Last Wednesday evening I visited University Hospital Galway where I was briefed comprehensively by representatives of the Saolta group and authorities in the hospital on the enormous challenges facing staff and the pressures under which they were operating and, in particular, the situation in the emergency department. After the briefing they brought me to see the emergency department at first hand. The conditions for patients and staff and the circumstances in which they worked made for an appalling vista.

Did the Deputy apologise?

More than 250 people a day, on average, attend the emergency department which works out at approximately 62,000 a year, but it was built to cater for 100 a day. The situation in the paediatric department was shocking. There were two bays in the corner of a room, children were on the ground crying, parents cramped together and there was no capacity to deal with infection control. I met the nurses the following day in Galway, those working in the emergency department and those working in the community and elsewhere. They articulated their fears about patient safety in the emergency department at University Hospital Galway and how the interventions to date had failed.

Did the Deputy tell them that he had commissioned a report when he was Minister?

The hospital has a solution to this problem which it has put to the Government. Fundamentally, it has stated to the Government that it has sought approval to progress to design stage for a replacement emergency department and shell accommodation to replace the existing maternity unit, a 1950s building, but incredibly the Government has not included the project in its health capital programme. It has rebuffed the proposition from the hospital, sent back the proposal to it and told it to scale it down and engage in another cost benefit analysis. The Taoiseach has set up task forces.

The Deputy set up a few himself.

Particularly since it is now the tertiary hospital for the west and north west, as the Taoiseach knows, and the numbers are increasing on an ongoing basis-----

Produce a report on it.

-----the very minimum required is a commitment to replace the emergency department.

I ask the Deputy to, please, put his question.

All of the projects so far in the health sector have been in Dublin. There is very little being provided outside Dublin in the rest of the country in the health arena.

You have been in power for five years, lads and lassies.

The Taoiseach is to reopen Roscommon County Hospital.

As those opposite have been in power for five years, they should get over it.

It is only the first five years.

Will Deputies, please, take a pill and allow the Taoiseach to reply?

A Cheann Comhairle, I am being heckled by Government backbenchers.

The emergency department at University College Galway is not fit for purpose in this day and age.

Will Deputies, please, stay quiet, as we cannot hear the Taoiseach?

We cannot hear him anyway.

The staff in the hospital are working under extraordinary conditions. It is one of the most inadequate facilities in the country and needs to be replaced. I am not privy to the details of the stage it has reached in its design or architectural planning. The HSE has to send its service plan to the Minister for Health in the next week or ten days.

Where is Leo?

Silence, please. What is the Taoiseach saying?

It is very necessary that this piece of infrastructure be provided. As the Deputy is well aware and as he has seen at first hand, University Hospital Galway is a centre of excellence which has an enormous reach in terms of the different medical facilities provided. I assume the Deputy saw the new building that is under construction and which has been awaited for a very long time. He is also aware that the capital programme provides for a mid-term review. I cannot say what stage the design of the replacement unit for the emergency department is at, but I will find out. I was in the hospital recently, not in the emergency department but to visit a patient. Clearly, it is a major university teaching hospital, but it is a facility that has served its time and in which staff are working under extraordinary pressure. I accept that the emergency department has to be replaced.

Like James Reilly.

I accept that it requires approval, design and planning, all of the processes that must be gone through, at the end of which a very substantial sum will be invested to replace it. I do not object to the point made by Deputy MIcheál Martin. The facility needs to be replaced, but we cannot replace it over night. As the Deputy is well aware from his own experience in this field, such major pieces of infrastructure need to be planned for the future. The planning regulations, the design of such facilities and the building regulations that apply to the construction of a very modern unit have utterly changed from what they were five or ten years ago. I do not know at what stage the design is at, but I will make it my business to see that the HSE is informed about the matter. I would like to think we could progress the project for people from all over the west who use the facilities of University College Hospital Galway, but as the Deputy is well aware, it is not the only piece of infrastructure that needs to be replaced. If we had had a stronger economy when the Deputy's crowd was firing money left, right and centre, we might now be in a better position, but we have to deal with this challenge also.

Back to the future again.

The bottom line is that the Taoiseach has said he has been to the hospital and that its emergency department is not fit for purpose.

The Deputy did the same in 2002 when he was Minister for Health. We need to hear again the speech he made to the INMO. He promised the development of an accident and emergency department.

Will the Deputy, please, stay quiet?

