Before proceeding to take Leaders' Questions under Standing Order 29, I point out to Members that yesterday we ran significantly over time and that overrun has implications for the transaction of business in the rest of the Dáil. I ask Members in this section to have regard to the time allowed. I call Deputy Micheál Martin.

I want to raise with the Taoiseach today the appalling length of the waiting lists and waiting times in the hospitals for patients throughout the country. The situation is truly scandalous and is unacceptable, particularly for children who are waiting far too long to get to see a consultant in the three children's hospitals, especially in Crumlin and in Temple Street.

One can trace it back to the decision of the then Minister, now Senator James Reilly, in 2011 to mothball and destroy the work of the National Treatment Purchase Fund. Prior to that, the average waiting times for elective patients was approximately two and a half months for those waiting for elective treatments. Senator Reilly changed the system - it is all documented - and it has been all downhill since with dramatic increases in waiting times and in the waiting lists. For example, we now have 415,000 people waiting for outpatient appointments and 62,000 people waiting longer than one year. We have in excess of 75,000 people waiting for inpatient treatment in hospitals. Some 4,500 children are waiting for appointments in the three children's hospitals, 2,000 of whom are waiting for more than a year. One would think that when it comes to children, we should be moving might and main to eradicate or shorten dramatically those waiting times, particularly in terms of those waiting longer than a year.

The programme for Government talks about progress and sustaining progress made. I would suggest that the Taoiseach should take out the language of sustaining progress because no progress has been made over recent years in terms of waiting lists and, in fact, the situation has become dramatically worse. The waiting lists are now up 45% in two years. It is a sad indictment of what has been going on over the past two to three years in terms of policy initiative and a lack of basic urgency in dealing with this crisis. Patients, in particular children, should not have to wait that long to get to see a consultant.

There is a commitment, involving €15 million, to re-establish the treatment purchase fund. The €15 million will not be enough. There is a wider commitment of €35 million, or €50 million overall, in terms of waiting lists. Will the Taoiseach outline to the House the plans to reconstruct and re-establish the treatment purchase fund back to the model that was in existence before Senator James Reilly mothballed it in order that it would be effective and have the capacity to deliver the results?

Does the Taoiseach accept these waiting times are absolutely unacceptable for the patients concerned?

I accept that any waiting list is never satisfactory because the patient must wait. As Deputy Martin pointed out, the programme for Government emphasises the need for a sustained commitment to improve waiting lists for patients, with a particular focus on those who have had to wait longest. The Department of Health will engage with the National Treatment Purchase Fund to deliver on that €15 million funding for an initiative targeted at those waiting the longest, with the continuing investment of €50 million per year to deal with waiting lists. I understand the Department is currently engaged with the National Treatment Purchase Fund and the Health Service Executive, HSE, is planning a dedicated waiting list initiative to be rolled out later this year.

The issue for patients is how long they must wait. Improving waiting times for scheduled or planned care for patients is absolutely key. The action taken by the previous Minister resulted in improvements. In 2015, some €51 million in additional funding was provided to address maximum waiting times of 18 months by 30 June and 15 months by year-end for inpatient, day and outpatient cases. The end of 2015 demonstrated a 95% achievement for inpatient and day case waiting lists and a 93% improvement for outpatient waiting lists against the 15 months maximum wait times. This year, the HSE service plan undertakes to maintain the 2015 levels of service in respect of scheduled care.

In 2016, the HSE's scheduled care governance group is focusing on a number of key areas, including ensuring that the chronological scheduling of cases is adhered to, putting in place validation procedures to ensure patients are available for treatment when they are deemed to be for treatment and relocating high-volume low-complexity surgeries to smaller hospitals. Many consultants have said to me they could do more work if some procedures of lower complexity were shifted to smaller hospitals. The group is also focusing on designating an improvement lead for each hospital group to provide support in meeting the national targets both for appointments and treatments.

There is an extra €800 million in the health system because the state of the economy has improved and that, in turn, will lead to improvements in a number of sectors. That money was not available before to deal with these very necessary cases.

That is not actually the case; the former Minister, Senator James Reilly, changed the policy. He got rid of the treatment purchase fund, which was a singular, dedicated and focused approach to dealing with waiting times. He blew it and got it terribly wrong. Another Minister, Deputy Varadkar, came after him and demonstrated no urgency at all on this. There are 5,000 patients waiting in Beaumont, meaning the numbers are up 57% on January this year. The Government must have a real check on reality and not quote the kind of figures I mentioned. The former Minister, Senator James Reilly, created a new target of 12 months - plucked from thin air - and up to then the target was six months for adults and three months for children. The former Minister, Deputy Varadkar, put it at 15 months. The Government could then judge against new targets that it created.

This is an urgent issue for the number of people who are waiting for procedures. In Crumlin's children's hospital, 2,000 children have been waiting for more than a year for an outpatient appointment. That is not good enough. We should immediately tackle that with a sense of urgency followed by real money now and not later in the year. We must get to the bottom of it. The numbers is Waterford are up 183% since January.

The Deputy's time is up.

That is the second-worst in the country. There are 4,000 people waiting at Cork University Hospital, which is unacceptable. This needs dramatic and urgent action by the Minister, with a proper re-establishment of the treatment purchase fund.

Time is up.

There should be a dedicated approach to getting the issue sorted. It is getting worse as time goes on.

As I said to Deputy Martin, the original allocation included €300 million extra for health. That has been adjusted with a further €500 million. The National Treatment Purchase Fund was discussed between the two parties in respect of the formation of Government and Deputy Martin himself, in fairness, made the point that it should be restored. It is being restored and the discussions are ongoing at the moment between the HSE and the National Treatment Purchase Fund for the roll-out of treating people on a dedicated waiting list, with €15 million allocated for it this year. Obviously, any figure is never enough when compared to the requirements in health, but there is a need here for outcomes and for results. The National Treatment Purchase Fund is now being put back in situ. Discussions are ongoing between the HSE and the National Treatment Purchase Fund for an initiative that is targeted at those who are longest on the waiting list. I hope that will produce good results for those patients in the very near future.