Speaking today at the launch of the HSE service plan for 2015, which outlines in detail the spending budget of just over €13 billion, the CEO of the HSE, Mr. Tony O'Brien, stated the funding will not be sufficient to fully address the increasing demand being placed on our hospital system, in particular the growing waiting lists for elective surgery. We have been here before, in terms of having no confidence in how the Government has formulated health budgets over the past three years, and we have been proven right on every occasion. Again we have a concern that the budget is being built on sand, in that it does not have sufficient funding in place to ensure the basic levels of service required in our public health system. This is not Deputy Billy Kelleher stating this, it is Mr. O'Brien, the head of the HSE, who will be directly charged with implementing the spending programmes on behalf of the Government.

In October, 7,000 people were on trolleys and 377 people were waiting on trolleys yesterday. More than 2,000 beds are closed, 56,000 people are on waiting lists for inpatient day care and 370,000 people are waiting for outpatient appointments.

Last year, a young man died in an emergency department in Limerick. He was admitted to hospital and marked as urgent, but was not seen for more than three hours. People on the front line have been consistently raising the issue of the pressures the public health system is under-----

Hear, hear.

-----in particular our emergency departments. There seems to be consistent denial from the Government that the health services are in crisis. If the Tánaiste wants the evidence, she should read the reports of the harrowing case of the young man in Limerick last year.

The broader issue is that we have had spin and lots of it, but next year the Government will already have a budget deficit on 1 January because of the demographic increases and the demands being placed on the health service, plus the fact that it is carrying over €500 million. Does the Tánaiste agree the spin from the Minister will not be sufficient to run the health services next year and that what we need is a proper funding system in place to ensure the health services can deliver what they are meant to do?

As the Deputy knows, the Department of Health, the HSE and the Minister for Health received significant additional resources this year, with an increase in the ceiling, and significant extra resources in respect of next year. I understand the Deputy's argument, that he would like to see more money made available to the HSE, but I would first like him to acknowledge that very significant extra resources have been made available. In this context, the Minister has undertaken to continue the reform programme in the HSE and provide to additional resources.

According to the HSE's most recently published data, the total number of patients on inpatient and day case waiting lists to the end of September was 56,902. This is an increase of approximately 3,400, or 6.5%, on August. Of these, almost 10,000 adults had exceeded the target waiting time of eight months for a procedure and 1,930 children had exceeded the target paediatric waiting time of 20 weeks for a procedure. A total of four out of five people receive treatment within the target time. The Minister has committed to addressing the issue of improving the targets in the context of the significant additional resources available.

Trolley waits are an unacceptable feature of anybody's hospital experience and I am perfectly aware of the distress it causes to individuals who use them, and even more particularly to their families who accompany them to the hospital emergency department. The figures to 21 November show that compared to the baseline year of 2011, there were 11,774 fewer patients on trolleys. However, compared to 2013 there was a small increase in the number on trolleys. This is something for which the Minister has been given resources and he has undertaken to make it a priority as he seeks to have ongoing reform of the health service.

With regard to the Limerick case, as the Deputy knows, the family of the patient who unfortunately died during the summer last year consequent on being in University Hospital Limerick asked that their privacy and confidentiality be respected. They said so to all of the parties. The Deputy is aware from previous discussions on the case that the man was in the hospital on a particularly busy night. The notes state he came in on 9 July last year, was seen by a triage nurse, was assessed as triage category two, which is a fairly urgent category, and was placed on a trolley. Subsequently he was in and out, as I understand it, to have a smoke and unfortunately subsequently the man died. As I stated, I am limited in what I can say about the case because of the desire, understandably, of the family to have their privacy and the man's privacy protected.

What is of concern in all of this is that the Tánaiste is beginning to believe the spin also. The difficulty we have is that the Government is in denial. The Tánaiste spoke about the HSE being charged. In the programme for Government it is proposed to abolish the HSE. It is also proposed to have universal GP care for everybody by the end of 2016 and to cut waiting lists to zero. We have seen no progress in these areas.

We are seeing escalating waiting lists, increases in numbers of people on trolleys-----

Beaumont Hospital.

Clonmel.

-----and all the time the Government is pretending things are improving.

Beaumont Hospital is out the door.

Deputies, please. Deputy Kelleher is well able to make his point.

Ballinasloe being downgraded.

Let us be very clear.

She is not interested.

The Government needs €500 million to plug the hole in the budget deficit this year. With the demographic changes, next year, in the words of the Minister, Deputy Varadkar, he needs €200 million and the Government is providing an extra €600 million. By any stretch of imagination the Government is automatically down €100 million before it even starts.

A question, please.

Mr. O'Brien is saying the exact same thing today at the launch of the HSE service plan which is meant to ensure we will have additional services next year, but that is not the case. Will the Tánaiste agree for once that this HSE service plan does not have sufficient funding in place?

Again.

The Government is again robbing from the most vulnerable to try to plug the holes here and there. It has not even committed the full amount of money provided for mental health in the programme for Government. We are still behind in terms of funding.

I thank the Deputy; he is way over time.

Will the Tánaiste at least agree that the HSE service plan, as with the previous three the Government published, is not sustainable even before we start?

No. I want to make it very clear that I do not agree because for both this year and next year the Minister has actually received a very significant increase in resources. The Deputy has made the point that he would like to see it increased further.

I want to see it prioritised.

I think everyone would like to see resources in almost every area increased further, particularly as the economy recovers. I do not dispute that. The Deputy wants to have an honest discussion. As he knows, the movement for instance to establish local health centres with the provision of services in an outpatient and a more local setting is critical in order to assist the emergency departments being reserved for the most serious cases.

The investment in primary health-care services, as the Deputy knows - he did not reference it in his comments - is increasing very significantly with new primary health care centres opening throughout the country. They are able to provide a number of the services that used to be provided in hospitals, particularly services for children and older people living in their homes who can now get a service at a local level thus taking the pressure off the emergency departments.

The Deputy needs to acknowledge that there are now 11,774 fewer patients on trolleys than was the case when we took over from the Government led by the Deputy's party.

That is the reality.

The Government is massaging the figures.

Sorry.

Through the special delivery unit and through the investment in primary health care-----

The Tánaiste should promise to stop the porkies.

-----there has actually been a significant overall reduction in the number of patients on trolleys, that Fianna Fáil left when it left government. If the Deputy is talking about an honest discussion, he should acknowledge that.

I know the Tánaiste does not even believe that.

Those are the figures.