The Labour Party believes in a fully funded, single-tier public health service. I was part of the team that spent 11 months writing Sláintecare. An extraordinary series of leaks was reported in the Business Post, revealing a dysfunctional relationship between the Department of Health and the HSE. That leads me to believe we are further away than we have ever been from the single-tier public health service we desire. To be frank, the commentary in the meeting that was the subject of the leak was quite derogatory from a relationship point of view as regards how we are ever going to achieve the service we want. The relationship between the HSE and the Department of Health is obviously going to be damaged. I believe I can vouch that this is the case.

Also worrying is how that will impact on the real lives of people. Officials in the Department of Health are saying that the idea we will recruit 10,000 people this year is, and I apologise in advance for the language used by one of the officials, "batshit". That is what those officials think about the recruitment of 10,000 people we need for our health service. There were many other similar comments. This was the type of meeting that was going on in the Department of Health relating to the necessary recruitment in our health service. What does that say about the Department of Health? What does it say about the Minister for Health and how the Department is being run? In fairness to the two junior Ministers who were on "Morning Ireland" the past two mornings, they tried to give some account of it but the Minister for Health is accountable. This comes after some terrible information emerging regarding the recruitment of a consultant psychiatrist in south Kerry. We know that 700 consultant posts are vacant. We know from Simon Carswell in The Irish Times about the shortage of GPs across the country. One in five GPs is expected to retire by the end of the decade. We need 2,000 more. In 13 GP areas, medical cardholders have been without a permanent doctor for over a year. There are 26 vacancies on General Medical Services, GMS, panels, covering 17,000 patients. It goes on and on. Many of us know of towns across Ireland that have no GP. We have an opportunity post Covid to put in place what we need and desire, that is, a single-tier public health service. The long-term health impacts of a lack of continuity of care and the difficulty of getting an appointment will cause even more waiting lists and issues.

Evidence from the UK shows that earlier intervention and having extra GPs per head of population saves people from acute and chronic illnesses.

We have a huge problem. We know that there are issues in respect of the relationship between the Department of Health and the HSE. I want to ask the Taoiseach quite clearly on the floor of the Dáil if he believes that we will recruit the necessary 10,000 staff for our health services this year. What plans does he have to ensure that we will resource the adequate number of GPs we desperately need across the country?

I thank the Deputy for raising this issue. The article to which he refers relates to a secretly recorded transcript of a meeting-----

That needs to be looked into.

-----which has its own issues attached to it.

I agree totally.

I believe that public servants and people more generally are entitled to brainstorm and hold meetings without being secretly recorded. That is a very basic right and entitlement of people. In terms of the relationship between the Department of Health and the HSE, the Minister holds biweekly meetings with the CEO of the HSE, the Secretary General of the Department of Health and the chairman of the HSE board. The Comptroller and Auditor General audits and signs off on the accounts of the HSE. That is how it operates.

More fundamentally, we need to stand back and observe that over the past two years there was record recruitment to the health service. The net figure was 12,500 people. More than 32,000 or 33,000 people gross were recruited. To just stand still, the HSE must recruit 9,500 people every year because of 9,500 people going in different directions and into different careers. That is an extraordinary level of recruitment. The net gain of 12,500 over two years is a record high number of recruitments. Add to that the 4,000 who were recruited as test-and-trace staff and for the vaccination team. A great deal of work went in there. There are 132,000 people now working in the HSE and our health service.

If we stand back from all that, in the past 30 years and 20 years in particular, we have witnessed very dramatic improvements in health outcomes, with major gains in longevity and lifespan. I say that because people need to realise that our investment in health services is delivering dividends, be it in the context of stroke, cardiovascular or cancer strategies. Survival rates in all those key areas have improved significantly over two to three decades. That must be acknowledged in all our commentary on the health service. The health service will always create, understandably and deservedly, issues of concern, given the enormity of it and the proportion of the population it covers.

That said, I am still impatient for reform and progress. An integrated financial management system is required and needed in the HSE. That is absolutely the case. When I became Taoiseach, I told the HSE, the Department of Health and the Minister that we need to modernise the information technology systems in the area of health in the context of the delivery of healthcare services. I refer in this regard to unique patient identifiers and so forth. Covid-19 intervened and, irrespective of what Deputy Kelly says, the HSE and health service rose to the challenge and developed a vaccination programme that is without question one of the best in Europe or the world. We need to acknowledge that.

I thank the Taoiseach.

There have been successes, but there are also, in my view, major concerns around the delivery of services-----

Time is up now, please.

-----in some aspects of mental health, without question, as we witnessed with the County Kerry child and adolescent mental health services and in other areas as well.

We have gone way over time.