The chaos caused by the Tánaiste's Government is starting to get out of control. Its mismanagement has led to chaos in our justice system, chaos in transport and chaos in governance, but perhaps the most stark and painful is the chaos in our hospitals. Waiting lists continue to soar. Exhausted and demoralised staff are leaving in droves, there is a dangerous lack of capacity in our ambulance services and there has been no let up. There has been no let up for the nurse finishing a 12 hour shift knowing that she has to go back to dealing with the consequences of this Government's mismanagement and chaotic attitude to health care.

Figures have been published by the Irish Nurses and Midwives Organisation. I want to thank it for publishing the figures because they are a valuable addition to our discourse on health. Very often, they inject facts which contradict the Government's spin. The figures show that March 2017 has seen the highest ever number of people on trolleys since 2006. For the benefit of those who have not heard, that is 9,459. In 2008, the figure was 4,700. Last month, 9,459 patients were admitted for inpatient care. A decision was taken by a doctor that they needed a bed and there was no bed for them. I remind the Tánaiste that it is only a short few years since her colleague, the former Minister for Health, now Senator James Reilly, gave a commitment that never again would we see 569 people on trolleys. In January, the Government was surprised by the influenza outbreak and the figure increased to over 600.

I believe that if something needs to be fixed we should stop what we are doing and do that. Clearly, reviews do not work. Committees do not work. Kicking the can down the road, and God knows that is one of the Government's favourite pastimes, does not work. The Government's winter initiative has not worked. The National Treatment Purchase Fund, the practice of the Government giving money into the private sector, crossing its fingers, closing its eyes and hoping that somehow that will improve the public service, has not worked and will not work in the long run. People need solutions that work.

Will the Tánaiste take the necessary steps to deal with the scale of this crisis? Will she listen to the voices of patients, carers, the workers and their representatives? Will she confirm for our elderly citizens sitting at home in fear that the Government will not means test the already overstretched home help service but that it will increase the number of hours available?

This Government has been and is taking action. The Minister for Health has a series of initiatives to improve our health service. The first point I would make is that it is the highest health budget ever at €14.6 billion, demonstrating the Government's commitment to investing the gains from the recovering economy I spoke about to improving the health services. There is increased demand, as the Deputy rightly points out, from a growing and ageing population. We have a series of new developments in drugs, for example, and the Deputy will be aware of the very welcome decision taken this week on Orkambi to respond to the needs of people who have cystic fibrosis.

As the Deputy knows, the Minister met with the INMO this morning, and it is worth putting on the record that over 80% of nurses voted recently to accept the Workplace Relations Commission recommendation.

In terms of improving our health service, the key issue is the recruitment of more nurses. Part of the proposals was that 1,208 fully funded new posts for nurses will be in place by the end of this year. Both the INMO and the Minister are working to ensure that we have that recruitment and retention. That is absolutely critical. There is a new Bring them Home initiative, increased supports for nurses who return here and further pre-retirement initiatives to ensure that we can retain the nurses we currently have. The Minister and the INMO are agreed on that. Over 80% of the nurses are agreed on it also.

I would point to other initiatives that have happened. We have seen the increased funding that has gone into home care for the very people the Deputy spoke about. Increased numbers of home care packages have been made available and there was additional funding of €18.5 million in budget 2017 to support the development of primary care services. This week, given the funding we now have for the National Treatment Purchase Fund, more than 2,000 people will get their appointments. That is now possible because that funding is available under the National Treatment Purchase Fund. Those are real people who need services.

I would point out to the Deputy also that the trolley numbers are down approximately 5% in the year to date. There are huge challenges but progress is being made. With the exception of one day, there was a decrease in the numbers on every day in April compared to the same time last year. The numbers range from a 3.6% decrease in waiting time on one day to a 27.7% decrease on another day. Progress is being made but there are huge challenges in terms of extra demands on our health services.

I totally acknowledge the distress that can and is being caused to patients and their families, and to front-line staff who have been working in extremely difficult circumstances, but a range of both budgetary supports and other supports are being made available. For example, with regard to an issue that was raised here frequently, in January and February of this year we had the lowest level of delayed discharges in recent years. Progress is being made but huge challenges remain.

In January, the numbers on trolleys hit a record level. The Government is fond of setting records. Unfortunately, none of them is very good or useful. The Tánaiste paints a rosy picture of all the things she would like to do and all the developments she says are happening. Would she like to go down to any of the 409 people waiting on trolleys today and tell them about her great plan because they cannot see it? I have already said that what the Government is doing is not working. It is clear there is a crisis in our health service yet the Members opposite seem to be more interested in the next leader of their party. The Tánaiste's eye is off the ball and her Government is letting down the 650,000 people who are on waiting lists.

The Government is letting down the 9,400 people who were waiting on trolleys in March. The Tánaiste cannot spin this as a good news story because it is not so she should not pat herself on the back for the Government's so-called achievements because it has achieved record numbers on trolleys. I again ask the Tánaiste whether the Government will commit to reopening beds, investing in primary care and recruiting the necessary staff. By that, I mean actually recruiting staff because between December 2016 and January 2017, the system lost 168 nurses. The Government's recruitment plan is not working.

The initiatives announced by the Minister, on which he is working, have his full focus. The INMO met him this morning to focus on the key issue of recruitment and retention. The plan that has been accepted by over 80% of nurses is important. I am certainly not complacent about the challenges and have said that. I have acknowledged that the distress caused to any one patient waiting on a trolley is one instance too many, but clearly these problems cannot be solved overnight. What I am telling the Deputy is that the initiatives and actions are in place to ensure we have continual improvements. It is very challenging. We have an increased population and an older population but the bed capacity review is under way and will be completed later this year. Discussions are under way with the GPs regarding contracts. That is another important building block towards ensuring that the kind of primary care we want to see in this country is in place. This in turn will lessen the pressures on our acute hospitals. There is no complacency. I understand the distress caused to any one patient who is on a trolley, but the Government is acting proactively to make a difference and improve our health service on an ongoing basis.