I would like to associate myself and the Labour Party with the expressions of sympathy for the family and friends of Dolores O'Riordan, and the people of Limerick, on her sudden and tragic passing.

The past two weeks have been dominated by what is now an annual crisis in accident and emergency departments. It is a sad reflection on our society that news of hundreds of sick people on trolleys is no longer shocking. According to the Irish Nurses and Midwives Organisation, INMO, there are 541 people on trolleys, 413 in emergency departments and a further 128 on wards today. Last year almost 100,000 people spent at least one night on a trolley. That is a shocking number. Our hospitals are operating at an occupancy rate of 95%, which is well above international safe levels.

The Government has almost perfected the management of the news cycle as this annual crisis erupts. There are many myths about the trolley crisis and many proposed solutions. I think the Taoiseach will agree with me that it is important that we do not talk down our health service. There are real problems that we need to resolve. Immense work is being done every day and every night in our hospitals treating sick people. Our population is growing. It is ageing and health problems have become more complex. Diseases that once killed are now being managed and new solutions are being provided to manage complicated illnesses. Progress is being made. Our health service staff are national heroes who save lives every day and we have much to be proud of but we must address the problems.

The Government has perfected the line that it is not a matter of money or resources and we heard that again today. At the heart of the trolley crisis is a lack of capacity and staff and to solve that requires money. Government makes choices and its choice in the last budget was to provide tax cuts rather than to move every cent we had into addressing the crises we face. We should have almost 4,000 consultants but we have fewer than 3,000. Everybody is in agreement that we also need more acute hospital beds. A bed capacity review is still awaited but the number of beds needed has been estimated from up to 9,000, or at a minimum 2,500, over the next ten years if the Sláintecare project agreed in this House is to be implemented.

What is the Taoiseach's plan and what is the actual target to hire more doctors in the coming 12 months? Is the Government going to close the accident and emergency department in Portlaoise hospital and reduce accident and emergency capacity further? How many extra acute beds will the Government put in place this year and each year up to 2021?

I am still shocked by the overcrowding in our hospitals. I am also shocked that it has taken and is taking so long to resolve it. The figure of 100,000 the Deputy gives does not refer to people who spent the night on a trolley. That is a count done at 8 a.m. and could include people on a trolley for fewer than nine hours, maybe even one hour or two hours. The figures collated by the INMO by its own explanation, on its website, include patients who are not on trolleys but are in the wrong sort of bed in, for example, an overflow ward or a unit that should have 12 beds but now has 14 and so on. As more categories of patients are added to that count inevitably the number will go up. That is how these things work.

I very much agree with what the Deputy said, there are many good things happening in our health service and we should recognise them. Life expectancy in Ireland is improving, we are living longer than ever before. That is because of improved public health and a better health service. Irish people when asked about their health rate it as being better than in any other country in the western world. Death rates from cancer, cardiovascular disease and stroke are falling. Those are real positives too and would not be happening if we did not have a well-functioning health service at least in some parts.

Good long-term strategies.

In respect of patient experience surveys, when 14,000 Irish patients were asked what they thought of their experience in the health service, never mind what we think, 85% said they had a good or very good experience of our health service.

That does not diminish for one second the fact that some patients have a very bad experience of the health service. That is something we need to change.

In pressing ahead, yes, there will be more beds.

How many?

There will also be more staff and money. The increase in the number of beds is happening. I think the figure for this year is 190 additional beds. We do not yet have a figure for next year, but we are working on it as part of the capital plan. There will be more beds this year, as there were last year and the year before. To give the Deputy the figures - in 2017 the number of inpatient beds was 12,123. By 2011 it had been cut to 10,849.

The Taoiseach should go before and beyond that year.

More than 1,200 inpatient beds were taken out of the system by previous Governments-----

The Taoiseach is incredible.

-----which involved Fianna Fáil, the Progressive Democrats and the Green Party.

Why did Fianna Fáil let them do it?

We are reversing that trend.

This is a disgrace.

We have more staff in the health service. I think the number is now 110,000, up by 10,000 on the figure five years ago. Notwithstanding the problems we are having in recruitment, we now have nearly 10,000 doctors working in the public health service and more consultants than ever before.

The central spin office is paying off.

The figure will increase. We have about 1,500 or 2,000 more nurses than we had two years ago. Therefore, there are more beds and staff. There is also more money and there will be more beds, staff and money.

There are more patients on trolleys. What is this about? What is missing?

The point the Government and I continuously make is not that we do not need more resources but that more resources on their own are clearly not enough. Increased resources have not produced the results we want.

There is a report in today's edition of The Irish Times that emergency care services may be removed from hospitals in the Dublin-Midlands hospital group. I have a simple question to ask. Is that true? On the specific questions I asked, does the Taoiseach accept that there is a need for between 2,500 and 9,000 more beds? Providing 190 additional beds in the coming 12 months will go nowhere near addressing the issues. Will the Taoiseach answer the question as to what he thinks is the correct number of consultants who need to be recruited in the next 12 months?

We do not have any plan to close any emergency department in the State, not least because to do so properly, one would need to make sure patients would be adequately provided for in the next centre, the new hospital or the adjoining hospital and that they would have the capacity to deal with the additional workload. We saw the difficulties faced by St. Vincent's University Hospital when St. Columcille's Hospital had its emergency department closed. We also saw the difficulties in Limerick arising from the closures in Ennis and Nenagh. It is not that it was the wrong thing to do. Clinically, it was the right thing to do. However, one needs to make sure the new central hospitals have adequate capacity to deal with the additional patient loads and evidently they do not. That is something we need to take into account.

The bed capacity review indicates that, with reform, we will need 2,500 additional inpatient beds by 2031. As I have no reason to dispute that figure, I am happy to accept the recommendation made in the report. It is not the provision of 2,500 additional inpatient beds yesterday or tomorrow but between now and 2031, which works out at about 200 or 250 a year. We would like to front-load that number, but one cannot build hospital wings and new hospitals all that quickly. As I mentioned, we will have about 190 additional beds in hospitals this year and we are working to see how quickly we can front-load that number, if possible. It is being worked on as part of the capital plan.

Spin.

When it comes to consultants, I think it was the Hanly report that recommended we needed about 4,000. As that is probably a little out of date at this stage, we will need to update it also. It takes a long time to train a consultant and having trained so long, a lot of them do not want to do certain jobs. We need to be realistic about how many we can recruit on an ongoing basis and advertise posts for which people will actually apply. Unfortunately, while there will be a lot of applicants for some posts in the big Dublin hospitals, there will not be for others. We need to be realistic about that, too. There are places where people want to work and places where they do not. That is just the reality.

There was one other part to the Deputy's question. I am sorry, but I have forgotten the next part.