 7,000 patients have been waiting for more than one year.

In Waterford there are 6,342 waiting. The figures are bad elsewhere, with more 4,500 waiting in Galway and so forth. A total of 46,000 people have been waiting more than eight months for a hospital appointment. The Government set the eight month target, which is higher than previous ones. On the inpatient waiting lists the numbers have soared from 1,764 to approximately 9,693 in about seven months, that is an increase of 450%. There are approximately 5,000 children on an inpatient waiting list, approximately 2,000 of whom have been waiting for longer than 20 weeks, which was the target the Government set.

The National Treatment Purchase Fund, NTPF, had set a target of three months for children and six months for adults and had broadly achieved those targets across most disciplines where people required elective surgery. The former Minister for Health, Deputy Reilly, changed those targets arbitrarily. He got rid of the NTPF and there have been dishonest and flawed budgets since. In last year’s budget €200 million was taken from hospitals. There has been appalling mismanagement and there are over 200 vacancies for consultants. The Minister for Health, Deputy Varadkar, is saying it will get worse before it gets better. How much worse will it get for children and adults having to wait for hospital treatment? Does the Taoiseach accept that the commitments he personally gave three or four years ago on waiting times and lists are simply in tatters and that urgent intervention is required to turn this around?

The Deputy spoke fairly convincingly a few years ago when he said he would end waiting lists permanently. He made great play of it and subsequently accepted no responsibility for anything that happened in the Department of Health. In 2007 there were just over 6,200 on the inpatient and day care waiting lists for over 12 months. While it is nothing great to shout about, this year the number is down to 1,800 waiting longer than 12 months.

There are 50,000 waiting for more than a year.

The Taoiseach is cooking the numbers.

That is not the correct record.

Orthopaedics is four years.

I will give the Deputy the numbers. The total number on inpatient and day care waiting lists at the end of September this year is 59,902.

The Taoiseach said 1,800.

The Taoiseach said 1,800.

Of those, 9,693 adult cases have exceeded the waiting time of eight months for a procedure and 1,930 children have exceeded the paediatric target time of 20 weeks waiting for a procedure.

That is what I said.

While we cannot be happy about not meeting all the targets for children it does mean that four out of five people are receiving treatment within target times. This morning the Government approved the draft service plan submitted by the Health Service Executive, HSE, to the Minister for Health. The Deputy is aware that over €600 million has been allocated for health for 2015. There was an overrun of €510 million which will allow for some changes to be made. In September of this year the number of patients waiting in excess of 12 months for an outpatient appointment decreased from 84,167 to 41,604, a reduction of 51% when compared with the same period in 2013. Up to the end of September this year there was a 3% increase in outpatient attendances compared with 2013. That is 64,289 more patients actually seen despite the fact that expenditure in the health service has gone from €16 billion to €13 billion. Although the increased provision and uptake of outpatient appointments is positive that will result in some additional demand for inpatient and day cases. In primary care, waiting times for physiotherapists and occupational therapists has decreased and there has been an improvement in the end of life care and the childhood health surveillance.

Deputy Martin can see where the demand is coming from. In the first nine months of this year, compared with the same period in 2013, the new emergency department attendances were up by 3.5%, and admissions were up 2% including a 13% rise in overnight admissions through the acute medical assessment unit, AMAU, system. Outpatient attendances were up 3.8% as part of the outpatient waiting list initiative, facilitated in part through appointments during additional working hours. That will have an effect on elective waiting lists. These things are never as one would want them to be. I cannot project the numbers for the future, except that the changes to be made following the approval of the HSE plan by the Government this morning will have an impact on the health service in general.

I never heard the phrase “These things are never what one wants them to be” before the last general election. That was not the Taoiseach’s tone or disposition.

Nor was it Deputy Martin’s.

It was. It was much different to the Taoiseach’s.

The Taoiseach should think of the sick people.

Deputy Martin’s was forget about the past.

If the Taoiseach had left well alone things would not be as bad in the health service as they are now.

There was a €64 billion plan.

The Taoiseach knows that. That is why he got rid of Deputy Reilly as Minister for Health. The thing was a mess. It was in tatters. All I said at the outset was that the number of adults waiting for more than eight months went from 1,700 to 9,693 in adult inpatients alone. That was the target the Government imposed, although the original target was six months and the NTPF was meeting it the Government got rid of it. The same applies to children, 37% are waiting longer than the target the Government set. The real reason for that is the Government starved the Department of Health last year and brought in a false budget. I am not allowed to use the words “a lie” here but a lot of porkies about the health budget were told to Deputies 12 months ago. That is why hospitals whose budgets were cut by €200 million could not meet the impossible targets the Government set them because it starved them of funds. The Government mismanaged the consultant situation with the result that there is a serious number of vacancies across the country, in the Mater, Tallaght and elsewhere because of the mess it made of the appointments. In the health service plan the Government has just approved will that €200 million taken from acute hospital budgets last year be restored? Yes or no?

The Government approved the health service plan submitted by the HSE to the Minister for Health this morning. The Minister will outline details of the extra resources for health and how they will impact on the major areas of frontline services this week. In September the number of patients waiting over 12 months for an outpatient appointment decreased by 51% from 84,000 to 41,000. Even the Deputy, with all his knowledge and memory, cannot indicate what might arise for the health services-----

We know what is coming down the track.

-----in the way of winter flus or vomiting bugs or whatever else.

The Government does not know.

It is incompetence.

The Deputy never actually discovered what happened every January and February for years-----

What about the Dutch model and money follows the patient?

Double Dutch.

-----when the system backed up because when those in the medical profession went away on winter holidays there was no theatre cover for operations to continue. That caused the back-up every year for as long as I can remember and Deputy Martin never even examined that.

He made the consultants work at weekends.

The medical profession would tell Deputy Martin that far more is being delivered with less because of greater efficiencies.

We actually had a system in place.

There are 9,000 on the waiting list for Galway, the Taoiseach’s regional hospital.

They can go abroad on holiday.

They will take a holiday in Mayo.

The €600 million extra allocated for the health budget as submitted by the HSE for 2015 is now part of the programme approved by the Government today. The Minister will give the details of that later in the week.