I wish to raise the orthopaedic waiting lists in the Galway region. Last Monday, a young man came to my office. He is 27 years old and is married with two children. He has been working, his wife is working and they have a mortgage. Unfortunately, he had an accident and he is waiting for treatment. He tried to continue to work but he had to give up the work five weeks ago. He was getting some painkillers for the pain. He was told when he was getting the injections that they would last up to six months. The pain left him for five and a half weeks. The prospect before him is 18 months waiting for an assessment. Then he will have to wait another four years for surgery. That is what he has been told by the hospital. This young man cannot lift his children, he cannot drive and he can hardly walk. That is his current position. He is relying on his mother to bring him to the doctor and relies on his father to help around the house. He has a mortgage to pay, which he is struggling to do. This is not somebody who is looking for a handout or for something soft.

This is what is happening with the services in the orthopaedic unit in Galway. There are massive delays. When Covid-19 started, I remember the Tánaiste coming down the steps from Government Buildings to address the nation and setting aside all rules and regulations to make sure we dealt with it. Today, the Taoiseach, the Tánaiste and the Minister, Deputy Eamon Ryan, need to come down those steps again and tell us how we are going to address our fractured health system.

The system was creaking before Covid but it has been further scarred by the effects of the pandemic. It is important that we get the health service right. We need infrastructure, additional beds, additional staff - when I say "staff" I mean nurses - and functioning accident and emergency units. We also need to put in place the necessary services our people deserve. We need to dispense with these codes for public procurement and appraisals for every project we have to undertake. The Minister for Public Expenditure and Reform, Deputy Michael McGrath, is in the Chamber. He has to take on board the fact that we cannot continue with the same processes, while the Minister for Health, Deputy Stephen Donnelly, who is sitting beside him, is trying to improve services. We need to take immediate, emergency, essential actions to make sure that whatever projects we have in place to improve our infrastructure and capacity are done rather than spending years looking at them.

I am afraid I do not have a specific note on orthopaedic waiting lists in Galway but I will make sure we get one and that we give the Deputy a fuller reply later. I acknowledge there are far too many people waiting far too long for the operations they need in Galway and in all parts of the country. Notwithstanding the fact we probably have 1,000 more beds than we had two years ago, more staff in our health service than ever before, a bigger budget than ever before, and more doctors than ever before working in our health service, we are, essentially, running up an escalator that is coming down at us. That is because of an increasing and ageing population with increased needs, a pandemic and a cyberattack. That has put us in a position that is not where we wanted or expected to be at this stage.

We have an ambitious plan to reduce waiting lists that has been published. The Minister for Health and I have been down the steps already with that plan. It is a €350 million plan to improve waiting times in 2022. It is the biggest waiting list plan I have seen in my time in politics by quite a distance. If it works, and a lot will depend on whether we get hit by serious waves of Covid, we should have fewer people on active waiting lists by the end of this year than at any point in the past five years. I am not saying we will get there but it will be a huge achievement if we can get to the point, by the end of the year, where waiting lists will be at a five-year low.

Every patient waiting more than six months for a high-volume procedure, which includes the vast majority of orthopaedic procedures, will be offered treatment through the National Treatment Purchase Fund, NTPF, this year. The waiting list action plan identifies 15 high-volume procedures. The commitment is made that anybody who is waiting more than six months and is clinically suitable can receive his or her care through the NTPF. That fund has confirmed it has authorised offers of treatment to almost 7,000 people and has sufficient capacity to increase what it is doing by approximately 100% by September 2022, thereby offering treatment to all 75,000 patients who are waiting for these procedures by the end of the year.

There are plans to improve waiting lists and money is going into the system as if nothing else is happening. I have a concern about all this money going in on the basis that, at the end of the day, it is not getting to the end user or patient. There is significant problem with staff morale. Nurses are leaving the public health service because they are completely disillusioned with what is happening. We have fewer staff available to deal with patients on the wards.

There is a daft idea relating to primary care centres that have been built. For example, we have one in Tuam where there is no X-ray facility so everybody has to go to Galway to get their X-rays done. I have talked previously about this with the Minister for Health. His predecessor, Deputy Harris, allocated €700,000 to put an X-ray facility in that primary care centre approximately four years ago. Today, it still has not happened. The equipment has been bought, is being stored in Germany and is probably out of date at this stage. We just cannot build a room for it. That is just a typical example of the challenges we have and how we get around them. We need to look at this from a completely different perspective and get to the nub of the issue.

I am aware that Galway is the specialist tertiary centre for a significant swathe of the country. Waiting lists in Galway are comparatively worse than in other parts of the country, but there has been a lot of investment in recent years. There is now more than 4,000 staff between University Hospital Galway and Merlin Park University Hospital; that is a 12% increase since this Government was formed. The budget for both hospitals is now more than €400 million, which is a 10% increase since this Government was formed. Construction of a temporary emergency department is under way, which should be completed later this year. The building of a new radiation oncology unit is also under way. We are very keen to get the new emergency department, and the new maternity and paediatric units, into planning as soon as possible. I have spoken directly to the CEO of the HSE about this in the past couple of weeks. I share the enormous frustration that the project is progressing so slowly. I will take a personal interest in it.