Ba mhaith liom ceist na n-ospidéal a phlé leis an Tánaiste, go háirithe ó thaobh na leapacha in ICU. Tá a fhios againn ón eolas a tháinig chun solais inné go bhfuil 13 dár n-ospidéil ar fud an Stáit nach bhfuil leaba ar bith ICU ar fáil iontu, agus i seacht gcinn eile níl ach leaba amháin le fáil. Tá an fhoireann atá ag obair sna hospidéil faoi bhrú millteanach. Ag an am céanna, tá a fhios againn ó Be On Call for Ireland go bhfuil níos mó ná 1,500 duine, dochtúir agus altra atá sásta dul ag obair inár n-ospidéil ach níl conradh faighte acu. Fosta, tá cúpla céad altra ann atá sásta theacht chun an tír seo ach níl an Roinn Dlí agus Cirt ag ceadú a gcuid visas in am. Tá sé ag glacadh trí mhí. Caithfear níos mó a dhéanamh, gan dabht, ar an ábhar seo.

In the past number of days, the situation in our hospitals has continued to deteriorate due to the number of Covid-19 patients requiring hospitalisation. The daily operations update on the situation in our acute hospitals is one that makes for very grim reading. The latest report available, from yesterday, states that there are now 13 hospitals without any ICU capacity, seven other hospitals that just have one ICU bed left and that a sizeable majority of patients in ICU beds throughout the State are now there due to Covid-19. ICU capacity, we are told, is expected to be used up by the weekend, as reported in the media. I want, first, to express my solidarity with the staff in all of our hospitals and, indeed, the patients. Our staff are experiencing at the moment something that is unimaginable. It is a very worrying time. They are overworked, exhausted and anxious about the period ahead and many of them are angry that they have been left in this situation. The least we can do here is thank them for their work and express our support for them at this extremely difficult time.

Over the summer, as the Tánaiste will be aware, Sinn Féin warned that capacity needed to be ramped up. This did not happen in sufficient ways. The IMO warned the Government, upon publication of the winter plan, that it was insufficient and that more needed to be done. The failure to build in the necessary capacity has left us again relying on surge capacity and the option of using private hospitals. These remain the only options at the Government's disposal at the minute to alleviate the situation. My own local hospital in Letterkenny has just a handful of acute beds left throughout the hospital at this time and no available ICU beds. I know from speaking to staff at the front line that they are very anxious about the coming weeks and they are very worried. They know that we cannot conjure up capacity in a couple of days and there is a huge job of work to ensure our medium-term and long-term capacity is expanded.

However, there are a number of things we can do to help to alleviate the situation in the short term. The deal with the private hospitals is one of them, a deal which provides one third capacity. Does the Tánaiste believe this is a sufficient amount of capacity? Does he believe it should be increased and have discussions begun to increase that capacity? There remains available, through the Be on Call for Ireland initiative, a pool of approximately 1,500 healthcare workers. Many of these are job-ready, including nurses, doctors and other staff willing to take up work in our hospitals but who have not been deployed. Why have they not been deployed and when will all the nurses and doctors who are making themselves available be deployed in our public services?

In addition, there are currently serious delays in processing atypical working visas, which is preventing the recruitment of healthcare staff. We are told that it is currently taking ten to 12 weeks to process the applications for these visas. The Royal College of Surgeons in Ireland, RCSI, had to cancel 200 examinations for nurses due to the delays in processing the applications in January alone. Last March, the Department was taking 48 hours to process these applications; now it is taking up to three months. The reality is that if it were not for the Department dragging its heels, we could have 200 additional nurses in Ireland by the end of the month. These nurses are willing to leave their own home country to come to Ireland to work in our public health system at a time when the virus is as its worst. We need to do a lot better. Why is the Department dragging its heels on this issue?

I thank the Deputy. First, the situation in our hospitals remains very precarious and, unfortunately, it is continuing to deteriorate. The very best way we can support the staff working in our acute hospitals is to continue to abide by the restrictions, to social distance and to do all the things that are being asked of us. That is what we need to do to decrease the number of people getting Covid and going into hospital. That is the best way that we can turn the corner on the current situation. As the Deputy will know, the situation in Northern Ireland is similar, if not worse, so I do not think today is a day when Sinn Féin, which is in government in Northern Ireland, should be scoring political points on an issue like this. The job that party has done in Northern Ireland is not one to be proud of, in my view.

