The Taoiseach's starting point in dealing with this issue must be that the health service for which he is responsible is in total chaos. Sin é; that is the truth of the matter. Last year was the worst year on record for patients in terms of the indignity and distress of waiting on hospital trolleys. The European health consumer index published recently found that this State had the worst emergency department waiting times among 35 European states. St. Vincent's hospital in Dublin yesterday became the latest hospital to cancel surgeries, following the debacle witnessed at Cork University Hospital last week.

Having promised to fix the health service, the Government has made it worse. Yesterday, there were 517 citizens on trolleys in emergency departments. The Government promised free general practitioner care, an end to prescription charges and the abolition of the Health Service Executive. Broken promise after broken promise and a health service in chaos - that is the Taoiseach's legacy as his Government prepares to leave office.

These difficulties arise because the Government has set its face against developing a universal health service. Fine Gael, the Labour Party and Fianna Fáil are committed to a two-tier system which is dependent on a patient's ability to pay and his or her location. The result is the appalling and chaotic conditions that the Government has refused to address.

If patients were treated as citizens-----

Like in America.

-----they would have a right to health care based on their health needs. If citizens were treated properly in this centenary of 1916, the Government would be obliged to guarantee not only the right to proper health care but also the right to dignity and respect. To do so, it would have to build a public system, but it refuses to do this. That is the nub of the problem. The Government's aim is to privatise health care. It wants to heap even more chaos on a system that is in bits.

Will the Deputy put a question, please?

Mo cheist is as follows.

How are things in America?

After five years in office, will the Taoiseach give a straight answer as to the reason the Government refuses to develop a universal health service for all that is free at the point of delivery and paid for through progressive taxation?

Is that the way it is up North?

That is the question the Taoiseach should answer, and he should ignore the hecklers behind him. Why does the Government not develop a system of universal health care for all, one that is based on equality and health needs and paid for through progressive taxation?

The intention was to introduce a universal health insurance system. The Government has been up front about the fact that that is not possible in its lifetime.

That is a different issue.

We also indicated that it was our clear priority to have a system of universal health care which works on a number of levels, including primary care centres, community care, home care packages and investment in hospital facilities and medical personnel.

The position is that given our ageing population and the existence of inferior facilities in many of the locations throughout the country, we need to have capacity to invest and provide the best facilities for front-line staff in respect of their patients. As I said to Deputy Martin, €13.6 billion is allocated this year for health and services.

I wish to point out to Deputy Adams again that €117 million was made available for the fair deal scheme.

Ask Deputy Michael Lowry to sort out his telephone.

Sorry, Taoiseach, a telephone is interfering.

I think it could be here, a Cheann Comhairle.

I think it might be Deputy Michael Lowry ringing the Taoiseach.

Some €117 million extra was allocated for a reduction in the fair deal scheme from 16 weeks to four weeks, which has allowed for the discharge of patients to free up beds.

What if they need 16 weeks?

Obviously, the expansion of community teams to deliver opportunities for people to be at home and having services outside hospitals, in so far as that is possible, are the aims. Deputy Adams will be aware of the decision, and its implementation by the Government, in respect of free general practitioner access for children under six and people over 70. The next stage is to have it provided for the children of all working families. The increase was substantial on the allocation from last year and amounts to €13.6 billion this year.

Clearly, the Government's intention is to set out a multiannual situation for investment in health which will allow for a far more structured and focused allocation of those moneys. The intention is for hospitals to be paid in respect of what they do rather than simply a blanket annual budget being applied with a percentage increase each year, only to find at the end of each period that the money might not have been spent in the first place. Money is not as flush as it used to be, so it is a case of allocating for the best purpose.

Deputy Adams does down the service of those who work on the front line by some of the statements that he makes. These people work under exceptional pressure, admittedly. The recent discussions between the Irish Nurses and Midwives Organisation and management will, I hope, result in the facilities in accident and emergency units being rectified and presented in order that staff can do their job professionally and in the interests of minding patients to the highest level of service.

I am not doing down health service workers. I have had the experience of being in their care since I came to this part of the island.

Let us go back to what the Taoiseach promised. The Taoiseach promised free GP care for all. Where has that promise gone? The Taoiseach promised to abolish the HSE. Where has that promise gone? The Taoiseach promised to abolish prescription charges. Where has that promise gone? The Taoiseach promised to bring in a universal insurance scheme, but, like the five-point plan, that was simply a public relations stunt.

The Minister for Health, Deputy Varadkar, said that was never going to work. Five years in, the Taoiseach's Minister - not me or anyone here on the Opposition benches - said it was never going to work. He also said that the chief executives of hospital groups should be allowed to transfer management of hospitals to private operations. He said that hospital groups should be able to conduct business in the manner of semi-State companies. That highlights the ideological position of the Government, which, as I have said, wants to privatise our health service.

I asked the Taoiseach a question which he refused to answer. Why has the Government refused to develop a universal health service for all, based on health needs, free at the point of delivery and paid for through progressive taxation?

Sorry, we are over time.

I will put my question now. We are on the cusp of an election. Whatever we can say about Margaret Thatcher, she told it as it was. Would the Taoiseach not be better facing into this election by telling people that he wants to privatise our health service? The Taoiseach should tell people that as opposed to all the slíbhín weasel words that he uses to disguise his real intent. That would be the way to deal with the citizens, as opposed to making the promises he has made as he creates more and more instability and chaos in people's lives.

The term "weasel words" comes from a different vocabulary and a different time. Perhaps Deputy Adams is used to using those words. As someone who does not use the health service here, Deputy Adams is an objective commentator from outside.

I do use the health service here.

Let me reject categorically the statement Deputy Adams has made twice this morning to the effect that it is the intention of Government to privatise the health service. Let me reject that categorically.

Is it the Taoiseach's intention to build a universal health service?

The Government is clear that there should be an end to an unfair two-tier system and that there should be a single-tier system whereby people can have access to medical care and attention as close to home as possible and based on their medical needs as distinct from their income or resources. The intention was that we would introduce a universal health insurance system. The Government has been upfront about not being able to do that in the timescale that was set out.

No, it was not.

The Government is very clear about having as an absolute priority the introduction of universal health care based on the principles of primary care, community care, home care packages and having an economy that can provide the resources to invest in facilities in hospitals and other locations, as well as the employment of qualified personnel, consultants, doctors, nurses and all of the other medical specialist personnel that are required.

Use taxes to provide it.

We cannot have that unless we have an economy that is thriving and moving forward, unlike the sort of fantasy populism that Deputy Adams comes out with in this House every week-----

The economy should serve the people.

-----as if everything can be paid for and provided without having to produce the resources.

The Taoiseach wants the people to serve the economy.

Of course, Deputy Adams does not use the system anyway.