Over the past few weeks, we have borne witness to the scale of the absolute crisis in the health service under the Taoiseach's watch and that of the Minister, Deputy Harris. Our nurses and midwives were forced to take to the streets, which would never have happened if the Minister had listened to and taken on board their concerns over the recruitment and retention crisis. General practitioners have protested outside the gates of Leinster House. Hospital waiting lists continue to grow to very high levels and the trolley crisis is one that we are facing day in, day out, and not just during the winter period. The debacle surrounding the national children's hospital rumbles on. It will have a serious effect on capital projects in health and in other areas. Thankfully, we will have an opportunity later today to quiz the Minister for Health on his handling of this because there are very serious questions that still need to be answered. Despite the acquiescence of Fianna Fáil, an apology that was offered yesterday will not cut it. It is not good enough. We in Sinn Féin are very clear that this Minister is out of step and not up to the job.

The issue I want to raise with the Taoiseach today is yet another example of why the Minister, Deputy Harris, needs to go from the Department of Health. As has been mentioned, it emerged this morning that nearly 80,000 smear test results are subject to a delay of up to 27 weeks. This happened as a result of a ministerial decision taken last year to make free screening available in the wake of the CervicalCheck controversy. Women we know are now waiting up to six months for the results. It is undoubtable, unfortunately, that some of those results will indicate cancerous cells. It is appalling and of the utmost concern to women right across the State. It is yet another example of the complete incompetence and chaotic system that we see in the Department of Health and that are evident in the ministerial oversight of that Department.

The Minister announced free screening without any consultation with the laboratories and without carrying out any analysis of whether there was capacity to do what he intended to be carried out. Going ahead without ensuring the laboratories had the means to carry out the tests and to deal with the increased workload guaranteed a major crisis and major problems that we now see emerging.

It was suggested earlier this week in the media, including on RTÉ, that the former director general of the HSE was not made aware of the political decision made by the Minister, Deputy Harris. He also suggested he indicated that the decision should be walked back because it would have unintended consequences. Unfortunately, we see very clearly what those unintended consequences are. Unfortunately, there are 78,000 women waiting up to 27 weeks for their results. The Minister did not consult the laboratories. He made a political decision, which has now had a direct impact on the length of time taken. Is this not another clear example of how the Minister is out of his depth? During the period in question, the Minister pledged to us that the HPV vaccine would be rolled out.

The Taoiseach to respond. Deputy Pearse Doherty will have another minute.

He said it would be in the autumn and then said it would be in January. Now we hear from the committee that we cannot even be told whether it will be rolled out in 2019.

The Taoiseach should respond.

Should the Minister have taken on board the advice of the director general of the HSE? Should he have consulted the laboratories to avoid the crisis we are in today? Is it not now really time to face up to the fact that the Minister has to go?

The Taoiseach to respond.

I think Sinn Féin called for it.

It is curious to hear Sinn Féin now quoting Mr. Tony O'Brien, the former director general of the HSE, as part of an attack on the current Minister for Health. Sinn Féin's last motion of no confidence, if I remember correctly, expressed no confidence in the former director general of the HSE, Mr. O'Brien-----

It was in the Minister for Housing, Planning and Local Government, Deputy Eoghan Murphy, actually.

The Taoiseach should be allowed to continue without interruption.

-----whom Sinn Féin thought a few months ago was unfit for office. Now it is using his words as an attempt to pursue the next head. It shows the entire approach of Sinn Féin to the health service. It really does not care about patients or the health service whatsoever; its approach is just a stick to beat the Government with. It is just a constant, ongoing political attack.

