Now that the Government has apparently survived its own health scare, perhaps it can turn its attention to the far more pressing matter of the health of the nation as a whole. There appears to be a lack of urgency in the Government's response to the Sláintecare report, produced by the cross-party Committee on the Future of Healthcare. The report, with its far-reaching recommendations for radical changes in this country's approach to health care, was published back in May, but we are still waiting for the establishment of an implementation office that will see its recommendations brought into action.

If proof was needed of how much a major revamp of our delivery of health care is required, then one only needs to look at recent developments. At a time when waiting lists for treatment in Irish hospitals are spiralling out of control, the recent RTÉ "Prime Time" investigation revealed how a number of consultants were in breach of their contracts to provide a certain number of hours in the care of public patients, opting to boost their salaries with work in private hospitals. One who was observed for eight weeks was found to be working fewer than 13 hours on average in the public system even though he was contracted to work 37 hours a week.

Such scandalous behaviour, for which HSE and hospital management must also take their share of responsibility, no doubt at least partly contributed to the latest waiting list figures in our hospitals. There were almost a half a million people, more than 494,000, waiting for outpatient treatment at the end of October. That is an increase of 56,000 people on the same time last year. Despite several undertakings to improve the situation, there has also been an increase in the number of people waiting for inpatient and day case operations and procedures compared with this time last year. More than 80,000 people are on waiting lists as inpatients, also up on last year. The number waiting for 15 months or more as outpatients has almost doubled, up by 88% to almost 92,000. Add in those waiting this unacceptable length of time for inpatient or day case procedures, and there are little short of 500,000 people the length and breadth of Ireland facing absolutely unacceptable waits for a call from their local hospital. They have been forced for more than 15 months, and much, much longer in some cases, to live in pain, to live in fear and to live constantly waiting for the postman to deliver a letter that will finally signal relief. Meanwhile, the workload of nurses and other staff has increased to a point of great stress to them and to a point where questions should be asked about the level of care to some vulnerable patients. They are simply being spread too thinly on the ground. Resources are being stretched in most hospitals and the solution is not just a question of more beds. The required additional medical resources in terms of staffing, equipment and theatre facilities must be allocated too.

The Committee on the Future of Healthcare recommended that the implementation office for Sláintecare would be located in the Office of the Taoiseach. I understand that there was a worry among at least some members of the committee that the Department of Health might be given the responsibility for implementing the wide-ranging and radical changes recommended by the report. They felt that such a move would hamper progress.

Can the Taoiseach confirm that the implementation process will be under the control of his Department and not the Department of Health? Can he indicate when the process will be up and running?

On the last question, the progress report will be made to the Minister of Health but the Minister for Health reports to the Taoiseach in the context of the Cabinet subcommittee on health, which has a specific focus on Sláintecare. The Taoiseach holds the Department and the Minister to account on progress made.

The concept of Sláintecare is an all-party approach to ensure we have consistency in terms of providing decent health care across the country as Governments change and we are absolutely committed to this, as are other parties. We are anxious to get on with the implementation process to which we have committed. In July the Government agreed to move forward with the establishment of a dedicated programme office, specifically the recruitment of a lead executive. This marked a critical first step in gearing up for the significant programme of reform and demonstrates the Government's commitment to this process. Some €1 million has been allocated to this office for 2018 in line with the report's recommendations. The recruitment process for a head of this office is already under way and is being managed by the Public Appointments Service. It is essential that we are positioned to attract candidates of real calibre who can be responsible for driving the reform programme in which the office will be involved.

In parallel to this process the Minister for Health, Deputy Harris, is developing a response to the report and a draft implementation plan, which will be done and published by the end of this year. This process seeks to translate the Sláintecare report into a programme of action for the next ten years and will consider issues that arise in designing such a programme, including key actions, deliverables, costings, timelines and the interdependencies which will be necessary across Departments. It was acknowledged in the Sláintecare report that more detailed consideration of these issues would be required and this work is under way. The process is being led at a most senior level in the Department and in the HSE and also involves close engagement with the Department of the Taoiseach and the Departments of Finance and Public Expenditure and Reform. The involvement of these Departments was a key recommendation of the report and that is why it is happening. We will have an implementation plan, as recommended by the Sláintecare report, by the end of the year and the Minister, Deputy Harris, is on schedule to get that done. In parallel, we are putting in place a delivery office with people who have the motivation and talent to ensure we move the process forward into next year.

My own local hospital, University Hospital Galway, UHG, which is the busiest in the country, is an example of the woes of the current health system, with its growing waiting lists and overcrowded emergency department. The situation has been made worse by the fact that leaking roofs over the operating theatres in Merlin Park Hospital have resulted in some procedures having to be carried out in UHG and, of course, the cancellation of many operations. I appreciate that there has been some movement to reduce the inpatient and day case list but I find it disturbing that this hospital still accounts for more than a quarter of all the patients in the country who are waiting for more than 15 months for inpatient treatment that they badly need. Put another way, one in 11 patients on the waiting lists for inpatient or day case treatment nationally have been waiting for more than 15 months. In Galway that proportion is one in six patients. It is shocking, for instance, that a total of 114 people have been waiting for more than a year in Galway for cardiac treatment, when this time last year there was just one patient in this situation. There were 17 people last year waiting for more than a year and a half for oral surgery and this total has since soared to 570. We seem to be going backwards, rather than forward, in terms of health care and the reforms suggested in the Sláintecare report cannot come fast enough.

I suspected there would be some questions relating to Galway in the Deputy's contribution. As part of budget 2018 it was announced that funding to improve access to emergency care in 2018 will enable the opening of additional hospital capacity, including new beds, and additional diagnostic services and surgical capacity will be provided to reduce emergency department overcrowding. Additional capacity will be introduced in Galway in this respect. A new 75-bed ward block was completed in 2016 and the new acute mental health department is expected to be operational by the end of 2017. Galway is a pilot site for the national patient flow improvement programme and it is starting to work. There has been significant progress in planning for the new emergency department, with a design team to be appointed in the coming weeks, and there has also been a significant upgrade of the maternity unit, as well as 30 additional beds opened in 2016 as part of a wider winter beds programme. The cystic fibrosis outpatient department was completed a number of years ago and we are also looking at elective orthopaedic contingency implementation work at Merlin Park.

I am not saying we are where we need to be and there are clearly issues with, and pressures on, health provision in Galway, of which the Minister is very aware. However, we have a significant funding programme, both capital and current, and that will ensure we address these issues over time.