The House will be disappointed at the lack of progress at the October European Council meeting. The issues were well discussed in the House yesterday. We hope that more progress will be made through today. This is an opportune time to pay tribute to the officials in the Department of Foreign Affairs and Trade who are putting in such work for the country.

This morning, I wish to focus on a more domestic issue, that is, the problems and difficulties with accessing our health services. Yesterday, a figure was revealed showing that 9,864 people aged over 75 were left lying on trolleys in emergency departments for longer than 24 hours. Almost 10,000 people, aged 75 or older, in the first eight months of 2018 were waiting longer than 24 hours on a trolley.

When people get through our health services there is fantastic treatment. The staff work incredibly hard to give them world class treatment. Yet, when we see that figure and the trolley figures for July and August, which are traditionally quiet times in our hospitals, they show the crisis facing our health service.

Regrettably, there is little action to deal with the crisis. Today is 18 October but we have yet to see details of the winter initiative or the ongoing capacity review. Have the 600 or so beds promised by the Minister for Health, Deputy Harris, amid the usual flurry of spin and public relations, actually been delivered? The evidence suggests they have not. We have oceans of promises and spin, yet 10,000 people aged 75 and over have been left for more than 24 hours on a trolley in our hospitals. That figure will only rise as the winter kicks in with the usual avalanche of cases of the cold and flu, etc.

The Minister for Health launched the bed capacity review and outlined the country's bed capacity requirements until 2031. He said that some 600 extra beds would be delivered in the system in 2018. Many hospitals cannot see these extra beds. For example, in Letterkenny a 19-bed unit remains closed, as my colleagues, Deputy McConalogue and Deputy Pat The Cope Gallagher, have pointed out on many occasions. The unit is closed, yet the hospital is overcrowded.

What commitments can the Tánaiste give today that 10,000 people over the age of 75 years will not be left on trolleys for longer than 24 hours and that we will not have a repeat of the situation we had last November, December and January when trolley figures went into orbit? What work or action is the Government undertaking now to ensure that will not happen? When will the winter plan for 2018-19 be published?

I thank the Deputy for raising these issues and giving me an opportunity to respond to them specifically. Plans are under way for the winter initiative and have already begun to start kicking in to place. The Department of Health is working with the HSE to ensure local and regional plans are consolidated and supported through policies and plans at national level. The idea is to ensure the most effective response to the challenges that we know always come through the winter months.

As part of budget 2019, an additional €10 million in funding is being provided in 2018 to prepare for and manage the expected peak in demand for health services in the winter ahead. This funding will focus on initiatives to enable the hospital system to de-escalate before Christmas. Support for patients in the over-75 age group will be a priority, with measures to respond to a surge in capacity, transitional care beds and aids and appliances to support the journey home for patients following a hospital stay. The Minister for Health has asked for a significant increase in the provision of social care measures to promote hospital discharging in the first quarter of 2019 in response to the expected surge in demand after the Christmas period that we can always expect.

I assure Deputy Calleary and patients that while of course we recognise the pressures in the system that result in patient care not being as good as it should be – in other words, far too many people, including elderly people, are on trolleys - we are trying to plan ahead for the surge in demand that we know our hospitals will have to cope with in the months ahead.

This is seasonal and happens every year. It is predictable. The Minister has allocated more money and has put plans in place. There are ongoing conversations between the HSE and local hospitals to ensure that we prepare for this and try to de-escalate the system in hospitals in preparation for the surge that will come in the post-Christmas period. Planning is very much under way for that.

The Tánaiste's first comment was that there are plans. There is no shortage of plans. The difficulty is with implementation and follow-through. The plans get published and the Minister for Health does a tour of a hospital. He puts on a white coat like the Minister for Housing, Planning and Local Government, Deputy Murphy, puts on a hard hat for housing. Despite all the plans, 10,000 people aged over 75 spent longer than 24 hours on a trolley up until the end of August. Where were the plans for those people?

The Tánaiste spoke about the Minister for Health wanting to ensure community discharge and early discharge, yet there are not enough resources for home help hours or home care packages. Throughout the country people are being accepted and are eligible for home help packages but the local health services do not have the resources.

I will ask the Tánaiste the question again. The Minister for Health announced 600 extra beds during 2018 to address capacity issues. We are now in the middle of October 2018. How many of the 600 beds promised in one of the plans to which the Tánaiste adverted have been delivered? Given all the planning and, to use the Tánaiste's phrase, that this is predictable, can he give a guarantee today that we will not have a repeat of what we had last December and January in terms of a trolley crisis in our hospitals?

What I can give the Deputy is a commitment that we are planning for this. We have put money behind those plans. We will ensure that everything possible is done through better management, better policy and more funding to ensure the pressures that come through the winter on our healthcare system, in particular on our hospitals, are managed in the best way they can be.

The Minister for Finance, Deputy Donohoe, has provided an extra €1.2 billion for healthcare next year. Much of that will go into our hospital system and driving down waiting times and waiting lists. An extra €25 million has been allocated for the National Treatment Purchase Fund. Next year we will spend €75 million on the NTPF because we know it works.

The Government did not spend extra in 2016.

We have seen the benefit of that. From the peak of 86,000 people on waiting lists in July 2017, we have seen quite a dramatic reduction since then. The figure is a little over 70,000 now, which is a reduction of 16%. This is not only about promises and plans. It is about reducing waiting times and waiting lists, but there is still more work to do.