Yesterday, a terrible fire broke out at Wexford General Hospital, which has led to the evacuation of more than 200 patients. Our thoughts this morning are with the people of Wexford. I commend everybody involved in the emergency response. In particular, I commend the Wexford fire brigade, all of our front-line healthcare workers, those in the ambulance service in the hospital and nearby hospitals and all of those who responded to the tragedy yesterday. The priority now must be to support patients, their families and the staff in our healthcare service. Their safety must come first. I offer our full support to the crisis management team and to our front-line heroes in Wexford, Waterford and Kilkenny and right across the State who have been asked, once again, to step up and respond to a crisis. I have no doubt they will continue to keep the health service running under immense pressure, just as they have always done, whether during the Covid pandemic, the cyberattack or what is now the constant year-long winter overcrowding crisis.

Tá ár smaointe ar maidin le muintir Loch Garman. Tugaim ár dtacaíocht iomlán dár laochra ar an líne thosaigh sa réigiún atá ag déileáil leis an ngéarchéim. Níl aon amhras orm ach go leanfaidh siad ar aghaidh ag coinneáil an tseirbhís sláinte ag dul, seirbhís atá faoi bhrú ollmhór, mar a rinne siad i gcónaí, fiú tríd an phaindéim Covid, tríd an chibirionsaí agus tríd an phlódú geimhridh.

It is essential that, while the healthcare service responds to the crisis, the Government responds quickly to support the health service and to put in place additional capacity and alternative care plans for these patients. As we know, it may be some time before full service resumes at Wexford. Appointments and procedures have necessarily been cancelled until it is safe for them to proceed. The disruption will undoubtedly cause much distress and anxiety to people in Wexford and the surrounding region. There are two important steps that must now be taken. First, the families must be kept fully informed. There needs to be really strong lines of communication with them throughout this crisis. This is particularly important for those who have been transferred a considerable distance, including as far as Drogheda, which will be difficult for their families, their loved ones and themselves. These families need to be engaged with, involved and supported right throughout this process.

Importantly, as the Tánaiste will know, our hospitals are already stretched thin and full to the brink. Overcrowding is systemic and widespread right across the State. In the south east, occupancy rates are as high as 95%. This will undoubtedly put significant additional strain on a healthcare service that is already at breaking point in the region. Not only must we restore Wexford hospital to full operational capacity as soon as is practically possible, but we must inject much-needed additional capacity into that region to manage the fallout. The Government needs to look at all options available in the short term. It needs to look at community capacity, private hospitals and nursing homes. The full healthcare capacity of the region must be marshalled and mobilised to support the State's response. As the Tánaiste will know, there are proposals for an additional 90 beds at Wexford and expansions for other hospitals in the region. These proposals now need to be fast-tracked and delivered at pace.

Can the Tánaiste confirm that there will be open, considerable and ongoing communication with the affected families? Can he confirm that his Government will go above and beyond to support Wexford and the region, to mobilise healthcare resources and to rapidly inject additional capacity into the region? Will he ensure that the crisis management team and the HSE have the full support and authority of the Government in doing everything they must as quickly as they can? Will the Tánaiste ensure that sufficient time is allocated as early as possible next week to ensure we have a proper, rounded and full debate on the response needed as a result of this incident?

I thank the Deputy for raising this issue. We were all shocked at the potential impact of such a disastrous fire in one of our major acute hospitals. If you stand back and think about what the implications could have been, it is clear we owe an extraordinary debt of gratitude to all of the essential services involved, especially the fire service and Civil Defence personnel who got there quickly and marshalled their resources expertly to reduce the impact of the fire, but also everybody working in the hospital and the HSE who managed to take out 207 patients under very stressful circumstances with no fatalities. We should pay tribute to all involved, first responders and emergency services. I will add to that the National Ambulance Service, which did incredible work in transporting patients from a very acute and stressful scene to other hospitals. At times, we can be rightly critical of our services but, at other times, we need to salute the bravery and courage of our fire service and all involved in activating the local and area emergency plans so effectively and efficiently. That underlines the importance of emergency planning and everybody putting the shoulder to the wheel to prevent disaster. I say that sincerely in respect of all involved.

Gabhaim buíochas leis na seirbhísí éigeandála agus gach éinne a bhí páirteach aréir as ucht an mhéid a dheineadar. Gan amhras, tá an ceart ag an Teachta go gcaithfidh an Rialtas gach aon rud is féidir linn a dhéanamh chun cabhair agus tacaíocht a thabhairt do mhuintir Loch Garman, pobal an ospidéil, gach éinne atá ag obair ann agus na hothair ach go háirithe. Táimid agus beimid sásta é seo a dhéanamh. Tá sé sin ríthábhachtach.

