Before I begin, I offer my condolences to the family and friends of Máire Mhac an tSaoi, Brendan Kennelly, Paddy Moloney and Tony MacMahon, all pillars of Irish arts and culture for so many years. Their deaths are a huge loss to us all, or as Theo Dorgan - the Taoiseach is aware he is another Corkman - so eloquently put it, we are so much poorer for their absence and so much richer for their lives and for their work.

Today, the Cabinet has announced plans for further easing of restrictions. Covid is a horrendous virus and it is still with us. Thankfully, our population is largely vaccinated and this should allow us to proceed safely back to normal, but our healthcare capacity leaves us vulnerable. The crisis that we face now is a hospital bed and capacity crisis. Science has done its bit, medical professionals have done more than their bit, but the Government has failed to step up.

Here are the facts. Hospitals across the State are seeing record levels of overcrowding. Emergency departments are overflowing. The trolley count is rising. It is 416 today. Health waiting lists now stand at almost 1 million waiting for care, and almost a quarter of a million of those have been waiting for more than 18 months. Yet, in the face of this crisis, and increasing Covid numbers, the response of the Government in the budget was not one single additional inpatient bed. Not one. How are we to make it through the winter? How will burnt-out, front-line workers cope? How will the health service survive? The Government's approach means that for the remainder of this year and the entirety of next year, we will have no additional inpatient hospital beds. Is the Taoiseach seriously suggesting that no additional inpatient beds are needed until 2023?

The crisis is now, the overcrowding is happening now, the trolley count rises now and waiting lists are growing. Phil Ní Sheaghdha of the INMO has said of our hospitals: “They cannot cope today, they won't be coping tonight and they won't be coping tomorrow." This is a very stark warning and the Taoiseach needs to listen.

None of this has come out of the blue. The Taoiseach has to have known that this crisis would hit our hospitals hard in the wintertime. Indeed, last July, Sinn Féin and our colleague, Deputy David Cullinane, called for planning for the winter to start then. We urged the Government to prepare for what was to come. We called for an additional 600 inpatient beds and the recruitment of staff to service those beds and we repeated that call in our budget. The Taoiseach chooses to ignore those calls. He chooses not to properly invest in and resource our hospitals, and that leaves us exposed again. So, now, the chickens come home to roost, and it is patients, hospital staff and wider society who pay the heavy price. Tá ár n-ospidéil faoi bhrú ollmhór. Ní féidir leo déileáil leis an mbrú sin. Caithfidh an Rialtas infheistíocht a dhéanamh iontu anois.

I want the Taoiseach to change direction immediately. I am calling on him to do that. I want him to provide the investment needed, increase the number of beds in our hospitals, relieve the overcrowding and lift the intense, unbearable pressure on front-line staff, who are now beyond breaking point. This must be a central plank in the Government's response to the Covid-19 crisis.

I thank the Deputy for raising the issue. I also join the House in expressing our sympathies to the families of the late Máire Mhac an tSaoi - b'fhile den scoth í a rinne an-chuid ar son ár dteanga dhúchais - Brendan Kennelly, Paddy Moloney and Tony MacMahon, artists and musicians who enriched our lives in a wonderful way.

I think the fundamental premise of the Deputy’s question is wrong. The driver of our responses over the last two years in terms of health, and public health in particular, has been the Covid virus itself and the various mutations. The Alpha mutation earlier this year had a devastating impact on us. Likewise, now, the Delta variant is even more transmissible than the Alpha variant, and it has had a very significant impact globally and in this country in terms of the incidence of cases in terms of hospitalisation, ICU admissions and mortality.

Thankfully, because of vaccination and a very effective, efficient and well-run vaccination programme, we have achieved up to 93% vaccination. The vaccines are very effective in preventing severe illness, hospitalisation and admission to ICU, and in terms of mortality and preventing death. However, over time, in terms of protecting against infection itself, it is not as strong as it would be in terms of the cases I have just outlined. Therefore, there is a need for a booster campaign. That was the key recommendation from NIAC yesterday, which the Government will implement immediately. It will be the administration of the booster vaccine to the over-60s which will help us in holding back the impact of Covid.

In respect of hospital beds, close to 938 beds are due to be delivered by the end of this year. The Deputy has ignored completely in her presentation the fact that well over 900 beds have been budgeted for and have been provided for, with the follow-through provided for this year in terms of the staffing, for example. That was the largest bed increase ever in one year in terms of hospital capacity. Likewise, in terms of ICU, again, there has been a substantial 25% increase in ICU beds over the last two years. It is close to 300 now and it will get to 321 by the end of this year or, at the latest, very early next year. These are very substantial increases both in ICU and bed capacity.

The situation as advised to us by NPHET is that, in all age groups now, people are getting infected. While we are reopening, we are doing so in a very cautious way, with the vaccination certificate at the heart of the protective measures that need to be taken.

The Deputy opposed tooth and nail the vaccination certificate provisions that were introduced the previous time in this House to facilitate access to hospitality. She and her colleagues very strongly opposed that, yet it was the key to opening hospitality and it was advised by NPHET that this was what we should do. NPHET is now advising the same in respect of the remaining elements of hospitality. Conscious of the growth in incidence levels, it is very anxious that, where practical, appropriate and where it makes sense, a range of protective measures be introduced, the most critical being that the vaccination certificate be applied across the board, together with due diligence by operators and consumers. That is the key issue. We will be increasing staff in the health service by another 8,000 this year. There is going to be no let-up in the investment.

Covid is a terrible virus and sickness, and it is with us to stay. The level of vaccination, at more than 90%, is extremely high. As I said, science has done its job and the medical professionals have done theirs. The Government now needs to do its job. The fact is that the lack of capacity within our health service leaves us vulnerable still. It means there is a panic right across society when infection levels, hospitalisations and ICU admissions rise. That is all down to capacity.

I put it to the Taoiseach that the Government did not make additional provision for as much as one new inpatient bed in the budget. That is a fact. Provision was made for 19 new ICU beds, but that is a drop in the ocean. Everybody knows that at the heart of our dilemma, with a highly vaccinated population and people doing their best and being very thoughtful and cautious, we are still left with this huge vulnerability in terms of healthcare and hospital capacity. The professionals are telling the Taoiseach this. He knows this; it is not just me saying it.

Thank you, Deputy.

I want to know how the Government will address that, how we will get through the winter-----

The Tánaiste to respond. Gabh mo leithscéal. The Taoiseach to respond.

-----and how hospital capacity will be supplemented.

An increase in the number of ICU beds from 255 to 321 by the end of this year is not a drop in the ocean. If the Deputy knows anything at all about ICU beds, it is not about the beds themselves but the entire staffing team that goes behind them.

You are just playing with numbers.

The number will be up to 340 by the end of 2022. That is an enormous increase in ICU beds over a very short period of time. In addition, as I said earlier, well over 900 beds will be provided.

Are you are saying we have enough?

What we did last year - in the funding we provided for the winter initiative, which got us through last winter - was we provided two-year funding to enable the staff to be recruited and the beds to be provided, so we would not have the annual struggle that went on between Departments in respect of getting annual allocations. That has been very effective.

No, it has not. You are playing with the numbers.

However, other measures have to take place, of course, in respect of diagnostics and other measures in terms of home care and so on to make sure, as far as we possibly can, that there is a very good, efficient flow through our hospitals.

Thank you, Taoiseach.

I want to make a final point. The issue about the increasing numbers is not about hospital beds alone, although that is important. It is about individuals. We want to protect individuals and that is why protective measures are needed from severe illness and so on.

Hospital beds are the issue.

We are over time. Táim ag bogadh ar aghaidh.