The time is up and I call Deputy Michael Collins now on behalf of the Rural Independent Group.

I thank the Ceann Comhairle. I have no doubt that after the easing of the Covid-19 pandemic that the biggest crisis that this country will have to deal with will be health and waiting lists. At the present time we are shockingly ill-prepared for the crisis which leaves many questions hanging over the head of the Minister for Health.

I ask the Taoiseach to look at his own county and the shambles that health is in at the moment in west Cork. Hundreds of people are going to the North for crisis operations as they have no other choice. During the summer, we saw the shocking handling of Bantry General Hospital, which is west Cork’s only general hospital and serves up to 90,000 people living in the area along with tens of thousands of visitors. Accident and emergency admissions were closed for 16 days due to a lack of staff. This was flagged three years prior to this but due to major incompetence on the part of the HSE it was not addressed until the HSE was pulled, dragging and screaming, through the streets of Bantry by the great people of west Cork in a public protest. The HSE then woke up and reopened the accident and emergency unit. During all this time, the Minister of Health was nowhere to be found. It looked, yet again, like another Minister was asleep at the wheel.

SouthDoc services in Castletownbere and Kinsale are now non-existent. Imagine the people of Ardgroom, Allihies, Adrigole, Urhan, Glengarriff, Castletownbere and Lauragh in south Kerry spending every night without a proper out-of-hours doctors service unless the day doctors in Castletownbere continue to work by night. It is shocking to ask anybody to work day and night. This is coupled with a crippling ambulance service in west Cork. The Castletownbere ambulance, which one of four in west Cork, now spends its nights in Kerry. The Clonakilty ambulance is now dubbed the Cork city ambulance. Every night during the week, the other two ambulances are in every other part of the country but west Cork. As a result, car accident victims in west Cork were recently left by the roadside for two hours and 45 minutes and two and a half hours, respectively, with gardaí and fire personnel to care for them.

We had a suspected stroke victim in Schull recently, where efforts were made to source an ambulance from another county. Another person near Skibbereen passed away while waiting for an ambulance from another county. This leaves ambulance staff, fire brigade staff, doctors, gardaí and suffering patients and families astonished as to how this is allowed to happen.

All of this has happened over the past two months on the Taoiseach’s watch. If this were not enough, CoAction has now decided to close its community houses in Castletownbere and to move loved ones with intellectual disabilities to Skibbereen and Bantry, which is nothing short of heartbreaking. Again, the excuse is lack of staffing. This is the same excuse that was used for Bantry hospital recently and for SouthDoc. Now, the most vulnerable in our community - some of whom are in their 50s, 60s and 70s - will have the doors of their community homes shut in their faces. This is another astonishing attack on the vulnerable people of west Cork.

Can the Taoiseach tell me why Bantry hospital was allowed to close its accident and emergency unit at the busiest time in August of this year, why there is no SouthDoc out-of-hours service in Castletownbere and Kinsale and why there are no ambulances in west Cork on most nights of the week? Can the Taoiseach personally intervene with CoAction to prevent many heartbreaks with the closure of the CoAction homes in Castletownbere? I may add that the funds for these homes were raised by local people.

First of all, the performance of the health service in the last year has been exceptional-----

Hear, hear.

-----in particular in dealing with Covid-19, both at the primary care level and at the acute level. Great credit is due to all involved, particularly all those who worked in west Cork in our ambulance service who did fantastic work in bringing vaccines to people who were bedridden and for mobility reasons could not leave.

They are badly underpaid.

I pay tribute also to those in the GP infrastructure across west Cork for the extraordinary work they did. Deputy Collins should have paid tribute to them for the outstanding service that the health service provided in the most difficult of times during a pandemic. It is easy to be condemning all of the time.

During August, I was very well aware of the Bantry situation. Deputy Christopher O’Sullivan contacted me on a daily basis. What had transpired was no surprise to anybody, in terms of personnel issues rather than policy. The Deputy would know that if he had bothered to ring the hospital or the HSE. They would have explained it to him. I believe they eventually spoke to the Deputy about this. Resources have been provided for Bantry General Hospital. There has been continued consistent investment in the hospital. The Minister for Health engaged with the issue. There were personnel issues in terms of availability which were beyond anyone’s control at that particular point in time, but they were dealt with by the HSE in the south west. Bantry hospital continues to play a very significant role for the entire hinterland because of the extent of west Cork right down to the Kerry border, to Castletownbere and so on. I have always been a strong supporter of and advocate for Bantry hospital. In my time as Minister for Health, we secured significant investment for that hospital and its identification as a unique type of hospital given its location and its need to service a very large rural hinterland.