It is a big blow to the health services in the south east. It will have an impact on existing services as regards capacity to absorb and develop. Everything that can be done will be done to restore services as quickly as possible. A helpline has been established and can be reached at 053 9153012. It is for patients and families of patients. The Deputy is correct when he says that communication with families and with people awaiting appointments and so on in the coming days is very important. The HSE is aware of that. In many ways, the services are still in an emergency phase in managing the patient aspect and dimension of this. I refer not only to those who were in the hospital, but also to those who were scheduled to come to the hospital and those awaiting outpatient treatment. The HSE and the Minister will work with Government colleagues to determine how service provision - I am particularly thinking about diagnostics and outpatient care - in the interim period can be organised as quickly as possible, potentially in different locations, to get certain basic things done. I refer to things such as the restoration of minor injuries units in the quick phase. Obviously, the implications of this fire for the general structure of the hospital and its impact on services will have to be assessed but we are focused on and conscious of the need to get services back as quickly as we can. There is a significant continuum of services involved, ranging from outpatient care and diagnostics right through to acute and emergency care. It will be challenging. There is no point in saying it will not. However, I would like to think that, as we rebuild from the ashes of this fire, we can create a modern 21st century facility in Wexford.

It is at times like these that we recognise the value of the emergency services. I saw it myself, standing at the lines in Creeslough where people were rushing in to a building that could collapse and, again, yesterday evening, as people risked their own lives to make sure that other lives were saved. Thankfully, we are standing here today with a plan that was executed without fault in relation to the safety of patients. That needs to be our focus in the time ahead.

We are conscious that this is still, as the Tánaiste said, an emergency phase but we need to hear of some actions now in relation to where we go forward. There are the concerns, as the Tánaiste will recognise, of people who have had appointments cancelled. Is there any information that we can provide them in relation to whether they are likely to be rescheduled in other hospitals over the intervening period?

In relation to capacity in the region, as the House will be aware, for eight years this 90-bed ward has been talked about. It has not been delivered. Is the Government committed now, as the Tánaiste mentioned, that from the ashes of this here we can ensure that the capacity is injected into the region to make sure that we support it? Crucially, can we provide adequate time next week to look at the response and to make sure that we respond in an appropriate way when we have more information?

First, I take the points that the Deputy has made in good faith, of course. On the earlier point the Deputy made, it is worth reflecting that the Health Service Executive, which comes in for criticism from time to time, in the context of Covid, the cyberattack and now this, has responded in a coherent, effective way to real emergencies. These have been three that we can identify. That needs to be put on the record. I thank all of the HSE staff, from the leadership down, for the magnificent manner in which they have responded as a service to this terrible event that has happened.

Second, in terms of the 92-bed unit-----

Ninety-six.

In terms of this opportunity, by which I mean we are building now anew and fresh, we should examine how we deal with the future needs of the hospital in Wexford. That is my view. Obviously, the Cabinet will discuss this. There are opportunities. Also, it is an emergency. We have to look at the planning situation and see what we can do to expedite the return of permanent facilities here.

In the interim, we have to allow the HSE do the assessment. Following that assessment, it can plan out the programme of interventions.

Can we have time next week?

Hopefully, yes, but we might discuss that. We want to give those at the coalface the opportunity to get the main work done first and, of course, to come back to us then.

There is a palpable sense of relief in Wexford this morning. What could yesterday evening have become an historic tragedy was averted by the calm, dedicated professionalism of the emergency services in Wexford. Our fire brigade, local authority staff, Civil Defence, ambulance services, hospital staff and management, the voluntary sector and, indeed, private ambulance operators all immediately rallied to the cause supported magnificently by the entire health community. All are due remarkable praise for an outstanding response.

The emergency plan that the Tánaiste has indicated was activated and, more importantly, worked and now, I understand, has been stood down.

Understandably, the focus now moves to dealing with the consequences of this terrible fire. Two hundred and twenty-one patients were in Wexford hospital yesterday evening. Over 180 have now been dislodged to hospitals from Waterford to Navan. The challenge now is how we are to continue with their care plans in a seamless and uninterrupted way ensuring their medical charts are available and that their families are kept fully informed of their medical progress.

Clear information has to be provided for the 165,000 people of Wexford who depend on their hospital for vital services. Expectant mothers are looking forward to delivering yellow bellies in their hospital. What is to happen? What arrangements are made for them? There are patients in the middle of treatment for cancer or for any number of life-threatening illnesses. Of course, the people of Wexford will continue to experience, today, tomorrow and the day after, heart attacks, road traffic accidents and other urgent issues that require timely medical responses.

Responding to this, as the Tánaiste says, will be enormously challenging. The crisis management team has been in session in the hospital since early morning and we will learn further of its plans today.