In regard to the hospitals, at the moment there are 1,838 patients with Covid in our hospitals and 176 in ICUs. What is somewhat encouraging is that the number of admissions to hospital yesterday was 149 but the number of discharges was 128, so the net increase, at least in the past day, was much smaller than on previous days. There is a glimmer of hope. Cases have been falling now for a number of days. We may see the total number of people being hospitalised starting to fall in about a weeks' time and ICU numbers starting to fall in maybe two weeks' time, but it will be a very difficult, precarious and dangerous situation for the next two weeks, at the very least, in our hospitals. In total, across the hospital system - I appreciate it varies from place to place - there are 510 acute beds and 29 ICU adult beds free today. There are also paediatric beds. It is possible, and not unusual, for people to be transferred from one hospital to another where there is capacity. There are 29 ICU beds and 510 acute beds available today across the system.

In regard to solutions, which the Deputy touched on, and what we can do to alleviate the situation to make sure our hospitals do not become overwhelmed over the next couple of weeks, there is the deal with the private hospitals. That allows us to use up to 60% of their capacity, not 30%. Those discussions are under way with hospitals at the moment. The 30% is secured and a further 30% can be sought and has been sought. We are going to try to access that. It is also possible to create surge ICU capacity within our hospitals. We have increased ICU capacity since this time last year but, as people appreciate, an ICU bed is not a bed. It is an entire care system and it requires trained and qualified staff. We have the kit. We have 1,800 ventilators and we probably only have 100 or so people on ventilators at the moment. We have 1,800 ventilators and we have the kit, but having the staff trained up and ready to go is a different matter. Some are out sick, some are close contacts and cannot come to work and lots are really exhausted after a very difficult year, which the Deputy will appreciate. We can provide extra ICU capacity, which is the surge capacity, by turning ordinary wards, theatres and recovery areas into additional ICU beds.

In terms of the Be on Call for Ireland issue, I will ask the Minister for Health, Deputy Stephen Donnelly, about that and come back to the Deputy on it.

My understanding is that when we ran that programme some months ago it ran into real difficulties because a large number of people who signed up were not qualified. Many were already working, for example, in nursing homes and were seeking to transfer to hospitals. That is not something we wanted to happen because nursing homes are under pressure as well. I will certainly seek an update from the Minister, Deputy Stephen Donnelly, on that and come back to the Deputy.

The Deputy asked about working visas. I was not aware that was the situation with regard to working visas in my Department. There can be delays but the turnaround times given by the Deputy now versus then are new to me. I will take that up with my Secretary General to see if there is something we can do.

The issue is very serious. My local hospital in Letterkenny had seven ambulances parked outside on Sunday night. Patients were being treated in the forecourt of Letterkenny University Hospital in ambulances because there was no capacity. A total of 11 beds were closed within the hospital because of staffing shortages. As the Tánaiste says, many are out sick. Up to 180 are either close contacts or Covid-19 positive themselves.

We have the statistics. What concerns me is that hundreds of nurses who are qualified and job-ready with completed clearance under the Be On Call for Ireland programme have not been deployed. There are currently 268 in the pool of doctors. There are 1,491 in total in the pool. More than half of these are job-ready but they have not been deployed. Some 200 examinations had to be cancelled for nurses who were willing to come to this country. Applications made as far back as November still have not been processed. These people are supposed to be taking up positions in community settings and different hospitals throughout the State but the visa application system is preventing them.

I will finish on this point. We all absolutely recognise the work of front-line workers but when people are willing to step forward, we have a responsibility to take some of the pressure off those in the system and ensure all the red tape is taken away. Will the Tánaiste answer those questions?

The Deputy asked about Be On Call for Ireland. As I mentioned earlier, that was something we launched last March. I launched it as Taoiseach with the Minister for Health at the time, Deputy Harris. We had a significant level of interest in it but it did not turn out to be what we thought it would be because we found that a significant number of people were not available. Some were not resident in the State. Some were already working within the health service and we did not want to redeploy them from areas where they were already working. Others did not have the appropriate qualifications. I will seek an update on that from the Minister, Deputy Stephen Donnelly, as things may have changed since I last looked into that issue.

I will do the same in respect of work visas. That matter has not yet been brought to my attention in person. Neither the HSE nor the Minister for Health have said to me that it is an issue. It may well have arisen in written questions but no one has raised it with me in person until now. I will certainly look into that to see if there is something we can do. It is important to point out that working visas need to be processed properly. Ultimately, we have an obligation and duty to the public to ensure people are safe and that those who receive work visas and permits are who they say they are and have the qualifications they say they have. It cannot simply be done overnight although perhaps it can be done more quickly.