We in Ireland, along with much of Europe, imported the idea of lockdowns from China. However, in China hospitals were built in 14 days in response to Covid-19. The HSE's capacity census last year showed that ICU capacity in Ireland increased from 255 beds to 280 beds in the nine months from April to December. At the end of last year, the Minister, Deputy Stephen Donnelly, announced that capacity was to be increased to 446 beds, including an increase to 321 beds by the end of this year. However, capacity has only been increased by nine beds to date this year.

I would like the Taoiseach to explain what we are doing to increase hospital capacity. The Tánaiste announced earlier this week that our hospitals are under pressure. I do not remember a time when they were not. ICUs operate, generally, to capacity and one would rarely have a time like now when 40 ICU beds are free. Yet we are being frightened again that our ICUs will come under pressure and we will have to endure more restrictions and, potentially, lockdowns. What are we doing to increase capacity? I appreciate the Taoiseach cannot develop ICU beds overnight and it takes time. However, we are not talking about 14 days, like China. We are more than 14 months into this and progress is slow.

On Monday last, there were 278 people on trolleys in hospitals in Ireland, 63 of them in Limerick. This Monday, there were 293 people on trolleys, 60 of them in Limerick. We know that sort of overcrowding is a recipe for disaster in the event there is another wave of Covid. If we look to other countries, like Israel, where the success of the vaccine roll-out was lauded, there has been another wave. There will be more and more waves but all I hear is that we are putting all our eggs in the vaccination basket and doing, apparently, very little to develop our healthcare capacity. I am not saying we should not do both but what is the Government doing to increase healthcare capacity? We have grandiose promises from the Minister, Deputy Stephen Donnelly, and there are three former Ministers for Health in the Cabinet, including the Taoiseach, who have delivered plenty of grandiose promises but no additional capacity.

I would like an update on capacity and what will be done about it, as opposed to what will be promised.

I thank the Deputy for his question. All health systems across Europe and the world come under pressure in a pandemic. That applies through wave after wave in different countries. The acute hospital system, as the Deputy says, continues to be in a challenging position, particularly with the significant backlog of non-Covid care arising from the demand for Covid care in the early part of the year. The ransomware attack of 14 May exacerbated that, particularly in terms of the front line.

The Government has really moved on healthcare and the allocation of resources across the system. Budget 2021 saw an extra €4 billion added to the health budget. It is the largest budget increase in the history of the State. That funding signals how determined the Minister and the Government are to funding expansion and improvement across the board in our health and social care services. That is a 20% increase. Some €1.67 billion of that went towards Covid-related care supports, including the vaccination programme, but there was significant additional funding to address capacity issues and the deficits by funding more beds and employing more staff.

The €600 million winter initiative has made a significant difference to the capacity of the health service. Without it, we would have been in real trouble over the Christmas period. I am glad we took the initiative early last autumn to sanction that. Had it not been for that level of investment in home care packages, community diagnostics and acute capacity, we would have been in far greater difficulty during the winter period. Some €236 million in revenue and €40 million in capital expenditure was provided as part of the winter plan in budget 2021 to fund general acute beds on a permanent basis in our acute hospitals. This funding has provided an additional 834 general acute beds to the system over the number available on 1 January 2020. We need more information from 6 May but, because of the ransomware attack, it is not readily available. In addition, 73 sub-acute beds have been provided under the winter plan. Funding of €52 million was provided in budget 2021 to allow for 66 permanent critical care beds to be put in place to bring permanent baseline capacity to 321 by the end of 2021. Baseline capacity at the beginning of 2020 was 255. The HSE has advised that 41 of those 66 beds are staffed and open on a permanent basis, bringing the national total to 296. We want to get to 321.

The number of beds open on any day can fluctuate due to a variety of factors, including the use of surge capacity. The HSE also has capacity in the private sector arising from agreements with private hospitals on additional needs that will emerge. There have been real tangible gains on capacity increases.

I have no doubt money is being spent. The Government is throwing money around like confetti. Our borrowings are entirely unsustainable. However, it is not having an impact. The Taoiseach said 296 critical care beds; Dr. Colm Henry, the chief clinical officer of the HSE, said 289 last week. Either way, it is a long way short of the number promised by the Minister for Health, Deputy Stephen Donnelly. In addition, we provide 6% of our budget to mental health. I suggested mental health was suffering because of Covid and the restrictions. I was pilloried for it but it seems, unfortunately, that it is suffering. Yet our funding to that remains low. Above all, the barometer is the number of people on trolleys. That number is still at an all-time high. Whatever the Government is doing and whatever money it is spending, it is not having the impact we need. There were 60 people in trolleys in Limerick last Monday. That is not good enough at any time, especially in a pandemic, when we know there will be more waves to endure and we cannot restrict and lock down indefinitely.

We need to give credit to the health system. It stood up strongly to a difficult wave in the winter period. The investment in the winter initiative plan was key in enabling us to have a better flow through hospitals even before the wave came. November and December were better months than in previous years for flow through hospitals and the home care packages were key to that. The 5 million extra home care hours provided had a significant impact on flow through acute hospitals. The overall health service plan provided for about 16,000 additional recruits. The biggest challenge is getting a sufficiency of staff quickly in all areas indicated. Recruitment remains a big challenge. The HSE put forward that it could recruit 16,000 people. It is moving in that direction and over time will get there but getting the levels of staff that have been provided for is an issue.