Over the recent period, the number of patients on trolleys in our accident and emergency departments has broken all records and fairly and objectively represents a damning indictment of the Government's lack of planning in respect of this crisis, its lack of urgency, its lack of prioritisation of a phenomenon that has caused significant distress to many patients and families throughout the country, and much more. The Irish Association for Emergency Medicine reasonably asked how many more patients would have to die needlessly while inertia prevailed. This is in a context in which it is estimated that 350 to 400 deaths per year are directly attributable to emergency department overcrowding.

This situation is interesting, given what happens in Scotland and England. In Scotland, just 6% of patients waited for longer than four hours. In Ireland, 19% of patients waited for longer than nine hours, which is a considerable difference. In England, commentators describe people waiting longer than four hours as a shocking lapse. Ms Susan Mitchell recently put it well in her article in the Sunday Business Post, which stated: "What passes for inexcusable in Britain would represent a huge improvement for the Irish health system."

Three years ago, the Taoiseach as Minister for Health said that he was "sick to death" of the problem and that he would solve it once and for all. He referenced a long-term plan to solve it. Three years on and that plan has never materialised.

As we know, the situation has become much worse since that announcement by the Taoiseach. This reflects a continuing unacceptable approach, a fundamental lack of urgency in respect of this issue and, sometimes, an attempt to normalise it. The toleration threshold relating to people waiting in accident and emergency departments is simply unacceptable and too high. The level of complacency is shocking.

In terms of some of the Government's own metrics and targets, the capital provision is woefully inadequate and does not provide for any meaningful response to the awaited bed capacity review. On the GP contract talks, we have been told for the past two or three years that something would materialise but it has not. Nothing is happening. Community intervention teams have not been established and providing diagnostics in the community is another aspiration. There is a lack of home support and so on and the crisis is all round. The budget is passed in October and the HSE's service plan is published in late December. There is an absence of transparency in the lead up to the budget. The Government takes it on trust that adequate provision will be made for acute services but that never materialises.

Does the Taoiseach accept that the Government did not adequately prepare for the current crisis and that this is why there were record numbers on trolleys, which caused enormous distress to people throughout the country? Will he confirm that real, meaningful funding will be provided to underpin the recommendations of the bed capacity review in terms of extra beds in 2018?

I would like to start by welcoming everyone back to the House after the December and January recess. I also want to begin by paying tribute to Dolores O'Riordan who died yesterday. For so many of us, especially those of us who grew up in the 1990s, she was the voice of a generation. No matter where one was in the world in recent times, it would not be long before one heard a Cranberries song on the radio, even in the most far-flung places. Dolores blazed a trail across the world with her unique voice and song-writing talent. Our thoughts are with her children, family, friends and the people of Limerick in particular. Guth glúine ab ea Dolores O'Riordan. Beidh a hoidhreacht ceoil linn go deo. Go ndéana Dia trócaire ar a hanam.

Regarding hospital overcrowding, which was raised by the leader of the Opposition just now, according to the HSE, 415 patients were on trolleys in emergency departments and on wards this morning. We expect that number to fall throughout the day, as it usually does, to approximately 250. It is important to say that two thirds of people who attend an emergency department are through it within nine hours. In other words, from the time that he or she registers, a patient is either in a hospital bed or discharged home within nine hours. That is the experience for two thirds of patients but, of course, the experience for many others is much worse and can sometimes involve prolonged periods spent in emergency departments or on trolleys while waiting for beds. That is something I do not seek to defend in the House today because it is not defensible.

If this was simply a matter of political will or finance, we would have resolved this problem a long time ago. Indeed, in 2006, Deputy Micheál Martin was a member of the Government which declared this a national emergency. The Deputy's party was in government for a further five years after that. That was-----

The Taoiseach served as Minister of Health in the intervening period.

What is this Government's plan?

If it was simply a matter of political will on the part of any party or of providing Government funding, the matter would have been resolved by now. That is particularly obvious when one considers that there has been an almost 20% increase in health funding in the past three years. The population has increased and there are now more older people here. There has also been pay restoration but certainly not in the region of 20%. Depending on whose figures one accepts, funding for our health service puts Ireland in the top six or top three in the world on a per-capita basis. As a doctor who worked for seven years in our health service, including in emergency departments, as a former Minister for Health, as a politician who represents tens of thousands of constituents and as somebody who has elderly relatives who, on occasion, have had to spend time on hospital trolleys, I can say that the Government is doing everything it can to alleviate both the short-term and longer-term issues involved. I do not want any citizen to face the indignity or the clinical risk that comes with a prolonged stay on a hospital trolley.

In terms of what is being done, the Cabinet discussed this matter in detail last week. We are going to continue to press ahead with increasing our hospital bed capacity - increasing the number of acute beds in our system.