The bottom line is that the Taoiseach knows and has said the emergency department is not fit for purpose. He has been to the hospital recently, yet the project has not been included in the health capital plan. He knows that if provision for the project is not made in the capital plan for the next five years, it will be a further five years beyond that before any start will be made on it. While the hospital has other priorities, it is stating the replacement of its emergency department is number one on its list of priorities. It has been stating that to the Government for quite some time.

This is like a Christmas card.

The policy makes it clear that everybody on the western seaboard must go to University Hospital Galway.

A question, please.

The community nurses I met said people in the community were begging them not to send them to the emergency department in University Hospital Galway because of the conditions there. It escapes me how the project was not included in the health capital plan. The Taoiseach has said he does not know at what stage the project is at. He should know if it is at design stage. He should know what is going on in the major tertiary hospital for the west.

Contact Leo.

Of course, the Taoiseach should know.

The Deputy should have known when he was in office.

The bottom line is that the project has not been included in the health capital plan and nothing can happen if it is not included in it.

There is no point saying to the hospital, "Scale it down, we want a lesser plan"-----

The Government said that about Beaumont Hospital.

-----because the Taoiseach knows what is proposed is essential and should be included in the plan.

Sorry, the Deputy is over time.

Will he now commit to its inclusion in the capital plan in respect of health? What I said earlier is correct. If he looks through the national capital plan-----

The Deputy should come on. We are over time.

-----there is a distinct discrimination against the regions in terms of the allocation of funding for those projects.

Deputy Adams might make the Deputy Minister for Health yet.

There are precious few health projects for the western seaboard, including the north west and south west. The Taoiseach should look at this; he will be surprised by it.

Deputy Adams will make the Deputy Minister for Health.

When the Deputy had responsibility for this, he said back in 2003 that the crisis was not his responsibility. I recall it well.

I invested heavily in Galway.

When the Deputy comes to the House, why does he not ask me if I know what the design status is for Our Lady of Lourdes Hospital or any other hospital around the country?

The Taoiseach used to be a Deputy for Mayo.

I am well aware of the problem in so far as the accident and emergency department in University Hospital Galway is concerned.

The Taoiseach should get the Minister for Health on the phone.

Would the Deputy ever stay quiet?

It needs to be replaced and it cannot, and will not, be replaced overnight. There is a process to be gone through - planning, design, regulations and permission.

Start the process.

The Government is not even allowing it to go to design.

When the Deputy comes to the House, he never mentions the 75-bed unit under construction at the moment. Did he see that?

That is not the accident and emergency department.

Maybe they have to go to the accident and emergency department first.

Patients are left standing in the chemotherapy department.

Perhaps Deputy Martin did not want to see it or comment on it. He did not comment on the fact that 30 beds are being provided in the old physiotherapy unit, which will be opened in spring 2016.

We know that. There is no problem there.

Deputy Martin did not mention the fact that 14 additional beds are being provided in Merlin Park hospital. All of these go to ease the pressure on the emergency department in UHG.

The Taoiseach is there to solve problems, not to clap himself on the back for the things that are going okay.

Would Members mind staying quiet and listening to the reply?

Believe me-----

We cannot believe the Taoiseach after Roscommon.

-----the Health Service Executive has a responsibility to send its service plan to the Minister for Health.

The Taoiseach closed Roscommon hospital so people have to go into Galway, which cannot cope.

The Taoiseach made a solemn promise.

I assume that if this project were to be shovel ready or ready to go, it would have been included.

All they want is to go to design stage and the Taoiseach has refused.

It will never be shovel ready the way the Government is going on.

When Deputy Martin met the nurses and every other member of the medical personnel there, did they explain to him what stage of the design programme this is?

Yes.

So it was ready to go?

They said they sent the design proposal to the Government, which sent it back. How many more times do I have to say it?

The Deputy should resume his seat. We are now three and a half minutes over time on this question. Please respect the Chair.

That is awful. The Taoiseach is clapping himself on the back for a few beds that he opened in the physiotherapy ward.

In that case, the Deputy should follow his own logic. He visited Castlebar last week and he was welcome. He attended the Sacred Heart Home. His representatives there are saying it will never proceed, despite the fact there is €14 million on the table.

Will the Taoiseach please resume his seat? I call Deputy Adams.

It is a disgrace from a west of Ireland Taoiseach.

Will Members please show some respect to the person asking the question and the person replying, no matter what party he or she is in, or none?

They do not want to hear the reply.