I wish the Ceann Comhairle a very happy 2015.

Thank you.

Last week the crisis in accident and emergency departments across the country reached intolerable and unacceptable levels, with 600 people on trolleys. We are not talking statistics because these are real people, whether a child, a parent or a grandparent. Immense distress has been caused and a fundamental question is whether their health or their safety was compromised as a result of the unacceptable and chaotic situation in our accident and emergency departments. Great tribute must be paid to front-line staff.

The crisis should never have escalated to the level it achieved. Notwithstanding the promises of Deputy James Reilly when he said, "Never again will there be 569 patients on trolleys on a single day while this Government is in office" -----

Cá bhfuil sé?

-----it took us a while but not too long to understand that the man did not have much credibility when it came to making promises and commitments. However, people actually believed the Taoiseach when he said on that big billboard, "I will end the scandal of patients on trolleys". We were to go to www.finegael.ie, for details of how it would be done and to look at the plans.

The west is awake.

As far back as July, the Minister was alerted by officials in the Department to 650 delayed discharges. This was six months before Christmas. In October the Taoiseach was warned in the House about the fair deal scheme. Despite all the rhetoric and language, how can the Taoiseach possibly state he can deal with this when he has funded 1,400 fewer beds under the fair deal scheme for 2015 than he did in 2013? Year after year the Taoiseach has taken beds which had been available for discharge and has expected the system to cope. It could not possibly cope and the Taoiseach knew this. He and the Minister were warned. In late December the Minister set up an accident and emergency forum, but he stated he knew this was coming. He stated he put in plans to try to deal with it. When he came back from holidays he stated he did not know why the plans did not work. God help Joe Citizen who contacts finegael.ie to try to find out, if the Minister himself does not know how the plan did not work.

Does the Taoiseach believe the accident and emergency departments were safe for patients at the level of overcrowding which was experienced in recent weeks and which continues to be experienced? Will he reverse the cuts to the fair deal scheme and provide adequate financial resources to ensure we do not have waiting times for access and eligibility to the scheme? With regard to the nursing home beds which are available to be commissioned, will the Taoiseach commit to providing the financial resources so they can all be commissioned and opened and front-line staff recruited to provide for same?

I am just checking on Deputy Martin's record on this matter. When this happened previously he stated it was not a crisis and not his fault.

We are talking about now.

Come into the present.

If I recall correctly, he spoke about putting an end to waiting lists in two years, but that is in the past.

This is the present.

The answer to the question is the accident and emergency departments were not as safe as they ought to have been with the numbers in the units and, as a consequence, in the corridors

And the ambulances.

The Minister for Health established the emergency department task force in December 2014 and it held another meeting today. Obviously it is working on a serious plan to regulate this in a way which will not have these surges which occur every so often becoming full-blown crises.

The Deputy is aware the Government provided €25 million in the last budget, on top of an additional €3 million in late 2014, to address delayed discharges in hospitals. This is targeted at hospital and community services which can demonstrate initiatives to move patients from acute or transitional care into long-term care or to enable them return home with appropriate supports.

The HSE has advised the Minister that additional beds to cope with surge pressures are now open, and all non-urgent elective procedures have been cancelled. Urgent and cancer surgeries will continue. The role of consultant doctors in terms of ensuring additional ward rounds and patient transfers has been emphasised by the Minister, particularly because of the change of rota of junior doctors. The use of additional capacity in non-acute hospitals, particularly to provide rehabilitation care, is being expedited in Saint Luke's, Cappagh and Navan. Ambulance bypass cover arrangements will be put in place in exceptional circumstances and with the prior agreement of the group CEO.

The plans are working, with numbers below the high occurrence on 6 January, although they are not satisfactory by any means. I understand the number this morning was 298. This area is a priority focus for the Minister, together with the task force, to see whether it can be dealt with. Some hospitals are more difficult than others. The Minister has just answered a Topical Issue matter on the subject and a Private Members' motion will be taken this evening when there will be greater opportunity to discuss these events.

In respect of nursing homes, obviously there is a growing need for places with an aging population. The physical location of many of them is not as close as one would like them to be for the transfer of patients from heavily populated areas. It is an issue which must be addressed.

The fact the emergency department task force has been set up and has held a number of meetings, including one today, is indicative of the priority being attached to it by the Minister for Health and the HSE.

The Taoiseach's initial response was a bit sleeveen, if he does not mind me saying so. He stated they were not as safe as they ought to have been. What does this mean? I asked the Taoiseach a simple question, whether they were safe from a clinical perspective for patients. Stating they were not as safe as they ought to have been is meaningless and does not deal with the core question. I asked the question because numerous HSE spokespersons were asked simple questions on television on whether they were safe. If one reads the transcripts of the interviews one will see everybody fudged the answer-----

Yes.

-----just as the Taoiseach fudged the answer now. It is a core question.

This was coming for quite a long time and the new Minister was told about it in July. Let us go back to the budget 12 months ago and the fraudulent figures with which we were presented. The Taoiseach closed beds during the year. A total of 48 beds were closed in St. Luke's General Hospital in Kilkenny, 14 beds were closed in South Tipperary General Hospital and 75 beds were closed in St. Joseph's Hospital in Ennis. I have a list of all the beds which were closed. As well as this, 1,400 beds were taken from what had been provided under the fair deal scheme two years ago. In the name of God, how did the Taoiseach think the system would cope with this?

He knew it would not.

A question please.

The Taoiseach tried to get away with it, and he has been trying to get away with health for the past three to four years. He has neglected it as a priority in government. This is fundamentally why all records were broken last week with regard to accident and emergency departments. There has been no consistent and persistent application to the issues which occur and which will continue to occur. The Taoiseach tried to get away with it by cutting it short and he got caught. I am not worried about the Taoiseach getting caught; I am worried about the more fundamental question of whether he can guarantee patient safety in the overcrowded scenarios which occur in accident and emergency departments throughout the country, as happened last week and this week and which will happen in the coming weeks. Will the Taoiseach guarantee it? Does he accept they were not safe for the patients concerned? Elderly people and people with serious conditions were in armchairs and there was a potential risk of cross infection.

If I recall, the Deputy is the former Minister who accepted no responsibility for any of this. He denied there was a crisis when billions were sloshing around and being wasted by a profligate government.

This is not a history lesson. We are dealing with the here and now.

The answer I gave is not meaningless, with respect. Overcrowded emergency departments and patients on trolleys in hospital corridors mean the situation is not as it should be. We have admitted on many occasions that it is not right and proper to have patients on trolleys, particularly those who have had to wait for more than nine hours on a trolley. This is not as safe as it ought to be. This is clear, and far from being meaningless it is a realistic appraisal of the scale of the challenge we face. It is not all about money, it is about management as much as anything else. One can never foretell accurately the numbers who may wish to avail of emergency departments. It is not a black and white situation to state it is safe at 4 o'clock but not safe at 5 o'clock. It is not right and proper to have trolleys occupied by patients for more than nine hours and it is in this area in particular the Minister is working very hard to regulate properly.