Impím ar Theachtaí agus ar An Taoiseach na srianta ama a chomhlíonadh. I make the usual appeal to Members to keep to time limits.

In February 2015, a 100-year-old woman was left lying on a trolley for 24 hours in Tallaght hospital. The case sparked outrage and anger. At the time the Taoiseach described the incident as “a truly scandalous situation”. We were told this should not have happened and the cry from the Government was one of never again. In November of that same year, a 91-year-old man spent 30 hours on a hospital trolley. The Taoiseach's response was that the then Taoiseach and the Minister for Health must take responsibility for the ongoing crisis.

Fast forward six years to today, on his watch as Taoiseach, figures show that in January alone, nearly 1,100 patients aged 75 years and over were lying on trolleys for 24 hours and more. The Taoiseach was right in 2015 when he said that one elderly patient lying on a trolley was scandalous. That 1,100 elderly patients were left waiting on a trolley in a single month is 1,100 scandals, one after the other. Numbers are very clinical. Numbers are not personal but every one of these 1,100 is a person, somebody’s grandfather, grandmother, mother, father, brother or sister; somebody's loved one.

This crisis has not fallen out of the sky. The Irish Nurses and Midwives Organisation, INMO, has been ringing the alarm bell at the Government for weeks and weeks. It says we face an extremely dangerous situation and that in some cases it is the worst the organisation has ever seen. Yet the Minister for Health sits on his hands and the HSE fails to act. On 25 January, University Hospital Limerick registered a record number of people on trolleys for a hospital for a 24-hour period. That same day, trolley figures across the State hit a two-year high. Yesterday, in the Taoiseach's own neck of the woods, Cork University Hospital registered its highest number of patients recorded on trolleys since the trolley count began.

The big question that arises this morning is what exactly is the Minister for Health doing. What exactly is the HSE doing? The Taoiseach tells us we have to pay big bucks to get big results. The Minister for Health, Deputy Stephen Donnelly, is paid €225,000, Paul Reid of the HSE is paid €412,000 and Robert Watt who is the Secretary General of the Department is paid €298,000. I believe that when you pay people that kind of money you expect big results. You expect that the job is done. Yet promise after promise has been made but we still have a crisis in GP provision, we do not have enough inpatient beds or enough community recovery beds and the scandal of trolleys continues. Despite paying these three men almost €1 million between them, the root causes of hospital overcrowding persist.

Tá géarchéim tagtha arís leis an bplódú inár n-ospidéil. Ní rogha é easpa gnímh leanúnach ón Rialtas. Caithfidh an tAire cruinniú éigeandála de thascfhórsa na Roinne a eagrú.

Do the Taoiseach and the Minister for Health accept responsibility for the crisis in our hospitals? How is it that in the midst of this extraordinary crisis the emergency department task force has not yet met? I am asking that the Taoiseach instruct the Minister to ensure that the task force meets as a matter of absolute urgency.

Hear, hear.

I thank the Deputy for raising the issue. Without question there have been record attendances in our emergency departments over the last month. The situation is very challenging in many emergency departments across the country with those record attendances. What is more worrying is the preponderance or majority of those over 75 years are presenting to emergency departments with more acute illnesses than would have been the case in previous times. The clinicians on the ground say that this is a legacy arising from the Covid period because people did not present earlier during the pandemic for obvious reasons. There were lockdowns and most recently during Omicron elective procedures were de-escalated and diagnostics were not at the same levels. For example, cancer biopsies or attendances went down by 15% in 2020. In the next period, we will witness delayed diagnosis coming to the fore, more acute illness, and more acute cancer presentations because Covid meant that people did not get the earlier interventions that would have been the norm without the pandemic. That is the reality. That is notwithstanding the fact that we have dramatically invested and increased home package care hours, for example. Some 55,000 families now benefit from home care packages that are fully funded. However, there is a problem around hospital discharging as Deputies will be aware. Some 50% of nursing homes and community nursing units have had Covid outbreaks now. The regulations governing that mean they cannot accept new patients for about 28 days. We understand why that regulation was put in. I understand that the Health Protection Surveillance Centre is examining that. That has created a problem in egress from hospitals which, again, is a legacy of Covid. Indeed, it is not just a legacy but a present-day reality of Covid which is preventing people from leaving hospitals when their care is complete. Bed capacity has increased to record levels in the last 12 months. Investment in health has been at record levels. I think it has increased by €6 billion since the original allocation of 2018. There has been a range of innovations. The Deputy mentioned GPs. There has been huge investment in general practice service in the last two years, particularly around chronic disease management and GP access to diagnostics. That has made dramatic progress. Some 138,000 radiology scans were delivered in the community in 2021. That reduces pressure on the acute services.

However, we must respond to this current situation by pressing ahead with increased capacity on the acute side but also by examining the situation with nursing homes and community nursing units and further delivery of home care packages as well. Across the board, a whole range of measures have been introduced because it is not just about one task force for one or two months of the year. It must be a more holistic approach that is system-wide within the health service. It must be on the primary care side, community care side and acute side and there must be discharge provision and capacity as well. Government is working with the HSE to ensure we can do everything we possibly can to alleviate the pressures on emergency departments right now.

In those circumstances the Taoiseach and his Government are failing miserably in their task. I do not accept his excuse that this is a consequence of Covid. For example, he said he would eliminate waiting lists when he was Minister for Health 20 years ago. We now have 900,000 people waiting on lists. In 2015, the Tánaiste, the Taoiseach's partner in government and a former Minister for Health, said people would be waiting no longer than 18 months to see a consultant. Last month 155,000 people were waiting longer than 18 months. I could go on and on.

The truth is the failure lies with a lack of capacity; that is for sure. We lack beds but also resources, theatre capacity and diagnostics. The list is very long. Arguably, however, the bigger failure is a failure to reform. I was very alarmed to hear, as recently as this morning at the health committee, that it seems the Secretary General of the Department of Health has not signed up for Sláintecare and has not signed up for the type of reform we need.

I will put it to the Taoiseach again. Does he accept responsibility for this situation? How is it that the emergency department task force has not met? I see the Minister has joined us. Can we have an explanation for that, given the chronic situation?

Hear, hear.

Hear, hear.

Does Deputy McDonald just say anything? Did she read the Secretary General's speech to the Oireachtas committee this morning? Where in that speech did she pick up-----

From his email. He said it himself. I will send it to the Taoiseach.

-----that he was not committed to Sláintecare? The presentations today reflect that commitment to Sláintecare but Deputy McDonald simply thinks she can come in and say anything and it does not matter whether it is true or not. She just comes in and says it-----

Taoiseach, answer the question.

-----and throws it out there. If you throw enough mud, it will stick seems to be her approach to what are very serious issues. Yesterday's progress report on Sláintecare shows very dramatic progress in a whole range of areas in respect of that plan. I referenced one, namely, GP access to diagnostics. The whole chronic disease management has resulted in about 220,000 consultations as GPs work with consultants. There is much innovation and much implementation going on. There are increases in bed capacity, there is the reduction of the General Medical Services, GMS, threshold-----

And people on trolleys.

-----there is the reduction in regard to medical card prescriptions and there is improvement in access. There are challenges and legacies arising out of Covid that Deputy McDonald should accept because it is obvious. It is obvious to anybody watching the situation.

There was already a crisis before Covid.