That is under way already. Almost 200 new beds have come into the system in the last year. The number of beds in the system increased in the previous year as well. The Minister for Health will bring the bed capacity review to the Cabinet before the end of the week. We have approved the resumption of talks with GPs on a new contract. Obviously, it takes two to tango. We are very keen to have the new contract agreed this year in order that implementation can begin. The position of director of health service reform, as head of the Sláintecare office, was advertised on Friday. I hope we get good applicants for that position.

We want a particular focus on mainstreaming best practice across our health service because there are huge variations. Hospitals like Beaumont Hospital, St. Vincent's University Hospital, Connolly Hospital, Cavan General Hospital and Our Lady of Lourdes Hospital in Drogheda have seen considerable reductions in hospital overcrowding. Interestingly, figures from the Irish Nurses and Midwives Organisation for the eastern region show that last year, overcrowding across the hospitals in Dublin and Naas was at its lowest level since records began, even though there has been a big increase in population and in ageing in that region. There are huge variations across hospitals. I suggest that in the future, we should place a greater focus on mainstreaming best practice where it occurs in the health service, as it often does. We need to make sure best practice is mainstreamed. We need to ensure additional resources are put into rewarding good performance and best practice. We should not always put more resources into systems that do not work.

On a point of order, I would like an opportunity on the Order of Business to pay tribute to Dolores O'Riordan. I thought that was the opportunity we were going to be afforded.

Yes.

I was Minister for Health from 2000 to 2004. Some 1,600 extra beds were provided between 2000 and 2005. That occurred under my watch. Contrary to what the Minister, Deputy Harris, has been saying on the radio, there was massive investment in acute hospitals at that time. I will leave that to one side because people are interested in the issues we are facing here and now.

I will explain why I have said there is a lack of urgency. Last summer, Letterkenny University Hospital made a submission to the HSE and the Government for an extra 20 beds at a cost of €1.8 million. It did this last summer so that it would be ready for Christmas and the winter initiative. It did not receive a reply. Deputy McConalogue raised the matter with the Taoiseach and the Minister, Deputy Harris, and as a topical issue, but no action was taken. As a result, there are 36 people waiting on trolleys at the hospital for admission today. Last week, Letterkenny University Hospital had the unenviable claim of having the highest number of people on trolleys - 45 - which is an illustration of how chronic this issue is. I understand there were 2,000 people on trolleys at the hospital in 2016. According to Deputy McConalogue, that figure increased to 5,000 in 2017. The hospital had a solution and it made a submission, but it did not receive a response. When Deputy Kelleher raised this matter at the health committee some months ago, he was assured that things would be looked after and that we would not have record numbers of people on trolleys. We are beating those records every year.

The Taoiseach and his Fine Gael colleagues have been in government for seven years. It is about time they took responsibility for their time in government in respect of issues like this. The failure to respond to cases like Letterkenny resulted in the exacerbated crisis we witnessed this Christmas. There are other examples across the country of submissions being made to the Minister in plenty of time. Hospitals sought funding to try to alleviate the worst of the crisis but they simply were not responded to. The Taoiseach and the Minister, Deputy Harris, were alerted to the Letterkenny submission but there was no response to it.

Funding for Letterkenny University Hospital has increased from €94 million five years ago to €121 million this year.

I am talking about capital provision for beds.

Its budget has increased by almost €30 million.

What about the 20 beds and the 36 people on trolleys today?

We need to have a health service in which such a level of increase in funding and investment results in better outcomes for patients.

That is not the issue.

If that does not happen, we will continue to do more of the same.

Is that a threat to close wards?

We know that more of the same does not work.

The Government controls the HSE. It should have got rid of the board.

I did not bring up the fact that Deputy Martin is a former Minister for Health. I brought up a different fact, which I think is important. I mentioned a decision that was taken. It is important for us to double back a bit when we analyse these issues. In 2007, it was decided to start reducing our hospital bed stock. That decision was not made at the time because we were short of money. It was made during the boom.

That is not true.

From 2007 onwards, the number of acute beds was reduced.

No. The Taoiseach is wrong.

Fianna Fáil, the Progressive Democrats and the Green Party made an ideological decision-----

That is factually incorrect.

It is not factually incorrect.

I have the figures.

If Deputy Micheál Martin wants to see the figures, they are available in the key trends in health document published by the Department at the end of each year. From 2007 onwards, the number of acute hospital beds was reduced every year. In 2015, however, as Minister for Health, I took the decision to reverse that trend and started to increase the number of acute hospital beds again. The figure increased in 2016 and 2017 and additional beds will be provided this year in Beaumont Hospital, St. James's Hospital, St. Luke's Hospital, Kilkenny, Drogheda hospital, Limerick hospital and Galway hospital, with a modular build under way at Clonmel hospital. It is not the case that this is a simple matter. Where we have put more beds into the system, it has not always resulted in reduced overcrowding, yet significant changes to practices have made a big difference in other places. The Government will do all it can in the short to medium term to alleviate the problem.