From 2002 on, successive Governments have espoused and implemented the downgrading of hospitals and the transfer of acute hospital services to so-called centres of excellence. We all know that that policy has created chaos. It was wrong then and it is wrong now, and it should never have happened. We in south Tipperary were lucky that 15,000 people on the streets stopped the transfer of our services to other areas, but other areas were not as lucky. It is now time to recognise and reverse that policy failure.

The trolley figures are a clear example of the chaos. The human beings on trolleys in accident and emergency departments, on corridors and in wards are a clear example of the chaos, failure and indignity suffered by thousands of patients over the past ten years. The total figure for October is 11,452, which is outrageous. The figures are climbing year on year, and we have not yet entered winter.

One of the areas which has suffered the brunt of the policy about which I am speaking is the mid-west, including Limerick, Clare and north Tipperary, which is part of my constituency. There are knock-on effects on South Tipperary General Hospital. University Hospital Limerick and South Tipperary General Hospital consistently have the highest trolley figures in the country. Today's trolley figures are obscene. Patients are suffering and dying on trolleys in our emergency departments, something the Irish Association for Emergency Medicine has warned us about for the past number of years. Today's figures are the second highest ever recorded.

Mary Harney, the former Minister for Health, declared an emergency when 602 patients were on trolleys. Today, the figure is 679. The particular problems at University Hospital Limerick and in Clare and north Tipperary started with the closure of the accident and emergency departments in Nenagh and Ennis general hospitals. A local campaign held a number of very successful meetings to demand the reopening of the accident and emergency departments in those hospitals.

The chaos resulting from the policy I have described has been compounded by two moratoriums. Everybody in this Chamber, including the Taoiseach, knows they are real.

Thank you, Deputy.

We have a moratorium on the recruitment of staff. There are 432 vacant posts for staff nurses, public health nurses and staff midwives. There are more than 500 nurse vacancies in mental health services. I know three nursing posts have been vacant for the past six months in south Tipperary mental health services, child and adolescent mental health services-----

Thank you, Deputy. The time is well up.

-----and mental health services in the accident and emergency department in Clonmel. Is it now time to accept that the policy of downgrading hospitals has failed and that the policy should be reversed? Is it not time to agree to the reopening of the accident and emergency department in Ennis and Nenagh?

Please Deputy. The time is up.

Regarding Clonmel hospital, which I know is very severely overcrowded at the moment, a new bed block is under construction there and we will get it open as soon as we possibly can once construction is finished.

Where will we get the staff?

As for Limerick, as Deputies will be aware, a new emergency department, perhaps the most modern in the country, is open and functioning; a new block, the Leben block, opened two or three years ago; a further block of 60 beds is under construction and should open next year; and another block of 96 beds is planned to be built after that. Deputy Healy, I think, called for the reopening of the emergency departments in Nenagh and Ennis and perhaps other parts of the country. He also quoted the Irish Association for Emergency Medicine. They are the doctors who work in emergency departments, they are the experts when it comes to emergency departments and they say we should not reopen-----

They say 350 patients are dying on trolleys.

-----any emergency departments. In fact, they say we should further consolidate them because modern emergency care can only be provided properly in a relatively small number of large centres rather than a large number of small centres. The latter might have worked in the past, when medicine was different, but it will not work in the future.

The mid-west and the north east tell different stories. In the mid-west, it is absolutely the case that Limerick experiences very severe overcrowding. I know that people there link it to changes made to the role of Ennis and Nenagh. In the north east, however, the story is very different. Monaghan and Dundalk emergency departments were closed quite some time ago - again, long before my party was in government. However, we see in the hospitals that took over from them, namely Cavan and Drogheda, the lowest levels of overcrowding in a very long time. There are record low levels of overcrowding in some of those hospitals. Therefore it is not as simple as saying reconfiguring causes overcrowding because one sees such a totally different story in the north east than in the mid-west.

I am shocked at the lack of urgency, almost indifference, the Taoiseach displays, almost as if this situation is normal. The trolley figures are absolutely obscene. We have people suffering and dying on trolleys in our hospitals. The Taoiseach is the leader of this country and has a responsibility for this obscenity, the suffering and the deaths of these people on trolleys in our hospitals over recent years, a position that continues to this day. He absolutely can solve this problem. I ask him to introduce immediately a supplementary budget to tax the 1%, the very wealthy people, the billionaires who own 27.3% of all the wealth in this country. They are not paying their fair share now, nor have they ever done so. I want the Taoiseach to reopen the accident and emergency departments at Nenagh hospital-----

I thank the Deputy. He is way over time again.

-----and Ennis hospital and to reopen Our Lady's Hospital Cashel, a state-of-the-art hospital which has been vacant for the past ten years.

The Deputy's time is up.

The Taoiseach has the responsibility to solve this problem. He can do it. The question is whether he has the political will to do it.

I thank the Deputy and call the Taoiseach to conclude on this matter.

I assure the Deputy there is absolutely no need for a supplementary budget. The HSE will get an extra €1 billion next year.

This situation is normal, is it?

This will be the biggest budget the HSE has ever had and a very high one relative to other countries per capita-----

The Government will not tax the rich then.

-----so that will not be necessary. The Deputy thinks the solution to hospital overcrowding is higher taxes; it is not.

I referred to higher taxes on billionaires, who own 27.3% of all the wealth in this country. They are the 1%.

Please, Deputy.

The solution is more beds, more funding for fair deal, more home care packages and investment in primary care and public health, all of which is being done.