I express my condolences to the family and friends of Kim Damti. Their heartbreak, grief and immense pain are things no family should ever have to experience. I wish Kim's family, and all of her friends who loved her, strength at these very difficult times. Ar dheis Dé go raibh a h-anam dílis.

As we turn towards the budget, tá sé soiléir go bhfuil an Rialtas seo i ndiaidh an tuáille a chaitheamh isteach ó thaobh ár seirbhísí sláinte. Cé nach raibh an ghéarchéim inár seirbhísí sláinte níos measa riamh, ní raibh siad mar thosaíocht i mbuiséad an Rialtais.

Our health services are under enormous and unprecedented pressure. Hospitals are persistently and dangerously overcrowded to record levels. Hundreds of thousands of people are on treatment waiting lists. Kids are left in agony and spinal procedures that would change their lives are going undelivered. Children and adolescent mental health services are on the floor, and nurses, doctors and other front-line staff are working under conditions that are so difficult that we have a serious recruitment and retention crisis across the board. The chronic and deepening crisis in health sees so many of our people locked out of the care they need.

Yet looking at the budget, you would believe that the Government thought none of this was happening. At a time when the crisis has never been worse, it beggars belief that health was not a priority for the Government in its budget. Our health service required ambitious investment and a radical plan, one that ensured additional beds and staff so that patients could get the right care right across the system. Instead the Government gave the health service less than half of what it needs just to stand still - not to improve, progress or turn the tide but just to stand still. That is shocking.

Hear, hear.

What happened to the promise made by the Minister for Health, Deputy Donnelly, of 1,5000 additional hospital beds? He announced it on three occasions. That promise has melted away like snow on the ditch. It seems that the Minister was hung out to dry by a Government that has backed his incompetence every step of the way. It is clear to everybody that the Minister is out of his depth. He has no real plan to transform our health services and makes it up as he goes along.

What does the Government's failure to provide the necessary investment in health mean in plain terms? Let me break it down. There is no additional money for national strategies to improve cardiac, cancer and maternity services. There is no additional money to cut the cost of healthcare. There is no additional money for new medicines and therapies for patients with cancer. There is very little, if any, additional money for mental health services and child and adolescent mental health services, CAMHS. As section 39 and other workers prepare to strike next week, there is no guarantee of addressing pay inequality for those who care for our most vulnerable. Incredibly, as the Government breaks new records with hundreds of people on hospital trolleys daily, it has not provided for a single additional hospital bed anywhere in the State.

This budget is a disaster for our health service. It means the crisis in our health service is going to continue. Chronic waiting lists will continue. Overcrowding will continue and the Government has made sure of that. When things in hospitals get bad this winter, and when they get worse again next winter, the Government should remember why it is happening. It is happening because of the Government's choices. That will be why it is happening. The Government had an alternative. Sinn Féin put forward a plan to deliver extra beds and the resources our hospitals need. What did the Government do? It ignored it.

My question to the Tánaiste, on behalf of his Cabinet, is why the Government decided to throw in the towel on health. What does he say to the hundreds of thousands of people who are locked out of healthcare and who the Government has failed with this budget?

On my behalf and that of the Government and the people of Ireland, I convey heartfelt condolences to the family of Kim Damti in Ireland and Israel. This was an horrific, indiscriminate, random and barbarous attack on the Israeli people resulting in up to 1,300 people, including Kim, losing their lives. Anyone looking at the photograph of Kim in the media in recent days will have been struck by the radiance and energy in her expression. She was a young 22-year-old with her full life ahead of her only for it to be cut down in a barbaric way. Our thoughts remain, in particular, with her family at this very sad moment.

Ní aontaím leis an méid a bhí le rá ag an Teachta ó thaobh cúrsaí sláinte na tíre. Níl aon amhras ach go bhfuil infheistíocht ollmhór - suas le €7.5 billiún - curtha isteach againn sna seirbhísí ó thosaigh an Rialtas seo. Tá méadú an-mhór le feiscint sna seirbhísí sláinte de bharr na hinfheistíochta sin.

I thank the Deputy for the question but do not agree with his assessment and assertions in respect of the health service and the Government's commitment to and prioritisation of health. Disability has transferred to the Department of Children, Equality, Disability, Integration and Youth, which takes away some of the allocation that would have been in the health budget. That allocation has now gone over to that other Department. More fundamentally, more than €7 billion in additional funding has been allocated to the health service since 2020. That has resulted in an expansion of services across the board. There has been an expansion in capacity across the board. The funding this year will include staffing for new hospitals, ICUs, and community beds. It includes staffing for the six surgical hubs. It includes investments in our workforce, such as advanced practice, more college and training places and more hospital consultants. We will continue to invest in our community services through funding for mental health services, social inclusion measures and services for older people. We have recruited up to 22,000 extra people to the health service since this Government was formed. We have delivered record levels of investment in our health service.

