It is regrettable that I have to stand here again today and talk about a crisis in the health services in Galway, and particularly at University Hospital Galway, UHG. It is consistently one of the worst hospitals in the country in respect of the number of people who have to spend a night on trolleys. It has got so bad that older people, in particular, are genuinely afraid to go to hospital, knowing about the indignities that await them in what is supposed to be the west's flagship facility. Over the past three weeks alone, almost 600 sick or injured, worried and vulnerable people have been left lying on trolleys overnight at UHG, and that does not include weekends. In the first six months of this year, 2,391 people spent more than 24 hours in the UHG emergency department. Shamefully, more than 850 of them were aged 75 or older, distressed and fearful, having to endure a full 24 hours and more lying on a trolley in the corridors of the emergency department.

It is scandalous that such a fear should exist in this day and age. I have put forward solutions in the House in the past, to both the Taoiseach and his predecessor, Deputy Enda Kenny. One solution is to locate a minor injuries unit at Merlin Park hospital on the eastern side of the city. It could take up to 60% of the people currently attending the severely overcrowded emergency department at UHG and deal with them in a fraction of the time it takes now. Not only would that greatly benefit more seriously ill patients, who would be seen sooner, but it would make the department a joy to work in for those staff who are under such stress at present. Eleven such injury units are dotted around the country. I visited the one in County Roscommon, where people are seen, treated and are out the door in less than an hour on average. Why is there not one in Galway? When I raised the matter with the Taoiseach in the House previously, he replied that it was a good idea and indicated he would look into it but I have heard nothing from him since. Why does it take so long to get a new emergency department built? The last I heard is that it will be another five years or more.

In the case of health investment, as I pointed out in respect of sports capital grants some time ago, it seems the west will always be the poor relation. Another example is the delay in replacing operating theatres at Merlin Park hospital, which has resulted in a significant spike in the waiting lists for orthopaedic treatment, since leaks were discovered in the roofs of the old theatres a full two years ago. A sum of €400,000 is needed immediately to finish design and start groundworks on a new modular theatre building, while €9 million will be needed next year to complete the project at Merlin Park hospital. Will the Taoiseach give a firm commitment that money will be allocated and ring-fenced to complete the urgent project? Will he give a commitment to speeding up the provision of a new emergency department at UHG? I also want his commitment to getting the ball rolling with the establishment of a minor injuries unit at Merlin Park hospital.

I thank the Deputy for raising the issue of health services in Galway again. It is very much acknowledged by the Government that Galway requires additional capacity when it comes to our health service. It is a growing city and county, and UHG is the medical centre of excellence for the western and Connacht region. Over the past couple of years, there has been very significant investment in the hospital. The budget has increased for the past three or four years in a row, there are additional staff and there is also additional bed capacity. A new 75-bed ward block opened last year, which provides 75 en suite single rooms for patients who need them, including six isolation rooms. That has resulted in a significant improvement in bed quality and infection control at the hospital.

The next development at the hospital will be the new radiation oncology unit and the enabling works for that have started. In addition, plans are now afoot for another new block, which will house the emergency department and the maternity and paediatric unit. There are also plans, unfortunately stalled, for a new hospice in the region, with which the Deputy is very familiar. It did not get planning permission but a new planning application is being developed. Planning permission has been secured for a new 50-bed block at Portiuncula Hospital. That will go ahead and, hopefully, it will relieve some pressure on the hospital.

On the minor injuries unit at Merlin Park hospital, the Deputy raised the matter previously. I said I thought it was a good idea and I still think it is a good idea. It would not have any impact on trolleys but would mean that people attending with minor injuries would be seen more quickly. There would be fewer people in the department, therefore, but it would not impact on trolleys in itself. It is still a good idea, notwithstanding that. There is such a unit in Cork in the old orthopaedic hospital, where people who have a minor injury can be seen within an hour or two rather than joining a long wait at Cork University Hospital, and there are ones in Smithfield and Loughlinstown in Dublin. Where they exist, they work well. Given that Galway is a major population centre, it seems to be an obvious place to have a minor injuries unit.

I understand a nationwide review of minor injuries units and medical assessment units is under way. That was a commitment in the programme for Government. The Minister is waiting on an update, which he will pass on to the Deputy when he has it.

The position on the emergency department and maternity and paediatric block is as follows: the service scope for all floors has now been agreed; the enabling works packages have been defined along with specific programmes for delivering them; further work is expected to be completed in the coming weeks so that the project can progress to stage 2 of design; and then a submission will be made to An Bord Pleanála with a view to it being considered as a strategic infrastructure development so that it can go through fast-track planning. If it can do so, a formal planning application will be made right after that.

I thank the Taoiseach for his response. I want to outline the following facts to the House: in the two years since leaks were discovered in the roof of the operating theatre in Merlin Park Hospital, the number of people waiting for orthopaedic treatment in Galway has increased by 42% while the numbers in hospitals in the rest of the country have reduced; the number of people waiting for major orthopaedic operations in Galway has almost doubled; it is up by 86%; and last month, more than 500 posts remained unfilled in hospitals in the Saolta group stretching from Donegal to Galway, waiting for sanction by HSE headquarters through which all approvals must go. This is contributing to the increase in waiting lists in hospitals in the group which has grown by 11% or more than 10,000 people in the past year.

As the Taoiseach correctly said, there are 11 minor injuries units in Ireland, but there is none in Galway, even though three quarters of the 66,000 patients presenting each year at the emergency department in University Hospital Galway are discharged without the need for hospital admission and would be ideal candidates for such a fast-track treatment unit.

These facts speak for themselves. I ask the Taoiseach to put pressure on the Department of Health and the HSE to ensure that the new emergency department and theatres in Merlin Park are built without delay. This is the third time the Taoiseach has said that the minor injuries unit is a good idea, but he has done nothing about it. Such a facility is needed in Galway and in Merlin Park. Why is Galway the only county without such a facility? I ask the Taoiseach to personally take this on with the Minister for Health to ensure that Galway also gets one.

The Deputy has my absolute assurance that I will continue to put pressure on the Department of Health and the HSE on these issues. Galway needs this investment. It has had investment recently with the new 75-bed block.

If only Deputy Grealish were the Taoiseach-----

The radiation oncology centre is now under construction but it needs the new emergency department and maternity and paediatric block. I will put pressure on the Department and the HSE to get that done. The money is available, but we need to get it through the planning process, get it to tender and get it built.

On orthopaedics, as the Deputy has rightly pointed out, throughout the country we have had a very significant improvement in waiting times-----

Not in Galway though.

-----for people waiting for hip replacements, knee replacements and orthopaedic procedures. For example, in July 2017, more than 2,500 people had been waiting for more than 12 weeks for a hip or knee replacement. That has been reduced by half to 1,300.

They were done mostly across the Border.

That is the cross-border initiative.

We have had real success in reducing waiting times for people who need an operation or procedure.

There is a traffic jam of people going across the Border.

The Taoiseach without interruption.

When I became Taoiseach, just over 50,000 people were waiting more than 12 weeks for an operation. That is now down to thirty-something thousand, so it is an area where we are making a lot of progress.