It has been reported today in the media that there is a wide gap on Brexit between the EU and the UK and the Minister has referred to same. There is certainly a wide gap between Boris Johnson's understanding of the UK Supreme Court judgment and what the judges said. I will borrow from that language in a different area and, while we are talking about gaps, talk about the even wider gap between the Government's commitment to deliver a public health system and the reality on the ground. As the Minister knows, I have raised the matter of University Hospital Galway on many occasions in a constructive manner and I have repeatedly highlighted that the hospital is not fit for purpose. The previous Fine Gael leader and Taoiseach, Deputy Enda Kenny, said in 2015 that the accident and emergency department was not fit for purpose. The current leader of Fianna Fáil has repeatedly endorsed this same stance. It is a hospital with 43,000 people on waiting lists. Two theatres were closed in September 2017, of which one is still closed and consultants are writing to us about the catastrophic regional waiting lists. There are 64 nursing vacancies. Today alone, 47 people are on trolleys. I invite any member of the Government to go onto a trolley, even for a day. They should remember the words of Dr. Fergal Hickey in Sligo University Hospital when he said there are 300 premature deaths every year that are directly related to the time patients spend on trolleys. On this day last week, there were 49 people on trolleys in University Hospital Galway and in August, 655 people in total were on trolleys. There is an options appraisal for the future, which is positive, but it has gone into abeyance.

I mention all of that by way of background to the question I will ask. The Minister can relax because it is a simple question. That is a hospital and a public health system creaking at the seams. I will look at primary care now, and according to the Minister for Health, he will focus on developing a strong and efficient primary care system. These words have been used over and over. We look at primary care in Galway, which is essential of itself, but it is also essential to take the pressure off the hospital. Let me give the Minister a specific question and I might get a specific reply. We have 11 posts open in Galway. My colleague, Deputy Pringle, has a letter which details over 100 posts open in Donegal. The list starts with the post of a senior occupational therapist, an audiologist, a physiotherapist, a dental surgeon and so on. The point is they have gone through the process and the Garda vetting and they have got their jobs. Can the Minister imagine that? They have celebrated the fact they have got their jobs but what happens? They are told they cannot take up that position because sanction is needed from Dublin. That is from the letter my colleagues and I have been shown.

Please do not give me rhetoric or something I do not understand. Can the Minister tell me why those people cannot take up their posts if we are seriously interested in providing primary care? As I speak, i gConamara, i gcroílár na Gaeltachta, níl post ann don fhisiteiripe. Tá orthu dul isteach go dtí an chathair. There is nobody covering Connemara and all of the patients seeking physiotherapy have to go into the city. Specifically, is there an embargo or not?

As I understand it, there is no embargo but the Deputy spoke about issues with the hospital and trolleys. Since 2017, however, an additional 267 acute beds have been opened. The capacity programme for 2019 provides for a number of increases, namely, the provision of 75 acute beds and 70 community beds under the winter plan. Some 47 additional beds will include four high-dependency unit beds in Cork University Hospital, three in the Mater Hospital and a 40-bed modular build in South Tipperary General Hospital, which is due to be operational in the first week of January. Some 202 additional beds, of which 16 are critical care beds, will be provided during 2019, with a view to bringing this extra capacity into operation in quarter 1 of 2020.

On home care, which the Deputy mentioned, over €1.8 billion is available for 2019 for older persons' services. Of this, €985.8 million is available specifically for nursing home support schemes and €862 million is available for older persons' services. Despite the significant level of funding and service provision, demand for services continues to grow. The HSE is required to manage its budget and service provision throughout the year to ensure a balanced budget for 2019. As outlined in the HSE's national service plan for 2019, the HSE maximises the utilisation of current resources, prioritising those requiring discharge from acute hospitals, and significant resources and services have been targeted in 2019 to facilitate timely access. In the winter of 2018 to 2019, the immediate focus was on reducing delayed patient discharges through mobilising the additional resources made available and ensuring that social care measures were effectively deployed to enable older people to move to a more appropriate care setting, including to step-down care or to transitional care in their own home with the supports they need. The Department of Health is engaging extensively with the HSE in the context of planning for winter, including consideration of the response to dealing with the current challenges, such as the high level of delayed transfers of care. While this engagement continues, the HSE has been authorised to undertake immediate action to mitigate the challenges. Engagement will continue over the coming weeks, having regard to the process for the 2020 Estimates.

Democracy is a fragile process. We know that from recent events in Oughterard. Part of the democratic process is for the Opposition to hold the Government to account in language the ordinary person understands. I have asked the Minister a simple question. I refer to 11 specific posts in Galway - there is list of over 100 unfilled posts in Donegal - where people have received their positions for vital posts in a vital pillar of the Government's health policy, namely primary care, which I agree with. Did the Government direct the director of the HSE not to fill these posts? Has it had a role in that? Has it been drawn to the Government's attention prior to me drawing it to the Minister's attention?

The Minister refers to balanced budgets. Is the Government telling us that the budget will be balanced at all costs and that these posts will not be filled in the interest of balancing the budget and having a surplus? Is that what I am to tell the people of Galway, the patients on trolleys and the 43,000 on waiting lists? I have made it easy for the Minister because I am asking her about this issue specifically. They have gone through the process. I do not like to repeat myself, but I wish the Minister would answer my question. How can she stand over having 11 empty posts which are only the tip of the iceberg? She should state whether she is in favour of filling these vacancies, or that she does not know anything about them and will look into the matter, but I ask her to, please, just give me an answer I can understand.

I can give the Deputy an update on the position in Galway. The design for the new emergency department at University Hospital Galway is at an advanced stage. There is a seven-storey building which will include paediatrics and maternity services.

Deputy Connolly did her best.

I will get to the Deputy's question in a second. The hospital is awaiting planning permission. It is most likely that an application will be lodged with An Bord Pleanála. The Deputy asked me a specific question about posts.

Yes.

I cannot answer her because I do not have the answer.

That is an answer.

What I will do is bring the Deputy's specific concerns about the issue she has raised to the Minister for Health. I thank her for raising it.

I have raised it with him, which is why I am raising it-----

I thank the Minister. That concludes Leaders' Questions.