Chaos continues to reign in emergency departments in hospitals across the country. In the past ten months alone, 80,000 patients admitted to hospital had to languish on trolleys for an unacceptable length of time. Last month was the 15th month in a row that increasing numbers of people were waiting far too long on trolleys. This period coincides with the period since the appointment of the Minister for Health, Deputy Varadkar. In other words, the position is getting progressively worse, month after month. Last week, Beaumont Hospital apologised for the appalling treatment of the late Gerry Feeney, whose family described the distressing and traumatic circumstances surrounding his treatment. There have been many more similar incidents, including 90 and 91 year olds waiting on trolleys for 29 hours.

If one speaks to nurses working in emergency departments, as I have, the familiar refrain one hears is that it is very difficult to retain staff in emergency departments or attract staff to emergency departments because of the conditions and the unacceptable circumstances in which they must work. I meet nurses across the country on an ongoing basis who consistently give me that message. Morale in emergency departments is at an all-time low due to the record numbers of people waiting on trolleys in recent months, so much so that the Irish Nurses and Midwives Organisation, INMO, has balloted for industrial action in emergency departments.

Of the emergency department nurses who were balloted, 92% voted in favour of strike action in the middle of December.

A question, please.

They have had enough of the broken promises on this issue. It is a national campaign and, they say, a last resort against a daily acceptance by Government of emergency department overcrowding. Does the Taoiseach accept that morale is at an all-time low in our hospital emergency departments? Does he accept that staff retention and recruitment is extremely difficult, that patient safety is compromised because of what is going on and that the Government has constantly under-resourced this sector of the health service over the last number of years?

I accept that there are recurring challenges in the health system, not the least of which is in the accident and emergency departments. I am disappointed that the INMO has voted in favour of industrial action. While the outcome was expected, industrial action will not sort out the challenges we face. The director general of the HSE has already affirmed that health service management is keen to use the machinery of the State to deal with the decision of the INMO, which it was entitled to make. The emergency department task force has a specific plan which was developed in accordance with the authorities. The task force is co-chaired by the director general of the HSE and the INMO's general secretary. It is important to say that overcrowding continues to be a problem and the frustrations of staff have been expressed to myself and many others because of the pressure they work under in particular situations. The Deputy should know, though, that a strike will not assist a single patient on any trolley or in any accident and emergency unit or hospital.

The number of people on trolleys is 20% lower today than it was on the same day last year. The figures produced by the nurses themselves accept that overcrowding is slightly lower than it was this time last year. That is a big change from August of this year, when overcrowding was 40% worse, and it is also clear that we are a long way from the very bad situation at the start of this year when between 500 and 600 people were on trolleys in hospitals. The implementation of the emergency department task force plan is beginning to yield beneficial results. We have seen the expansion of community intervention teams to deliver services outside hospitals. Mount Carmel is the first community hospital to open in that regard. There has been a reopening of 100 beds that had been closed and the opening of a further 100 new beds. There will be 100 more beds in next couple of weeks and a further 100 between December and January. These are beds for which provision has been made in the budget and they have been brought about by the intervention of the Minister for Health. They will do a good deal to alleviate the pressure that has been built up.

In conclusion, it is fair to say that the investment in the fair deal scheme has brought the waiting period down from 16 weeks to two to four weeks and thereby reduced the level of delayed discharges in our hospitals by approximately 250. That, together with the home care packages, provides opportunities in the community for patients to receive treatment so that they do not have to be in hospital in the first place. I hope the negotiations can take place to prevent a strike which will not help any patient. The plan put in place by the task force co-chaired by the secretary general of the INMO is now beginning to yield very positive results.

The Taoiseach did not answer the questions I put to him, including the question about whether the Government has under-resourced the health service over the last number of years and particularly the area under discussion. Equally, I note the Taoiseach's use of language in stating that this is a "challenge" or a "problem." He has no sense of the crisis. It is not a challenge or a problem any more; it is a crisis. It is a crisis for patients and staff operating in emergency departments, and the Taoiseach had better begin to use that language.

The Taoiseach said the outcome of strike action was expected. Does that mean he understands that morale is so bad that 92% would vote in favour of industrial action? Does the Taoiseach think they want to go out on industrial action? They do not. Did the Taoiseach read the Sunday Independent last weekend? The former Minister for Health, Deputy James Reilly, made some interesting revelations in it. He admits the health service was under-resourced and that the writing was on the wall in the 2012 budget. He said he was considering resigning there and then. We pointed out that it was a false budget and said it to the Government.

He was shafted.

Deputy Reilly knew it was a false budget. It is very clear from the interview that he now feels he was shafted by the Taoiseach and is continuing to be shafted by the Minister for Health, Deputy Leo Varadkar, whose only response is "It is his fault."

Will the Deputy put a question?

It is interesting to note that universal health insurance, which was supposed to solve all problems and was used as a cover for the Government to say it would take care of everything, has been shelved. The Government told the Irish people it would get everybody off trolleys. I had to answer questions from journalists who kept asking me if Deputy Reilly got it wrong.

The Deputy is over time.

