I want to discuss the situation in our hospitals, particularly our acute hospitals. Nobody could deny that there is a state of chaos in some of our major hospitals this morning. In Beaumont, outpatient waiting lists have increased in the last few months by a thousand percent. A 33-bed surgical ward was closed last week, which will drag more patients onto waiting lists-----

That is Deputy Kelleher's job.

-----and the situation there has been described by consultants as a war zone. At University College Hospital Galway and in Merlin Park University Hospital this week, more than 850 people were informed that all outpatient rheumatology clinics for July and August had been cancelled and that emergency outpatient appointments would be dealt with on a case-by-case basis. There are already 1,500 people on waiting lists at Merlin Park for outpatient rheumatology appointments.

Scandalous.

When a person is diagnosed with rheumatoid arthritis, there is a 12-week window within which there is a chance of dealing with the condition if he or she gets treatment. If it goes longer, perhaps to two and a half years, which is the length of time people are spending on the waiting list at the moment, the patient's chance of beating that condition are severely restricted. In UCHG, all elective surgery has been cancelled until the end of this month.

Correct.

Deputies Naughten and Fitzmaurice highlighted that yesterday. We are led to believe that further cancellations of elective surgery will take place at UCHG. Is it acceptable that 850 people will be told this week that their outpatient rheumatology appointments will be in December? Is it acceptable that in the case of rheumatology, a consultant has gone on maternity leave this week and will not be replaced until September, which demonstrates a complete lack of planning? Is it acceptable that the appointment of a new rheumatology consultant to Manorhamilton, which was promised by the Taoiseach in December, still has not taken place? Is it acceptable that a consultant attached to Beaumont, one of our key hospitals, would tell a patient, as happened this week, that he or she would be better off having urgent surgery at a private hospital because at Beaumont he or she would have to wait for 14 weeks? That patient was lucky enough to have health insurance, which allowed access to the private hospital. What is going on in our key hospitals and what is the Government doing about it?

It is chaos. There is no health service in the west of Ireland.

The HSE has advised-----

Was the Government not going to get rid of that?

-----that due to consultant staff shortages, a number of rheumatology outpatient clinics in Galway University Hospital are being postponed during the months of July and August this year. New appointments will be scheduled as soon as possible and urgent patients will continue to be seen. Clinics in Manorhamilton will continue as normal. The hospital has issued a statement, as one would expect, saying that it regrets the undoubted inconvenience this situation causes to patients and their families.

I did not see the Minister for Health issuing a statement on that.

It is chaos.

I echo that. There are currently three consultants in Galway University Hospital covering outpatient clinics, a day ward service in Merlin Park, and an emergency medical intake and a consult service at Galway University Hospital. A locum consultant will take up a post in September, an extra consultant for Galway University Hospital will take up a post in October 2015, and an additional registrar is being assigned to rheumatology and will commence in July 2015. From 1 October, there will be four consultant rheumatologists at UCHG. Patients are being notified that their appointments have been postponed and they will receive new appointments as soon as possible, as is right.

Christmas.

They could be dead.

When extra medical staff is in place, the extra outpatient clinics will have to be held and will be held. Emergency patients will continue to be seen on a case-by-case basis. The national recruitment service is actively recruiting hospital staff and consultant posts are continually being approved for filling. That is what is happening at the moment in terms of the response. The HSE has advised that 38 acute consultant posts were filled in 2014 in HSE hospitals and that 36 have been filled so far in 2015. There is a great deal of progress. Recruitment for 193 consultant posts is in progress. This is being carried out in conjunction with the Public Appointments Service. It is true that there are specialties in which there are international shortages and which have traditionally been difficult to fill. Regardless of the salary scale, some of these posts are extremely difficult to fill, but I think the Deputy will see and the House will agree that significant progress is being made. Obviously it is a matter of regret if people's appointments are postponed. The response should be quick and humane, and we should ensure, as I know the hospital will, that those clinics are held and those patients seen as soon as possible, consistent with the need to carry out the recruitment process.

Eight months to fill a maternity vacancy.

The consultants that are currently in Galway are not full-time rheumatology consultants. Two of them are in general medicine as well. That means we have one and a half consultants.

