I wish to raise with the Taoiseach the serious crisis in University Hospital Kerry, UHK. Three weeks ago, eight senior consultants at University Hospital Kerry wrote to general practitioners and elected members stating: "Our hospital is in crisis since the second week of September." The letter went on to state that elective surgery has been cancelled, there are high numbers of patients on trolleys in the emergency department, there are staff shortages and staff burnout, that no surgical day ward is operating and that the acute medical assessment unit is closed more often than it is open.

There are 2,300 people on waiting lists for elective surgery, many of them in pain. Elective surgery has been cancelled. Elderly people up to 90 years of age are on trolleys in corridors for two or three days as they wait for a bed. That is not right. A respectable senior citizen who operated a highly respectable business in Killarney for many years died on a trolley in Tralee hospital. UHK needs 100 additional nurses. We need an independent assessment and external review to identify what has gone wrong in order that we can rectify the situation. I am told that senior decision-makers and on-call management rotas are practically non-existent at weekends, that elderly people are being sent home in ambulances without a home care plan in place, with many of those who can walk being sent home in taxis, that ambulances are queuing for three to four hours waiting to unload at the accident and emergency department and that ambulances assigned to Kerry, which operate on a 12-hour shift basis, are being redeployed at the start of a shift to areas in Cork and as far away as Dungarvan and that they often complete that shift in Clonmel, leaving Kerry unserviced during that entire shift. Reconfiguration of the ambulance service in 2012 has resulted in a reduction of service in Kerry. Staff are exhausted, mentally and physically. Last month, there were 422 patients on trolleys while four years ago, there were only 114 people on trolleys. The week before last there were 84 people on trolleys.

Never before has a crisis of the dimensions I have set out existed in Kerry. I ask the Taoiseach to deal with this matter urgently.

I thank the Deputy for raising the issue in the House today. The Minister for Education, Deputy Foley, also met the consultants and would have notified me of the situation as articulated by the consultants, and as articulated this afternoon by the Deputy. It is an issue that the HSE is engaging with. Suffice to say, Covid has had a very significant impact on our hospitals.

Not in September.

It has had an extraordinary impact, along with the cyberattack. Both have had a huge pressurising impact on people working on the front line. The degree to which the cyberattack impacted on many clinicians in the aftermath of the high point of Covid is not widely appreciated. Access to data, records and so forth was undermined by the cyberattack. That said, I want to make clear to the Deputy that the resources are there to deal with staffing issues. Last year alone, the HSE hired approximately 6,000 staff, which was the largest ever recruitment in any one year.

We do not have them in Kerry.

There is funding this year to hire a further 8,000 full-time permanent staff in 2022. That is a significant resource. We need to accelerate the HR side of this in terms of recruitment, but the funding is there to recruit additional staff. That applies across the country, including in Tralee. Additional funding has been allocated to the national clinical programmes. In terms of staffing, skill mix and so on, funding has been provided in the budget. Approximately 5 million home care hours have been provided to alleviate the pressures on hospitals and to facilitate flow through hospitals and so forth. An additional 12,150 community short-term, rehab and intermediate care beds were provided. Funding was provided for that in 2021. There has been a very significant expansion.

I will engage with the HSE on the specifics of some of the issues raised by the Deputy. The Minister has provided €350 million in the budget to deal with waiting lists and waiting times and to get the numbers waiting undue lengths of time on trolleys down. I sympathise with the person - I do not know if the Deputy knew the person - who passed in very unacceptable circumstances. As I said, the resources are there to deal with this issue. I will engage with the HSE in terms of the specific issues that the consultants have identified and communicated to all of the public representatives in the Kerry region, as articulated today by the Deputy.

I thank the Taoiseach. He mentioned that the Minister, Deputy Foley, brought this matter to his attention. What has the Taoiseach done since the Minister brought it to his attention? On behalf of the people of Kerry, I ask the Taoiseach to ensure that action is urgently taken to address this crisis to prevent people from dying unnecessarily. We need a resumption of elective surgery for the many people who are waiting and suffering in severe pain. We need an external and independent review of what has gone wrong so that the hospital can return to providing a safe level of care. That is what I am asking for.

We need to ask retired nurses to return to work. In light of the current crisis, we need the many highly skilled nurses who have retired to return for one, two or three days per week. We are in dire need in Kerry and urgent and drastic action is required to rectify the situation. People's health is their wealth. We must put the health of our people before anything else.

Action will be taken. The HSE has confirmed to me that the resources are in place to deal with some of the issues raised by the Deputy, including staff recruitment and measures to alleviate pressures on emergency departments. Presentations to our hospitals are higher than the 2019 levels. We are maintaining the full range of activities, in addition to the Covid issues. Hospitals are under a lot of pressure. I am not disputing that. I will engage further with the HSE and the Minister for Health in regard to the situation in Tralee. The Deputy spoke about the need for an external review. The HSE has systems in place-----

They are not working.

Hear me out, please. The HSE has mechanisms that it can deploy to hospitals if there are issues around governance, which is what the Deputy seems to be implying. I do not know if that is the point he is making in regard to the external review. The HSE has at its disposal units and mechanism to make sure that issues like this are rectified.

It needs to be sorted out.