Health is a very difficult area to manage and a very difficult area to lead in for any Minister or Government. It is, however, an area in which, despite the many difficulties we have, real progress is being made. We see that in the fact that life expectancy has increased in the past couple of years. We see it in falling cancer mortality rates, improving stroke survival rates, improving heart attack survival rates and much better clinical outcomes across the board. These things do not happen by accident; they happen because of the hard work and professionalism of our healthcare staff. They happen because the Government is pursuing the right policies and strategies, by and large, and because of the additional resources we are putting into the health service all the time. Even in some of the most difficult areas, as with people waiting for operations and procedures, until last month or at least until the strike, the number of patients waiting more than 12 weeks for operations was at a four-year or five-year year low. There will now be a setback for the next few months as a consequence of the strike but we will get on top of that again. This year so far, the number of patients spending time on hospital trolleys has been at a three-year low, if not a four-year low although I accept there are still too many.

In Clonmel, it is not.

The other matter to which I turn Deputy Pearse Doherty's attention is the situation in Northern Ireland.

The Taoiseach should answer the question the Deputy put to him.

It is an area where his party was in government for over ten years. The last health Minister, until two years ago, was the Deputy's party leader in the North, Ms Michelle O'Neill. Many of the same problems are faced in Northern Ireland, including overcrowding in hospitals, unacceptable waiting times, overruns on budgets and a reform plan that is not being implemented, the Bengoa plan. A very good editorial the other day in The Irish News stated the health service needs a Minister. Why does the health service in Northern Ireland not have a Minister?

Send Simon up.

This is unbelievable. He has not even answered the question.

The health service in Northern Ireland has no minister because the Sinn Féin health minister resigned over a heating initiative.

Send Simon up.

Having denied Northern Ireland a health minister, Sinn Féin now wants to take away ours. We are not going to let that happen.

Let me be very clear to the Taoiseach. The women at the heart of this latest scandal are our wives, sisters and mothers in Sinn Féin. Therefore, the Taoiseach should not lecture me about my concern for people whom we love. What has occurred is a direct result of a political decision that was made without any analysis by the Minister for Health. The Minister for Health has said he had full support in regard to the decision he made. What we have is the director general telling us he advised walking back from this decision because there would be unintended consequences. Regardless of this, what is known as a fact is that there was no analysis carried out of capacity. What is known as a fact is that there was no consultation with the director general of the HSE. What is known as a fact is that the Minister did not consult the laboratories about capacity.

The Taoiseach says that he acted with his heart instead of his head. That is cold comfort to the women who are waiting 27 weeks to find out if there are abnormalities in their smear tests.

The Government talks about accountability and that is what we are looking for. This Minister is completely out of his depth. It is not just the cervical cancer scandal or the children's hospital scandal. Week after week, people we know and love who have cancer are having operations cancelled because of the dysfunctionality of the Department of Health and the HSE and the lack of oversight and hands-off approach of this Minister.

Is the Taoiseach aware of any consultation or capacity analysis carried out by the Minister for Health before he made the decision which has resulted today in 78,000 women waiting up to 27 weeks to find out whether they have cancerous abnormalities in their smear tests? That is the issue and the Taoiseach should stop trying to divert attention from it.

That is the issue and I acknowledge the anxiety, concern and worry for tens of thousands of women who are waiting for results of their smear tests. When the programme was working efficiently, people would get a result in four to six weeks whereas it is now taking four to six months. I acknowledge that is a big problem and we are doing all that we can, working with the HSE and CervicalCheck, to reduce the backlog and get back to a turnaround time of four to six weeks and that will be done.

The situation has arisen, as I have pointed out, because of the increase in the number of women attending for smear tests both because of the free test and a general increase in those attending which has continued into this year. The solution to this problem is not a political attack on anyone, nor is it removing the Minister for Health. Removing the Minister for Health will not mean the children's hospital will be built any quicker or cheaper.

It might.

It certainly will not mean that the backlog and the waiting times for women worrying about smear tests will get any shorter.

The Taoiseach keeps making the wrong decision.

It would be the same as Northern Ireland and walking away from responsibilities.

It is about holding people to account.

It would mean not taking accountability and leaving the control of a health service in the hands of civil servants. Sinn Féin removed itself from responsibility in Northern Ireland and the department of health in Northern Ireland where it could have done things right and shown us how things should be done. Sinn Féin now wants to remove the health service in Ireland.

People should be held accountable.