Last Tuesday, I raised with the Tánaiste the critical issue of hospital overcrowding, and given the continued state of crisis in our hospitals, I want to raise it again today with the Taoiseach. Last week there were serious problems in Cork University Hospital, CUH, and a black status escalation was declared, which meant that the hospital was at maximum capacity and was deemed unsafe to admit further patients. The outworking of that has had serious implications and two specific incidents were reported in the Southern Star newspaper yesterday, which illustrate the extent of the problems at Cork University Hospital.

A general practitioner, GP, in Bandon, Dr. Mary Roycroft, has said that an 84 year old patient refused to attend the emergency department at CUH, despite being very unwell, and told her that she would rather die at home than be in there. She said that the patient's response is not unique and that many other patients have expressed similar fears. These are patients who need to be in hospital but who are unwilling and afraid to attend accident and emergency services because of persistent overcrowding. That is a scandalous situation. In addition, an elderly man who fell in Skibbereen last week was left lying on a pavement for nearly two hours while waiting for an ambulance to take him to CUH. The ambulance in question was one of eight that were queueing outside the hospital waiting to offload patients and it never came. This man was eventually taken to hospital by a paramedic crew from County Kerry. This is no way for our health service to operate and yet it is the reality. It is in a state of perpetual chaos and no meaningful action is being taken to address the extent of this crisis. That is a disgrace.

University Hospital Limerick was similarly in a state of chaos last week and that shows no sign of letting up.

There are 55 patients on trolleys there today and Limerick is yet again the worst affected hospital in the State. State-wide today, there are 631 patients on trolleys, the highest number in 2019 so far according to the INMO. There are 55, as I said, in Limerick, 42 at Cork University Hospital, 50 at Sligo University Hospital, 39 in Beaumont, and 37 in Galway. I am advised by Deputy Ferris that there are 36 patients on trolleys in Kerry University Hospital and nine sitting in chairs. It was equally chaotic yesterday. On and on it goes. It is frightening. Overcrowding, as the Taoiseach knows, impacts on patients and puts them at risk. It also affects the health and well-being of staff. Both of these things are intolerable. This is no longer a winter problem or one that is amenable to a seasonal intervention. It is year-round and State-wide. The Taoiseach has failed to get to grips with it. Quite simply, I ask what he and his Minister for Health, Deputy Harris, plan to do to respond to the capacity crisis in a meaningful way.

I am afraid I cannot comment on those individual cases without knowing all the facts. I do know and understand the enormous inconvenience and suffering that hospital overcrowding causes patients and their families who care for them, and also the stress and pressures it puts on staff. I say that as somebody who spent over a year working in emergency departments in three different hospitals, where we often experienced very high levels of overcrowding. None of us wants to see that persist.

I never like to reduce this to statistics because it is not about statistics, it is about people. The Deputy is right to point out that the number of patients on trolleys today, whether we use the nurses' figures or the HSE figures, is the highest so far this year. It is not higher than it was last year, however, or in the three years before that. It is always possible to pull out record highs and record lows by identifying a particular day of the week or a particular hospital or a particular month.

It is every day.

How about three years?

If we take the first three months of this year, according to the HSE we have had the lowest levels of overcrowding in five years. Even taking the nurses' figures, which cannot really be used for year-on-year comparisons because they change the way they count them every year, or at least have changed the way they count them on a few occasions in recent years, their figures show fewer patients on trolleys so far this year compared with last year.

The Deputy's question is what we are going to do about it. We should focus on solutions, not on accusations. Our solutions are threefold, namely, bed capacity, better use of our existing resources and beds, and I will explain what I mean by that a little later, and investment in primary care and community care. The first item is bed capacity and we are increasing the number of beds in our hospitals all the time. There are three new hospitals under construction, new wings in Limerick as the Deputy mentioned-----

Where is it?

-----and in Clonmel and many other places as well. By the end of this year, we will be back up to about 11,000 beds in our acute hospital system. That is the highest number since 2009, reversing the policy of the previous Fianna Fáil and Green Party Government to reduce the number of hospital beds, by restoring those beds.

The second area is better use of our existing bed capacity. Obviously a hospital with an average length of stay of six days needs way more beds than one with an average length of stay of four days, even though it sees the same number of patients. That is about making sure that there is reduced length of stay, that patients get out of hospital quicker, and if they are in hospital, that they get their tests and investigations more quickly and are not waiting around for days to see a specialist, have a scan or have an intervention they need.

The third area is investment in primary and community care, because in Ireland we rely too much on our hospital system. Much more can be done in primary and community care. That is why last week's agreement with the IMO on a revised contract for GPs is so significant. It is a 40% increase in resources for general practice over the next three and a half years, including provision of 250 more practice nurses. What are we doing? We are providing for more beds, more efficient use of our existing resources, and a decisive shift to primary and community care.

Having said that he does not wish to deal with statistics, the Taoiseach reached for statistics. He has typified the stories I told him as accusations. They are nothing of the sort.

They are the experiences of two people in Cork, namely, an 84 year old woman and an elderly man who fell and was left on the pavement for two hours. That is not an accusation. It is a scandal and an utter disgrace. I am shocked that the Taoiseach seems to be so out of touch that he would classify that as an accusation. These are the stories behind the statistics that are so regularly quoted.

The Taoiseach has said that he is pulling out all of the stops and is on top of this. All of the evidence contradicts that. The evidence tells us that this is a crisis and that the Government cannot manage it. It tells us that this is a disaster. Staff in Kerry told Deputy Ferris so earlier today and people are saying the same in Cork. I was in Mayo last week, where the emergency department and its staff is under enormous pressure. The Taoiseach seems to be totally out of touch and is blissfully unaware of this. I put it to the Taoiseach that, rather than providing any positive solutions, it is quite shocking that the Minister has spoken recently about a recruitment freeze and an overtime ban. How on earth will that do anything other than worsen the capacity crisis at accident and emergency departments?

The Deputy is trying to twist my words again. I said I could not comment on those individual cases because I do not know the facts. The accusations she made concerned what was said about the Government, not those individual cases. The Deputy asked about solutions. I provided the solutions to her. I pointed towards the three areas in which we are implementing solutions. I have not heard, nor do I ever hear, solutions in the Deputy's contributions to this House.

I appreciate that the Deputy is outraged and angry on behalf of patients who have received a very bad service, whether in Cork or elsewhere. Where is her outrage for those who are receiving a really bad health service in Northern Ireland? The last Minister for Health was Michelle O'Neill, the Sinn Féin deputy leader, or its leader in the North. She walked away from government in Northern Ireland. We should not forget what the situation in Northern Ireland is like at the moment. I regularly read the Irish News to ensure that I am up to date in the situation in Northern Ireland.

Perhaps the Taoiseach knows more about the situation in the North than in the jurisdiction of which he is Taoiseach.

The number of people waiting for an operation or procedure for more than a year is 21,477 in Northern Ireland, compared with 4,900 here, representing 1.1% of the population of Northern Ireland compared with 0.1% here. The number of people waiting more than a year for an outpatient appointment in Northern Ireland is 94,000, compared with 89,000 here, which is 5.2% of the population compared with 1.6% here. The situation in Northern Ireland is much worse.

Everything is great here.

Sinn Féin had the opportunity to show people what could be done. It controlled the Department of Health in Northern Ireland-----

Everyone is going to the North for operations.

-----and it failed. Why should anyone believe that it would do a better job?

The people from here are having to travel North.

Can we have silence for Deputy Howlin please?