Yesterday, there were 679 people across the country being treated on trolleys. Today, the number is 649. Behind the numbers are some horrific and appalling experiences for people in emergency departments. They are simply appalling and should not be tolerated by the Government. The Irish Nurses and Midwives Organisation, INMO, yesterday described the situation as "obscene" and said, "Winter has not even started, and Irish hospitals are overwhelmed". It went on to say that nurses are faced with an inhumane working environment, while patients are put at ever-increasing risk.

I spoke to an eye witness in Cork University Hospital. The person went there on Tuesday at 3 p.m. with a family member and was there until 5 a.m. the following morning. He said that what he had witnessed was simply unbelievable. He said the doctors and nurses were under "savage pressure", to use his own phrase. He could not comprehend how they were able to work under such circumstances. People were sitting on chairs and lying on trolleys everywhere. They ran out of seats to sit on. The chronically ill were in a desperate situation, to the great anxiety of their relatives. There were many elderly people there. I can give another illustration of these experiences. If one travels to Clare, Limerick or north Cork, and this did not start today or yesterday, the overwhelming issue on the doorsteps or when one meets people is their experiences at the emergency department of University Hospital Limerick. There is real anger from the relatives of loved ones who have gone through terrible experiences due to the overcrowding.

Critically, the Irish Association for Emergency Medicine has said that this is costing lives as people are dying as a result of the overcrowding. It says that 350 to 400 excess deaths are occurring each year because of the state of the emergency departments, the overcrowding and the long delays in treatment in those departments. This was confirmed to me by experienced medical authorities in Cork University Hospital, who reluctantly said that they had to admit and confirm that some people who attend the hospital will die as a result of the overcrowding and delayed treatment. In addition, there is a chronic shortage of consultants and a lack of rehabilitation beds, step-down facilities and home care packages.

When will the moratorium on the recruitment of staff be lifted? There are approximately 1,000 posts on the front line unfilled currently. When will the winter plan be announced? It is incredible that this is November and it has not been announced. Why is there this reactive approach as opposed to a proactive one from the Government? Will the Taoiseach, at a minimum, commit to lifting the embargo?

I am very much aware that our emergency departments are very overcrowded today. Indeed, they have been for quite some time. However, there has been a reduction in overcrowding today versus yesterday and we expect that reduction to continue through to tomorrow and Friday. As regards the actions the Government is taking, we are adding more beds to the hospital system. Since 2014, as soon as we had the money to do so, we started adding new beds to the system. That will continue. New bed blocks are under construction in Clonmel and Limerick and we will have them open as soon as possible.

We are also providing more funding for the fair deal and home care. The budget for the fair deal will exceed €1 billion for the first time next year. That will enable us to reduce the number of delayed discharges, where patients are in hospital and do not need to be there and could go to a nursing home or go home. We must ensure that happens much faster than it does currently. We are also investing in community care. We have secured a deal with general practitioners, GPs, to improve the level and depth of services they provide in the community, to ensure that fewer people go into hospitals in the first place. Much action is being taken to deal with this problem.

To answer the Deputy's questions, the winter plan will be published next week. In many ways it does not need to be published: what is in it is what has been in it in previous winters, which is funding for the fair deal and home care and to open any beds that are closed, although I understand that none is closed currently, and investment in transition care. That is already happening even though the plan has not been published.

There is no recruitment moratorium. As I explained yesterday, the number of staff in the health service has been increasing for many years now. There are approximately 15,000 more people working in the public health service now than there were three years ago. There are 600 more nurses than this time last year and more than 100 more doctors. However, it is the case that Health Service Executive, HSE, managers are not allowed to hire staff if they do not have the money to pay for them. We had a recurring problem in previous years of HSE managers taking on staff for whom they did not have the budget. That is not allowed in education, the Civil Service or the Garda. It was an anomaly that the practice was allowed in the health service.

With no disrespect, people are finding it difficult to comprehend this ongoing, robotic, detached response to their living experiences. There is a disconnect between what the Taoiseach is saying in the House about the numbers of nurses and doctors and the reality experienced by doctors and nurses at the front line in hospitals and by patients and their families. It is a huge disconnect. Either we and the people outside are not getting it or the Taoiseach has some insight, that nobody else has, in terms of the reality of people's experiences in hospitals and particularly in emergency departments.

The Taoiseach's comments on the moratorium are becoming very irritating and annoying. People have come to me who came top of the panel last February and gave up private sector jobs in the expectation that they were going to get jobs with the HSE. Those people have not been employed. They were recruited, but the contract has not been signed because there has been a moratorium since last April.

That is still the case. The Taoiseach needs to drill down and to stop coming back with the kind of response that involves seeing no evil, no damage and no harm. The scale of the Government's response to the chronic issues facing staff and patients in emergency departments is not what it should be. It simply is not there. The Taoiseach needs to engage in a fundamental reflection on the Government's approach to this crisis within our hospitals.

I do not mean any disrespect to the Deputy either, but his self-righteousness knows no limits. Let us not forget-----

I will provide some facts. Let us not forget that he was once Minister for Health and Children-----

He was a much better Minister than the Taoiseach.

-----and that he was famous for chiding Tallaght Hospital for not ordering enough trolleys-----

Was that when the Taoiseach was a doctor?

----when patients were being treated in the car park of that hospital.

I am enjoying this history lesson.

We do not even know how many people were on trolleys in those days because the then Government would not count them. The Deputy was also a member of the Government which took a policy decision - and not on the basis of financial considerations - to reduce the number of hospital beds significantly. He started that policy during the boom and continued on with it. We reversed the decision in 2014, as soon as we had the money to do so. The Deputy should get off his high horse when it comes to this matter.

The Taoiseach would not have a horse if it were not for Fianna Fáil.

This is a really difficult problem and it has been with us for decades. We know that there are also problems in many other countries as well. In that context, there is serious overcrowding in Northern Ireland. We are taking every possible action to deal with it. We are providing more beds, more staff and more funding for the fair deal scheme and home care, and we are investing in community services.