With the roll-out of the vaccine against Covid-19 under way, plans have been put together for how and when people will be given the vaccine. Plans have also been drawn up so that schools can fully open in the very near future and for when restrictions on business and social interactions might be eased or lifted, but the plans that I have heard little about are those for how our health system will return to some kind of normality. Thousands of elective surgeries have been put back and cancer screening services disrupted while our hospitals struggle to cope with the wave of Covid-19 patients. That has left the entire health system with a huge challenge going forward. Latest figures show that almost 900,000 people are on the waiting list for treatment in hospitals in Ireland, an increase of almost 12% on this time last year. Of those, more than 600,000 are waiting for their first hospital outpatient consultation. Shockingly, more than 280,000 of those have been waiting for a year or more to be seen for their first appointment. That is even more than the number of people who have been waiting at least a year for hospital treatment with the NHS in England, serving a population 11 times greater than that of the Republic of Ireland. In England, 5% of the total number on the waiting list have been waiting a year or more; in Ireland that figure is 45%. It goes without saying that Covid-19 is not entirely responsible for this but the pandemic has turned what was a crisis in our health service into a disaster. We are not just talking about figures. Every one of these people is a mother, father, son, daughter, sister or brother who, in many cases, desperately needs help to ease pain and suffering. Bringing hospital services back even to the so-called normal levels of pre-Covid times will be an enormous and costly task. According to the ESRI, it could cost more than €1 billion to clear the hospital waiting list caused by Covid-19. Regardless of the cost, it simply cannot be delayed. A task this huge requires the establishment of a special task force that would identify what needs to be done, come up with a plan of concrete action and have real power to clear any obstacles. Private hospitals should be commissioned to play their part in the recovery in the same way they were brought in to help the country handle the early wave of the Covid-19 emergency.

What are the Government's plans to restore vital hospital services and clear the record waiting lists? Will it employ the services of the private sector in doing this? Will the Government agree to establish a task force to oversee the recovery of our health service that is causing so much pain and anxiety?

I thank the Deputy for raising this important issue. Covid has caused unprecedented interruption to normal healthcare activity, with both community and acute settings affected. It also created extra pressures on the provision of cancer services, not only in Ireland but globally, because of the additional demands that treating patients with Covid has imposed on the health services and also the wider impact of Covid. The Government has asked the HSE to implement new pathways of care where services can be delivered in line with demand and in parallel with Covid care. Cancer services, for example, have continued throughout the pandemic in line with the national action plan on Covid-19 and the national cancer control programme is continuing to address backlogs and provide information to cancer patients on Covid-19. This year, overall GP referrals for weeks 1 to 10 amount to 110% of 2020 activity; breast referrals are very high at 122% of 2020 activity; lung is 64%; and prostate, 56%. Despite the Covid challenges, the number of Covid patients with symptomatic breast disease seen at clinics amounted to 88% of the 2019 figure. Surgery numbers to the end of November last are at 77% of the 2019 level. The number of patients receiving chemotherapy is at 88% of 2019 levels and radiotherapy is more than 90% of 2019 levels. Additional funding has been allocated, close to €500 million, to permanently fund 2,600 beds in acute and community settings and another €52 million for critical care beds, which will help to deal with waiting lists into the future.

During the second and third Covid-19 surges, more services remained open than in the first wave, demonstrating how we have adapted as a health service. The HSE is implementing a plan for the prioritisation and restoration of services. It is informed by data modelling undertaken by the HSE integrated national operations hub and is in continued alignment with guidance provided by NPHET. Phase 1 is March to June, phase 2 is July to September and phase 3, October to December. We provided an additional €240 million for an access to care fund, €210 million of which has been allocated to the HSE and €30 million to the National Treatment Purchase Fund, NTPF. That allows for treatment in both private and public hospitals to address capacity issues in acute hospitals and waiting lists. The NTPF is working with public hospitals to arrange treatment for clinically suitable patients and as of the end of February, more than 4,000 day case and in excess of 2,000 GI scope offers of treatment have been accepted. For outpatients, the NTPF had arranged 3,464 appointments by the end of February.

The safety net arrangement with all 18 private hospitals will continue and will be used to deal with the backlog and outpatient appointments.

The hospital with the highest number of people waiting for an outpatient appointment is Galway University Hospital with more than 54,000. It also has by far the highest number of inpatient or day cases waiting at 9,500 people. The biggest problem is the backlog of orthopaedic patients and people seeking help for painful hips and knees that need replacing are being told it could take up to three years before they are seen for initial assessment. I am glad to learn that work is to begin within weeks on the long-awaited second operating theatre for orthopaedics to replace the one that closed in 2017 but it will be a long time before it is operational. I urge that special action be taken in the meantime to clear the exceptional backlog in Galway that is causing so much pain and anxiety to so many.

I will pursue the Galway situation with the HSE. While we are waiting for permanent capacity to come in place, it is important that other interim capacity measures are taken to deal with that backlog, particularly in orthopaedics as well as other areas. That is why the more sustained contract with private hospitals gives the HSE options to deal on an ongoing basis with a range of services where there are backlogs and where works are on the way to give more permanent capacity in the public system. Significant capital works are under way. The service plan provides nationally for an additional 16,000 staff above the December 2019 levels. That includes more than 1,100 medical and dental staff, more than 3,500 nurses and midwives and 4,000 health and social care professionals. A significant expansion is provided for both in current funding for the health service, way and above anything in previous years, but also capital funding to increase capacity as quickly as we possibly can in surgeries, operating theatres and beds generally.