For the Government, the requirement is to act with the same speed and determination as the emergency services did and with the same clarity in its response. The asks I put to the Tánaiste today are to commit, on behalf of the Government, to provide whatever resources are needed to bring Wexford Hospital back into use - that means temporary provision plant equipment to get services up and running in those parts of the hospital that can be brought immediately back into use and the immediate sanctioning of the resources for construction and replacement of the damaged infrastructure; the deployment of whatever ambulance resources are needed, including emergency medical technicians, EMTs, and vehicles to ensure that there is a timely medical response in the county; and to commit to the fast-tracking of the long-promised 96-bed unit that officially is still awaiting a strategic assessment report - that must happen urgently.

The community rallied to this tragedy. We must do the same. Wexford, as I say, has responded magnificently to this destructive event. I am asking for the same determined, clear and unequivocal response from the Government.

I thank Deputy Howlin for raising the issue. The Deputy is personally committed to Wexford Hospital, as he has been for all of his political life, as indeed all of his colleagues representing the county have as well.

Deputy Howlin is correct. A disaster, on one level, has been averted in the sense of no loss of life and injury. It is quite incredible to comprehend the degree to which the fire services, the first responders and the ambulance service all got together so quickly to prevent disaster from unfolding in terms of human fatality and injury as a result of this fire.

Mar a dúirt an Teachta, ní neart go cur le chéile. Bhí spiorad na meithle le feiscint agus le brath aréir i Loch Garman. Táimid go léir buíoch de gach aon duine a ghlac páirt chun cabhair agus tacaíocht a thabhairt do dhaoine aréir.

As the Deputy said, the crisis management team is meeting today. The Government is clear and is determined to do whatever it takes to provide services for all those impacted in Wexford as a result of this and in the hinterland the hospital serves. We are determined to do everything we possibly can to help to assist and provide for services.

This is an emergency that has arisen because of this fire and we have to allow those at the coalface to put the nuts and bolts together in terms of the pathways for the patients and the protocols in respect of emergency responses to cardiac situations and how we deal with cancer patients. The entire health service nationally has to rally to this cause now because we have to respond in the manner that the Deputy has suggested.

As I said earlier, we should take the opportunity, in terms of a new build or a rebuild, to encompass additional capacity as well in terms of the 72 beds or 76 beds that have been promised -

Ninety-six.

-----sorry, 96 - the additional capacity as committed - because the population is growing. One of the big issues in terms of public services more generally over the past decade has been the growth in population. As we configure our services into the future, we have to think about that increased population. It is growing fast now and will continue to.

I trust the clinicians and those at the coalface to map out for us in government their recommended pathways and approaches to deal with an emergency situation of this kind. The first responder service will be crucial and we need to engage with the National Ambulance Service. In a cardiac situation, in particular, or in other accidents, that first response is the key response to eventual survival and to outcome in respect of particular sudden medical emergencies that can emerge. Sometimes that role of the first responder is under-appreciated in such a context.

Bhí spiorad agus cumhacht muintir Loch Garman sofheicthe tráthnóna inné. Tá an spiorad céanna ag teastáil ón Rialtas inniu. The commitment must be that whatever emerges today from the emergency planning task force, which is sitting as we speak, whatever is requested in terms of additional vehicles for the ambulance service will be provided. It is a long way from the south-east corner of Wexford to another hospital if Wexford General Hospital is not available so that must be provided, along with interim steps. There must be a commitment that whatever resources are required in the medium term to bring Wexford General Hospital, which is important and vital infrastructure for the county of Wexford and the south east, back into full function as speedily as possible, will be provided.

The Ceann Comhairle visited Ukraine and I visited a war-torn area where a hospital had been destroyed and was replaced by a field hospital provided by Denmark instantly. These things are possible where there is a will. I want that same warlike determination to be applied to this to assure the people of Wexford that nobody will die. After the heroic work of the firefighters and others yesterday, nobody should die because of the medium or long-term consequences of this disastrous event.

As I said, the Government will respond with clarity, commitment and resources to do everything we can to make sure we look after the patients who have been discommoded significantly as a result of this tragedy and meet the broader health needs of those served by the hospital, the consultants, the various clinics and so on. We expect that an assessment will be made quickly, both physically and in terms of what programmes and services we can get back more quickly. That is the approach I envisage and anticipate.

The Government must do what is required.

We must have a multidisciplinary approach and examine what can be done without patients and what can be done with various different services. We should allow the experts at the coalface to come back to us. The Government will respond to say what we think is the best way to deal with oncology, diagnostics and outpatient appointments, for example. That is immediate-----

The clarity that is required is that the Government is committed that everything that was in Wexford General Hospital will be back.

We have said that and there is no issue around that. No one anticipated that what happened last night would happen; it was quite shocking. As we have all agreed, when you think about it the implications could have been horrendous. We cannot get around that; it is just incredible that our services worked so well and that is the relief I take from it. Our response has to match that; I agree on that point.