We have also cut costs for patients across the board, to which the Deputy did not refer at all. We have removed inpatient hospital charges. We have had the biggest expansion of access to free GP care in the history of the State. It is available now to half a million more people. To put that in context, up to 60% of our population now hold a GP card or medical card. We have reduced the cost of the drug payment scheme. We have funded diagnostic scans for patients. We have introduced free contraception for women up to the age of 31. We are now publicly funding assisted human reproduction, including IVF. We have agreed a new consultant contract, with more than 800 consultants already signed up. There has been a 22% reduction in the number of patients on waiting lists who are exceeding the Sláintecare waiting time targets since the Covid-19-related peak. We have, in just the past two years, built up an entirely new community health service, including primary care, chronic disease management, older person services and ambulance services. As I have said, we have added 22,000 new staff since 2020. We have increased our hospital bed capacity by more than 1,000 in the same timeframe.

We have expanded our ICU bed capacity. It is not just beds, of course. It is the multidisciplinary teams that go with that. We have built a network of new primary care centres around the country. This level of investment is helping the health sector to meet the increasing levels of demand it is meeting. We now have one of the highest life expectancies in the European Union. Our survival rates for cancer, stroke, infant mortality and heart disease have hugely improved and our outcomes clearly show that our health service is delivering quality care across hospitals all over the country. We are-----

I thank the Tánaiste.

I can deal with it in the supplementary answer.

What land is the Tánaiste living in? He can walk into any of our hospitals any day of the week, any week of the year and he will see patients on trolleys or in chairs who have been admitted to hospital but cannot get into a bed. Why? Because the beds do not exist. The Economic and Social Research Institute, ESRI, told the Government that we need 1,000 beds right now and approximately 300 to 400 beds every single year. The Minister for Health said he was going to deliver 1,500 rapid beds. The Department of Health even put out an expression of interest.

The Government funded not one single euro for any additional bed despite the fact that it has broken new records in terms of the numbers of people overcrowding our hospitals in accident and emergency departments at the start of this year when more than 900 patients were without a bed and lying on trolleys. Those are the facts. Since the Minister for Health took office, our waiting lists have been growing with 40,000 more people languishing on waiting lists. We have people who are waiting for critical surgeries who are not able to get them year after year because the investment is not being made. The Department of Health and HSE told the Government what was needed to stand still. To leave the crisis we have at the same level next year, they told the Government what was needed, and it funded half of it.

I thank the Deputy. Time is up now.

The Minister for Health acknowledges that the Government has underfunded health so why did the Government throw in the towel? The Tánaiste knows it has thrown in the towel.

Time is up, Deputy.

Why did Government decide to do this and abandon all of these patients-----

Time is up, Deputy, please.

-----who we will hear about in the weeks and days to come?

Hear, hear.

Is "throw in the towel" the Deputy's new phrase?

It is true.

I heard it the other day. There were one or two other phrases-----

That is the Government's new response to every crisis - throw in the towel.

-----that become the norm during opposition, such as "missed opportunity", etc.

Put manners on them.

The bottom line is that the Deputy has not acknowledged the fact that there have been unprecedented and record levels of investment in the last three years in our health services. He has ignored the fact that we have come through a one in a century global pandemic, which has had a huge impact on our health service and continues to have an impact on our health services with, yes, dramatic increases-----

And the Government decided not to increase funding.

Please, Deputy. The Tánaiste without interruption.

-----in attendances, treatments and people requiring interventions. We have not been found wanting-----

You have.

Deputy Doherty, please.

The Government has underfunded health.

We have not been found wanting over the last three years-----

The Government has underfunded health.

Deputy Doherty.

-----in relation to our health service-----

It is going to create a disaster in the health services. The Tánaiste knows it and the Minister for Health knows it.

Deputy Doherty, please.

-----and we will not be found wanting again. Deputy Doherty can shout all he wants, and he shouts a lot.

Hear, hear.

He certainly shouts when he is endeavouring to refuse other people an opportunity to speak. Shouting and roaring about issues does not solve or resolve them.

I am challenging the Tánaiste's spin.

I acknowledge, through the Chair, that we have huge challenges facing health because when a budget goes up to €7 billion-plus in three years, we need to take stock.

Time is up now, Tánaiste, please.

We need to analyse and prepare for the future-----

Therefore, let us not deliver any additional beds.

-----which is what we have done-----

Let us not deliver any additional beds. Let the numbers go sky-high.

Deputy Doherty, please.

-----which is what we have done with the investment funds the Minister for Finance has provided.

It is ridiculous.

This is pathetic.

Deputy, please.

I apologise. However, the patients will suffer as a result of this.

He does it all the time.

Deputy, please.

Patients are going to suffer in every single constituency as a result of this-----

Stop shouting.

-----and the Government knows it-----

Stop shouting.

-----and the backbenchers know it also.

Stop shouting.

The Minister for Health is telling them.

Is Deputy Doherty putting manners on us?

The Minister for Health is telling them this.

Is the Deputy putting manners on us?

Can we move on to Deputy Cairns, please?