They did not ask whether Fine Gael had got it wrong or whether the Taoiseach or Deputy Varadkar had got it wrong, but whether Deputy Reilly had got it wrong.

The Deputy is not listening to me. He is over time.

I wonder how that happened.

Did Deputy Martin get it wrong?

That is the favourite response.

In fact, he doubled health spending in a few months.

"Blame anybody but me. Move on to the next culprit."

Deputy Martin should take a look at his own record.

He complained that Tallaght hospital had not ordered enough trolleys.

I want to put the following to the Taoiseach. In its strike notice, the INMO has made it very clear that-----

The Deputy is way over time.

I apologise, but I would like to get answers to the questions I put. The fundamental point is the resourcing of emergency departments. The Taoiseach talks about the reduction in the waiting time for the fair deal scheme from 16 weeks to four weeks, but the Government created the 16-week wait by under-resourcing the scheme at the time.

What question is the Deputy putting?

Does the Taoiseach accept the INMO's proposition that additional resources are required in terms of nursing staff in our emergency departments to deal with the record numbers languishing on trolleys on the Government's watch?

It is a serious matter. I note the way Deputy Martin carried on himself when he doubled health spending. He said Tallaght hospital had not ordered enough trolleys and he fled out of the Department of Health and Children as fast as his two legs could carry him. He fled out of the place.

I was one of the longest-serving Ministers.

He ran like a scalded cat-----

Mary Harney was there for six years.

How long was the Taoiseach a Minister? How many weeks?

Please, Deputies.

-----because he was afraid to accept any responsibility. He cowered in the corner at the Cabinet table.

He threw his own Secretary General under the bus over the nursing home charges.

Deputy Varadkar pushed a fair few under it too.

He doubled health spending, got a worse result and fled the place as soon as he could.

I got a far better result.

The Government is still pushing Deputy Reilly under the bus. It pushed him under it, pulled him out and will throw him in again.

I point out to Deputy Martin that there are 750 more nurses working now than there were last year.

They should have been working last year. That is the point.

They are all going on strike.

A substantial increase has been made available in the budget by the Government to the Minister for Health. I have pointed out to the Deputy that in respect of the prevention, capacity and community issues, serious progress is being made, and the figures speak for themselves today by comparison with August and earlier in the year.

Does the Taoiseach agree with Deputy Reilly?

The emergency plan put in place and co-chaired by the secretary general of the INMO is now beginning to pay real dividends. I hope we can continue in that regard. Of course, everybody understands the pressures under which front-line staff work. I hope the State's negotiation machinery can be used to sit down and discuss rationally what is happening, including the extra allocation of resources, personnel and facilities and other good things happening in the health service, and I hope we can alleviate the burden on so many people in a way we were not able to do in the past. Deputy Martin should remember the financial abyss he left the country in when he ran out of the Department of Health and when he sat at the Cabinet table in the lead-in to the change of Government in 2011, when we did not have a red penny, as one of his own party members said, to build a hospital in Dundalk.

The Army was at the ATMs that time, is that it?

The Taoiseach is way over time.

The Turkish Prime Minister is looking for the Taoiseach.

Deputy Micheál Martin is the last remaining political link to an economic catastrophe perpetrated on this country and all of our people by his party. He was centrally involved in it.

The Taoiseach should not spill his water. That is costly.

Not as costly as Fianna Fáil was going to charge.

Look after that water, please. It is metered in the Oireachtas.

Do not go there.

Just a splash.

The Taoiseach is critical of the nurses' decision to strike. He claims it will not solve the problems in accident and emergency units, but what are the nurses to do? We have had a series of shocking revelations, such as the one that is cited ad nauseam of a man in his 90s being forced to spend 29 hours on a trolley. These are the front-line conditions in which nurses are working. They are being forced to take industrial action in support of all front-line staff and in defence of patient care. Those staff and patients have been let down by the Government. This crisis is a direct result of the Government's continual refusal to deal with the accident and emergency unit overcrowding chaos and resource a public health service properly. This is the flaw in the situation.

In 2013, the then Minister, Deputy Reilly, stated we would never again see 569 people on trolleys in a single day while this Government was in office. Under the current Minister, Deputy Varadkar, the situation has worsened. There are increased numbers on trolleys, delayed discharges, a lack of home care packages and a lack of public and nursing home beds.

Front-line workers perform heroics every day. In the first ten months of this year, almost 80,000 admitted patients were on trolleys, the highest ever figure for the first ten months of any year since trolley watch began. As we sit in the Chamber and the Taoiseach jokes and banters with Fianna Fáil, there are 339 patients on trolleys. For the 15th month in a row, last October saw an increase in the level of overcrowding in emergency departments.

A question, please.

The president of the Irish Hospital Consultants Association, Dr. Gerard Crotty, has stated that the cause of accident and emergency overcrowding is a lack of capacity because not enough money has been allocated. Will the Taoiseach acknowledge that the Government, for ideological reasons, has underinvested in the public health system, that the overcrowding in accident and emergency units is a result of that policy and that today's announcement of strike action by nurses is an entirely understandable response?

Even Deputy Adams with his weird economics on behalf of his party will understand that we did, after all, have an economic crisis in the country here that necessitated serious cutbacks in a range of areas.

