Over the last number of months, we have regrettably borne witness to the scale of the crisis facing our health service on the watch of the Minister, Deputy Harris. The debacle surrounding the cost of the national children's hospital rumbles on, nurses and midwives have had to engage in industrial action, one in seven consultant posts is vacant and support staff have announced their intention to ballot for industrial action. All the while, hospital waiting lists continue to grow and hundreds of patients are left on hospital trolleys, day in, day out.

Last night, in Cork University Hospital, there was a status black escalation declared, with patients attending the emergency department facing extreme delays of up to 12 hours and with services reaching breaking point. A status black escalation is declared, I understand, when the hospital is at maximum capacity and when it is deemed unsafe to admit further patients.

There is a capacity crisis in the health service and this is very concerning. There were 70 people on trolleys in Cork University Hospital this morning, with 570 people on trolleys across the State. Yesterday, in Limerick, there were more people on trolleys than in Dublin's nine hospitals combined, according to the INMO. I am sure the Tánaiste will agree that this is shocking.

There are also reports that during the status black escalation up to eight ambulances were lined up outside the accident and emergency at Cork University Hospital waiting to hand over patients. I am told that one of those ambulances was forced to wait for more than four hours. That is the sort of situation that puts patient and staff at serious risk and it is unacceptable.

We have raised the capacity crisis over and over again with the Government over the past number of years - nurses were on the picket line raising this very issue just over a month ago - and all we see by way of response is inaction and indifference on the part of the Minister. They are the ones who insisted that Deputy Harris remain in situ when we, in Sinn Féin, tabled a motion of no confidence in him.

What we need is a robust response. Last night, in the Tánaiste's own city, things got so bad that a black escalation, the highest level of escalation possible, was declared. Staff tell us that it is the worst they have ever seen. The Tánaiste must surely agree that this demands an adequate response. Can he tell me what is to happen at Cork University Hospital in the first instance, given this escalation over the past 24 hours?

More generally, what is the Government's plan to respond to the capacity crisis in a manner that will get to the root cause of the problem and address the crisis sooner rather than later?

I thank the Deputy for raising this matter. She had many questions but I will deal with those relating to Cork University Hospital, CUH, a facility I know well. This morning, the number of patients waiting on trolleys in Cork University Hospital was 55 and the Health Service Executive, HSE, trolley system reported 431 patients waiting on trolleys nationally. This is an increase on the same day last year when there were 296 patients on trolleys. The number of patients waiting on trolleys at Cork University Hospital this morning is exceptionally high. The HSE has confirmed that South/South West hospital group personnel were on-site and community teams were actively seeking additional community beds to support discharges. In addition, the national director of acute hospitals in the HSE will visit CUH today.

The HSE identified specific issues and challenges on the site. The first was a significant capacity demand mismatch, with high rates of attendance and admission and a low rate of discharges. The hospital remains in full capacity protocol, with the highest trolley count this year on the site. Key actions are now under way in Cork University Hospital to improve the position for patients and these include full mobilisation of all resources, escalation meetings with both the group chief executive officer and chief compliance officer and meetings scheduled with consultants. There is to be a review of diagnostics and cancellation of diagnostics tomorrow and Thursday. Community health organisation representatives are on the site to review patients for transfer to step-down facilities and there will be identification of patients to expedite transfers to local rehabilitation units. There will be utilisation of private capacity, with five beds being made available in the Mater Private. There will also be use of private ambulances to transfer patients.

The Deputy is right that a serious challenge has arisen in CUH as of last night and again today. We are responding with the seriousness that is needed. We need to put and are putting the extra resources and the priority systems in place to respond to that in accordance with the needs of patients there.

The status black escalation, as the Tánaiste knows, is essentially a declaration that a hospital is no longer safe. In Cork University Hospital, as I said, the position was unsafe for patients in the first instance but also for staff. Some of those staff, who have worked within the system for decades and up to 30 years, told us directly that they have never seen the like of this before. It was dangerous. I described the scenario for the Tánaiste, with ambulances lined up outside the hospital and one that I know of that waited for more than four hours to hand over a patient. This is a very serious accident waiting to happen and it is playing out on this Government's watch. I am advised that the actions described by the Tánaiste, including the various meetings, are standard procedure in any event for hospitals on a full capacity protocol. The Tánaiste has not described for us any kind of emergency intervention commensurate with the crisis that has unfolded at this hospital.

I ask the Tánaiste again what additional action this Government will take to intervene in the case of Cork University Hospital. When will he accept there is a capacity crisis within the system? What are the plans of the Minister for Health and the Government to address it?

I know Cork University Hospital well and I know many people working there. I accept that today there is huge stress on the system in the hospital and the management is responding to that as best it can. There are two issues. The first is today's pressure, which is difficult for the staff on site.

They are working together to deal with that. The medium-term issue here is about capacity, which is why the Government is increasing capacity and has been doing so month on month. It will continue to do that. If we look at the increasing number of beds being funded and provided, we will see it moving in only one direction. The truth is we need more beds in our system. We have the budgets and plan to increase the number of beds, not just in Cork but in other parts of the country. The Deputy mentioned Limerick. There is a commitment to increase bed capacity in Limerick through a 60-bed modular unit that is funded and committed to this year. There is a recognition that more investment and more capacity are needed and they are provided. In the short term, particularly through winter months, we need to ensure that management systems are in place that, in general terms, deliver reductions in the number of people on trolleys. There is an acute problem in Cork that was seen last night and again today which is getting the emergency response that is needed.