Second, the vacancy that has arisen and that has driven the total closure of the clinic at Merlin Park - it is not just that appointments have been cancelled; outpatient appointments at Merlin Park have been entirely shut down - is a maternity vacancy, which was notified and which should have been planned for. That child will be born and we wish him or her well, but a degree of planning would have put a locum consultant in place. Some 850 people have had their appointments cancelled. These 850 people will join the other 1,500 people-----

Correct

-----who are waiting for a rheumatology appointment at Merlin Park. Ireland is a no-go zone for consultants. We are having serious difficulties filling consultant vacancies.

They were driven out.

No matter how many budgets the Government is putting forward, people are not planning this properly. The Minister said the HSE had informed him, but I contacted the HSE about this on Tuesday evening and was told it was not a matter for the HSE but for the Saolta hospital group. When I contacted the Saolta hospital group yesterday morning, its so-called communications department said it was not aware of the issue, in spite of the fact that 850 people were getting notices. It is not a case of appointments being postponed; somebody who had an appointment on 7 July is now being told the appointment is on 14 December. They are being told, "Yes, you are in pain; yes, you have an appalling condition, but you will wait until 14 December for an initial investigation".

Shameful.

The Minister of Health must comment on what is going on at Beaumont.

Hear, hear.

He cannot allow one of the main hospitals in the country to be as it is at the moment.

Correct.

We need serious action on consultant recruitment. We need great urgency. It is clear that these hospital groups, which were created by the Minister and the former Minister, Deputy Reilly, are not fit for purpose.

Go up to Beaumont for an hour and have a look.

The Minister, Deputy Varadkar, is too busy tweeting.

I am not trying to say there are no difficulties.

We have been listening to this for four years.

I have not tried in any way to stonewall the Deputy's questions or say there are no difficulties, and neither is the Minister for Health saying so. There have been interventions in this regard.

The Minister for Health only comments on it.

I gave a list of real measures that are currently being taken, particularly in regard to the recruitment of consultants. The Deputy acknowledges that we have had difficulty in achieving this. The Minister acknowledges that. However, real and tangible efforts are being made and achievements are being secured in respect of the recruitment of consultants.

There are difficulties in Beaumont, but to ensure the record is absolutely clear, the only ward that is closed in Beaumont is St. Damian's, the kidney ward, which needs to be upgraded. Those are the facts of the matter. It will reopen.

There has been a 1,500% increase in the waiting list. That is a fact.

I am just giving the Deputy the facts.

The 1,500% increase is a fact.

The Minister has the floor.

The ward will reopen in the autumn. It needs to be upgraded, it is being upgraded and it will reopen in the autumn. If it could be done more quickly than that, it would be.

What about the waiting lists?

It is being achieved as best the HSE and the hospital concerned can manage. Regarding the Galway situation, I have pointed out to the Deputy the difficulty regarding recruitment. I will be straight with him on the rheumatology situation there. The hospital is trying to secure a locum for the summer, but it simply has not been successful in doing so.

Tough luck.

The Deputy is correct. It has not been possible to secure a locum but real efforts are being made.

It is not as if they did not have notice.

There is nobody more concerned and more engaged with this issue than the Minister himself and the HSE directors and managers involved in this issue.

And Twitter.

We accept that there is a difficulty but significant progress is being made. Deputy Calleary makes no reference to the legacy of the policies, including health policies, of the previous Government. He makes no reference, of course, because it would not suit his case-----

The Government had four years.

-----to the economic collapse which has such an impact on all public services, including the health service.

They were giving away money.

Four years.

As one of the more reasonable Deputies on the opposite side-----

One of the many reasonable Deputies.

It is not reasonable to leave 2,500 people waiting for an rheumatology appointment.

-----Deputy Calleary must give some credit to the achievement of this Government in turning around a shocking economic context and success in managing-----

Is there anything reasonable about it? The Minister should hang his head in shame.

-----to keep and maintain a health service, which has difficulties and problems to which he referred and which I do not deny, but which is making real progress in the interests of the patients who it is there to serve and the wider community.