And tax back for the wealthy.

Deputy Adams will understand also that the equivalent of an increase of €880 million has now been secured compared with the 2015 allocation of €12.295 billion for health services.

As I pointed out to Deputy Martin, the task force set up by the Minister for Health is beginning to pay its way in the sense of improvement in the situation that applies in the hospitals. Delayed discharges are reducing. That frees up beds. As I pointed out, beds in the community hospital in Mount Carmel have been opened. Three hundred additional beds will be opened this month and a further 100 in January. There are more staff working than ever before. Since January, there are 500 more nurses - 500 more professionals - in the health service. Since 2011, almost 300 additional consultants have been appointed throughout the country, including 57 this year. These are consultants - professional people - who are well able to do their jobs. The number of non-consultant hospital doctors has increased by 250 since last year.

I understand that the vote was expected in the way that it has been taken, but it is not going to solve the crisis and the challenges we face in the health service. The Minister for Health, working with the health authorities and the different sectors in the health area, has made significant improvements. We are not where we want to be yet, but the situation is better than it was and it continues to improve. As I said to Deputy Adams, €880 million extra has been allocated to the health system than was in the 2015 allocation.

But not extra since 2011.

That requires that every professional in the system in terms of management and staff, along with everybody else, must work together. One cannot blame nurses for the situation here. This is a cross-hospital, cross-health sector situation and everyone must-----

And cross-Government.

They are blaming the Government.

-----make the best effort he or she can in the interests of the patients whom he or she serves. The situation has more facilities, personnel and money allocated to it than before. Obviously, the management of that in the interests of providing better services for patients is what is paramount for everybody. I hope the INMO and the State's machinery will be able to work out a situation where we do not have to have a strike coming up to Christmas.

Is this all a pretence? Are people making this up? Is there not a crisis in our accident and emergency departments? Is there not a crisis of patients on trolleys? The Taoiseach referred to weird economics, but what sort of economics puts money in the pockets of the elites but not into public services? Riddle me that. It is nightmare economics of the Fine Gael-Labour kind. Last week in the dying days of the Government, it abandoned its flagship health policy, one of the central planks of the programme for Government and Fine Gael's five-point plan. The Government got rid of it and has no public health policy.

Neither does Sinn Féin.

The Government has no commitment to a public health service. The Minister, Deputy Varadkar, if he would just be ciúin for a moment, should explain to the Taoiseach why he stated that hospital groups should be able to conduct business in the manner of semi-State companies outside the constraints of public service rules.

A question, please.

He has made it clear that the CEOs of hospital groups should be allowed to transfer the management of hospitals to private providers. Where is the commitment? This is all about the privatisation of what should be a citizen's entitlement. This is an insight into the Government and how and why it presides. One must ask the question of why this is so and why we are in this difficulty. Why are the nurses going out on strike? Will the Taoiseach not just admit that the Government's long-term plan is to abandon even the pretence of public ownership models of health care, which is why it will not adequately invest in the public health system?

I repeat for Deputy Adams that there are 700 extra nurses employed in the system now.

The Government took 12,000 out of the system.

These are real, professional people.

So are the ones going on strike.

I have said to Deputy Adams that 300 additional consultants have been appointed since 2011, with-----

Who has the problem with figures now?

-----57 this year. These are professional people.

Half of them are leaving the country.

What does Deputy Adams want to do with the consultants? What does the Sinn Féin Party want to do with the consultants?

Tell me.

It wants to drop their pay and increase their taxes.

No, we do not.

We want to give them-----

It does.

Yes, it does.

And increase their taxes.

That is what Sinn Féin wants to do.

We want a public health system.

The Taoiseach should learn to read the document.

The situation is, clearly, if Deputy Adams examines the facts for once, that the HSE and the Department of Health have difficulty in recruiting consultants to work in our hospitals because of their remuneration levels.

Why?

The conditions are the reason.

It is the conditions.

The Government cut their pay dramatically.

Deputy Adams goes around the country saying that they are wealthy-----

What about the nurses?

-----and that consultants must have their pay reduced-----

It was the Government that cut their pay.

-----and their taxes increased.

Deputies, please.

He will do the same with the nurses and everybody else because his party claims that-----

We can give the Taoiseach the Ladybird version of this.

-----everything is free in this country-----

No.

-----but somebody has to pay at the end, and increased income tax is where it is based.

I would like to know what the Government is working on.

Prevention, capacity and community are all being addressed through extra facilities-----

They are not being corrected.

The Government has no cure.

-----extra personnel and extra resources-----

We are imagining it, so.

-----allocated by the Minister for Health to this particular situation this year.

The nurses have imagined the crisis.

Extra from last year, but not since 2011.

It is better than it was in August and it is better than it was in January, and if Deputy Adams has anything constructive to say-----

The Government has no policy.

-----he might point out the good things that are happening in here while we intend to address the challenges that remain.

Hear, hear.

I do hope that the INMO - its general secretary chairs the task force, which is now paying dividends - can sit down, approach this rationally and avoid a strike of nurses coming up to Christmas, especially given that they are so important to our system. I hope that can be concluded successfully.