Bliain úr faoi mhaise don Cheann Comhairle agus don Taoiseach freisin. I attended the INMO protest here earlier today. That nurses feel they must protest at the Dáil says everything about the state of our health services. Last week I wrote to HIQA expressing concern at the conditions in Our Lady of Lourdes Hospital in Drogheda. I requested that the authority conduct an assessment.

Today I received a truly shocking reply. In summary it states that if previous HIQA recommendations - it is all here if the Taoiseach does not have sight of this - had been implemented, current risks within hospital emergency departments would be significantly reduced.

The Taoiseach will recall that the 2012 Tallaght report made 17 recommendations on the safe care of patients. These recommendations have not been implemented. There were two further reports, one in June 2014 into overcrowding at the emergency department of University Hospital Limerick and another in December into emergency care services. Representatives of HIQA also met officials from the Department of Health and the HSE to express concerns about the failure to implement the Tallaght report and also to express concerns about patient safety. There is no question about whether patients are safe; they are not safe.

Does the Taoiseach agree that the HSE is obliged to take prompt action to implement recommendations made by regulatory bodies such as HIQA? Does he also agree that this is the explicit responsibility of the Department of Health and the Minister for Health? Will the Taoiseach explain to the Dáil why the HSE, the Department of Health and the Minister have failed to implement these recommendations?

Sometimes I reflect on whether one should listen to Deputy Adams or watch what his party actually does. He comes in here regularly and he, himself, chooses not to avail of the excellent quality of our health service here in Ireland, but that is a matter for him.

I remind the Deputy that there are 120 patients on trolleys in Northern Ireland today, 40 of whom have been on those trolleys for 48 hours or more. I know the Deputy has an influence on this in Northern Ireland and perhaps he might apply himself to that as well.

The hospital and HSE management are focusing on addressing the issues in accident and emergency departments concerning patients on trolleys before the nurses might commence their work to rule in any of the hospitals concerned. That has been going on for a while. Beaumont was the first hospital to ballot on a work to rule. This would encompass clerical and administrative duties and is expected to commence on 27 January. Representatives of the management at Beaumont and of the INMO met at the Labour Relations Commission yesterday. I understand the parties agreed to revert to local discussions to consider a number of issues that were raised during the course of yesterday's discussions and process. They agreed to go back to the LRC on Thursday, 20 January.

Management is available in all of the hospitals where the INMO is carrying out ballots in respect of a work to rule.

What is the Taoiseach talking about?

I am talking about the Deputy and his question.

I am asking the Taoiseach about the HIQA report.

Sorry, Deputy, please.

As the House is aware, the emergency department task force met today, which is the second meeting of the group. In the light of the recent pressures on emergency departments, the task force wants to access and assess all suitable non-acute accommodation to the maximum extent possible.

The Deputy will have an opportunity in Private Members' business to expand on the document he has and he will get a comprehensive reply from the Minister in that respect.

That would be a change.

I am satisfied, it should be noted, that the HSE has the capacity to recruit where it is necessary to deliver front-line services. In many of these cases the problem does not lie with the availability of front-line service numbers.

Does the Deputy want to shake hands with me while he is at it? Thank you.

Sorry, that is not-----

That is just a stunt, Gerry.

I thought the Taoiseach was going to be another victim on one of the Deputy's trolleys.

Sorry, please.

When will the Taoiseach learn to stop indulging in personal attacks on me or bringing the North into a question about this State when his latest visit there was an attempt by him to bring-----

Such double standards.

-----austerity into that part of the island?

Double standards in this House and double standards in-----

Please.

I asked the Taoiseach a very straightforward question. The question quoted the HIQA letter I have just given to him, which states that its recommendations have not been implemented. It continues to state, and this is crucial, that if these recommendations had been implemented, current risks within hospital departments throughout the State would be significantly reduced. That is straightforward. The Taoiseach should not engage in distractions, perambulations and verbal gymnastics.

My question to the Taoiseach is as follows. Does he accept-----

Sorry, would you stay quiet?

Will the Taoiseach acknowledge this and explain to the Dáil? Let us not wait until Private Members' time; this is Leaders' Questions time. I have asked the Taoiseach why the HSE, the Department of Health and the Minister have failed to implement these recommendations which HIQA has stated have not been implemented.

I do not consider that I engaged in a personal attack upon the Deputy. It is his own choice as to what he wants to do and he did that.

That has nothing to do with the question.

The Taoiseach has his own private health care and does not worry about the public. Every one of them has.

And Gerry does not have health insurance.

It is only right and proper that, as the Deputy continually refers to the excellence of the services in Northern Ireland for which he claims full responsibility, the truth be known in respect of the numbers on trolleys today and the numbers who have been on trolleys for 48 hours or more.

The Taoiseach should tell us the truth about today in this State.

Please.

I also take the Deputy to task in respect of his outrageous behaviour in respect of the discussions and negotiations being conducted by the Minister, Deputy Charles Flanagan, and the Minister of State, Deputy Sherlock, in Northern Ireland. The Deputy First Minister of the Executive was quite prepared to make much more solid progress than Deputy Adams.

We did a good deal, no thanks to the Taoiseach.

The Taoiseach should answer the question.

Thank you.

I am very glad that in the interests of everybody, particularly the citizens of Northern Ireland, the negotiations were concluded.

Would the Taoiseach answer the question put to him?

Sorry, please.

The Deputy marched across the floor today with a two-and-a-half page letter from HIQA. I thank him for that. I will study this letter very carefully. I take the point he makes. The writer of the letter, the chief executive, states that he wants to assure the Deputy, and therefore everybody else through this medium, that the authority will continue to maintain a watching brief on the issues and impress on those charged with the delivery of health care services-----

The Taoiseach will not answer the question.

-----the importance of implementing them.

He will not answer the question.

The point is that by Private Members' time this evening we will have a more comprehensive response to the Deputy in respect of the questions raised by the chief executive because I have not had time to read the detail of his letter.

A Cheann Comhairle------

I call Deputy Coppinger.

-----is there a responsibility for the Taoiseach to be kept at least to the question?

Sorry, you know-----

I have no control of the content of a reply given to Deputy Adams or anybody else.

But he has to be kept on subject, on the issue.

I ask him to accept the fact that I endeavour as far as is humanly possible to stick to the issues.

Will the Ceann Comhairle advise the Taoiseach of that?

The Taoiseach has finally said he will address the issue contained in the letter this evening.

But not on Leaders' Questions.

Who is chairing?

I accept that, but I cannot do anything about it. There is only a minute for a supplementary question and a minute for reply.

The Taoiseach has two health Ministers beside him and he knows the issue is coming up.

Three.

All right.

He has three health Ministers beside him.

I call Deputy Coppinger on behalf of the Technical Group. I wish her well in her new role as leader of the Technical Group.