The ambulance service is a national one, as the Deputy is aware. We will continue to work on any improvements that can be made to ensure provision of supply.

The Minister will be producing an action plan in respect of waiting lists both from now until the end of the year and right through to 2022. This is an enormous challenge because of the fact that we have had two lockdowns since March 2020 which impacted on the capacity of the acute system to get operations done. That is no surprise to anyone. Those challenges added to a list that had built up in the previous number of years. There will be an all-out effort, in the first instance, to reduce waiting times for people in respect of acute hospitals. Significant progress has been made on assessment of need; for example, in the past 12 months there has been a dramatic reduction by 91% in the number of children waiting for their assessments to be completed. The Minister of State, Deputy Rabbitte, did great work there. I know she will happily work with CoAction on any issues that it has. I have also been a long-term advocate for and supporter of CoAction down through the years.

I thank the Taoiseach for his reply. I welcome his confirmation that the Minister of State, Deputy Rabbitte, will work with us on the CoAction issue in Castletownbere. This is a very serious and upsetting issue for many of the families. I did not break the news for nearly two weeks until I got no reply from CoAction as to what is going on there and as to why they are closing the residential homes. For the Taoiseach's own information, I was well aware of what was going on at Bantry General Hospital.

The HSE was aware of it for three years. Does the Taoiseach not know that? The HSE knew for three years that this was coming. The consultants at the hospital have told us that. These are the facts.

I am well aware of what is going on in Bantry General Hospital; it is at my back door. I respect the staff who work there. I do not respect the way the HSE let down the people and left the hospital closed. The Taoiseach stated he knew about it but he was invited to the protest every day of the crisis. He should have stood with the people and that is where his voice should have been heard, but he failed the people. The same is true in the case of SouthDoc. The HSE reverted last week to say the issue relating to SouthDoc in Castletownbere had been resolved, but it lasted two days and collapsed. There is no SouthDoc service there by night.

There is a failure. The Taoiseach can praise the staff all he likes. There are great staff on the ground and the ambulance staff are second to none, but the bottom line is the problems in this country are at the top. There is overpaid management, with layers that collapse continually, and the Taoiseach is in denial. He is trying to say he knew about this issue every day of the week, but 16 days of admission were closed at a local hospital. If that had happened in Dublin, there would have been a national outcry. It would not have lasted even for hours.

Deputy, you are out of time.

When it was in west Cork, it was all right to talk about it for 16 days and to push it aside and say, "Ah sure, you don't understand what is going on, Deputy Collins." I certainly did know what was going on. I was told that myths were being spread about Bantry hospital and that it is a fact the doors were closed.

Time is up, Deputy.

The Taoiseach should open his eyes and wake up to what is happening. It is happening in his back yard, on his watch.

They are great phrases the Deputy uses and they are regulars, such as "asleep at the wheel", "on your watch"-----

It is a fact. The facts hurt.

Every time the Deputy contributes, that seems to be the standard terminology. The bottom line, in the context of Bantry hospital and the recruitment and replacement of personnel, is that management worked very quickly and got those issues resolved. We are not talking about a standard emergency department here, and the Deputy knows that. It should not be referred to as an emergency department because it is not an emergency department. A medical assessment and admission unit is what the Deputy is actually talking about-----

It is about getting admission to the hospital.

It is not an emergency department.

Next you will tell me it was not closed at all.

Let us not make it overly dramatic. That is an important point.

The Taoiseach was nowhere to be seen.

The hospital has, over the years, created a very important role. What is important is that we support what the hospital does well, and resource that-----

I agree.

That is what we are committed to doing and I have intervened to ensure that happens, as has the Minister for Health. Because of the geography of that area-----

Thank you, Taoiseach.

-----the need for the hospital and the range of services it provides are obvious.

That concludes Leaders' Questions. We are way over time. I regret the fact so many Deputies completely disregard the allocated time.