Yesterday the waiting lists were published and, unfortunately, it was like Groundhog Day all over again. Ten years ago there were 21,000 people on waiting lists for surgical and medical treatments and day-case or diagnostic treatments. Yesterday the list showed that there were 684,800 patients waiting on lists of various types: outpatient, 494,530; inpatient day-case, 80,894; endoscopy - active, 19,300; inpatient day-case, 18,000; inpatient day-case planned procedures, 11,700; planned procedures for endoscopy, 51,000; and endoscopy, 8,294. The reason I reference all those lists is simply that nobody knows how many people are waiting anymore because we consistently change the goalposts. We consistently change how we assess the numbers of people on waiting lists. We now have a situation where we have so-called suspended lists. One is suspended from the list, one is in abeyance, and then one is brought back onto an active list at some stage. People suffering with juvenile arthritis, scoliosis and several other paediatric illnesses and diseases are waiting inordinate periods of time for outpatient and inpatient procedures. It is wholly unacceptable.

In the NHS in England, there are 1,511 people waiting more than a year for an inpatient appointment. In Galway hospital alone, there are 2,914 waiting more than a year for an inpatient appointment. The fact of the matter is the health services are in crisis. Yesterday, if the Tánaiste wanted to seek clarity on that, all she had to do was read the Minister's two press releases, both contradictory, one trying to correct the other in terms of targets achieved and targets missed, numbers who were seen and numbers who were not seen. There were corrections even in the context of the press releases sent out.

Finally, we have a situation where advertisements are being issued for winter readiness and proofing of the health services for winter. One senior hospital manager told me that the only programme in place was the flu vaccine and prayers. The flu vaccine and prayers were how prepared we were for the winter initiative in some of our hospitals.

I raised this a number of weeks ago. Will the Tánaiste accept that a great deal has to be done, both in the context of the waiting lists themselves, enhancing capacity and ensuring people are seen in a timely manner, but also in the short and medium term on the issue of ensuring that our hospitals can cope with what will be thrown at them this winter?

Dealing with these issues is a priority for the Government. It is a priority for the Minister for Health, as every action he has taken supports that. This is shown by the budget that has been given for the health service, the new initiatives, the increase in the funding for the National Treatment Purchase Fund and the €1 million per week extra that will be spent on dealing with waiting lists, and the fact that the trend is downward.

There is much work to be done. Nobody questions that. I ask the Deputy to look at four hospitals with the lowest numbers on trolleys since 2006, Beaumont, Mayo, Cavan and Connolly. It is important to note this progress.

No doubt there is a huge challenge. Given the demographics, the fact people are living longer and the demand on the health services, and as we develop more primary care centres, of course, the demand continues in the hospitals. It is important to note that the home care packages, numbering 45 extra a week, will help deal with these issues because people will be able to get the services they need at home.

The truth in regard to waiting lists is that the latest NTPF figures show that the number of patients waiting for a procedure has fallen by over 2,000 in the past month and it is the third month in a row the inpatient day-case list has fallen. This is the category of patients who are actively waiting for treatment and these reductions have to be seen as real progress.

I accept the Deputy's point that more needs to be done - we cannot relax for one moment in regard to this because of the level of demand - but let us look at what is happening in the context of the trend being downward. There were significant decreases in October in both the 15-to-18 month waiting list, which was down over 1,000, and the over 18 months category, which was down over 1,000. For the second month in a row, there was also a decrease in the total number of patients waiting for an outpatient appointment with 788 fewer patients waiting for an outpatient appointment.

On the Deputy's point that patients were suspended because their doctors had decided they were unfit or unable to attend for clinical or personal social reasons, that is a reasonable thing to do because the people were not in a position to take up the appointments, and Deputy Kelleher himself asked for this.

The Minister has accepted the Deputy's broader point about the accuracy of waiting lists and how waiting lists in this country compare with those internationally. Trinity College is conducting a study on how waiting lists are compiled in this country and how it compares internationally and we will have that information at the beginning of next year.

If the Tánaiste wanted any evidence that our health services are in crisis, all she need do is go over to the Oireachtas print shop and see the number of Fine Gael Ministers and Deputies dispensing leaflets pointing out that one can get EU cross-border treatment and avail of treatment abroad schemes. Deputy Michael Collins from west Cork raised a case quite recently of a 91 year old man from west Cork who had to go to Belfast for cataracts because he was waiting so long. The fact of the matter is even the Tánaiste's own Cabinet colleagues and Deputies are running around the countryside dispersing leaflets advising people that the only way one can get treated is in another jurisdiction because of the Government's failures. That is what is happening.

They were exposed by Deputy Michael Collins.

Could we just accept for one moment that there are huge pressures on the health services? All this spin has to stop because people across the country are waiting inordinate periods of time in agony. Recently, a case was brought to me by Deputy Dooley of a very elderly man waiting over two years for an appointment even though it was marked urgent and he was in chronic pain and in need of a hip replacement. Every Deputy in this House could bring the Tánaiste instances of this. Will the Government accept that a great deal more has to be done, other than the spin and the PR, moving the targets and extending the waiting times, as was done by the Minister, Deputy Harris's predecessor who is now the Taoiseach? That is the reality of what is happening with Fine Gael's health policies at present and its only answer seems to be deliver leaflets to advise people how they can get treated outside this jurisdiction.

The Deputy referred to individual cases. Of course, nobody wants to see anybody waiting a day longer than is necessary.

Thousands of them.

Seven hundred thousand.

It is extremely important that the Deputy accepts that every effort is being made to deal with the waiting lists. The trend is going in the right direction. I accept that is no help for the individual to whom the Deputy referred.

The point is that it is an absolute priority to deal with this issue in a variety of ways. First of all, real money is being put in to deal with the 500 more operations for those who need hip and cateract procedures, etc., by the end of the year. There is €1 million a week to deal with waiting lists. The National Treatment Purchase Fund will have an allocation next year of €55 million, a huge increase to deal with people on those waiting lists. We accept that people are waiting too long.

In terms of Deputy Kelleher's point about people informing citizens of their rights as EU citizens-----

It was the Goverment's only answer.

-----it seems reasonable to me that that should be done.

It is, but it is the Government's only answer.

Is Deputy Kelleher suggesting that they should not be told what their rights are as EU citizens? The Deputy will be aware we have always had, and encouraged, cross-Border health care initiatives. That has worked well. We would like to see that continuing.

The Tánaiste knows it is an utter failure.

We accept that this is a huge challenge. I reiterate it is an absolute priority.

Our evidence is of providing leaflets rather than interest in the health service.

We care every bit as much as the Deputy about people who are on waiting lists, which is why we are making every effort to make sure people will spend less time on waiting lists and that the necessary resources will be given to the health service. It was an absolute priority in the budget to provide the kind of money that would make a difference and reduce waiting lists. The Deputy should acknowledge that the trend is in the right direction, but it is a huge challenge.