In ár n-ospidéil ar fud an Stáit, bíonn othair a bhfuil cúram práinneach nó éigeandála de dhíth orthu fágtha agus ag fanacht ar feadh uaireanta fada gan leapa agus ar thralaithe. Chuala muid inné faoi fear 87 bliana d’aois a chaith 100 uair in ionad éigeandála in Ospidéal Ollscoile Luimnigh. Tá sé seo scannalach. Tá an Rialtas ag teipeadh ar othair agus ar ár bhfoirne atá ag obair sna hospidéil.

This morning, Professor Conor Deasy, president of the Irish Association of Emergency Medicine, commented on the ongoing scandal in emergency departments. What he had to say should be sending shockwaves through Government Buildings. He described what he called a “dreadful” situation for patients who are waiting for care. He raised the difficulties that staff are facing to provide the care that patients are entitled to. Professor Deasy said: “These patients deserve to be in a hospital bed, a ward bed, and they are being accommodated on the corridors of the wards”. Of course, he is right. Describing the situation at Cork University Hospital, he said that people seem to have become immune to the level of overcrowding in the hospitals and that it is costing lives. He is telling the Government that it is costing lives. Cork University Hospital, which the Tánaiste knows well, is operating at 300% capacity this morning, which is scandalous. Patients in need of urgent and emergency care are languishing for hours on end. Some are putting off even going to the hospital at all.

We heard earlier this week of the case of an 87-year-old man in Limerick. He was left waiting for 100 hours in the emergency department. The Tánaiste and the Government do not seem to care that this is happening on their watch, and it is getting worse. The reliance on trolleys has continued every single year since the Tánaiste was Minister for Health and it has got worse year by year. The INMO yesterday said that overcrowding is leading to very dangerous situations. The situation persists and worsens in hospitals across the State. Dr. Laura Durcan is a consultant rheumatologist at Beaumont Hospital and also the former vice president of the Irish Hospital Consultants Association. She described how admitted patients are in every corner of the hospital. In her words, there is no corner of the hospital that is not at the moment housing an acutely unwell patient who has been admitted from the emergency department.

The facts and the reality are that the Government has abandoned patients and workers to this emergency department chaos. They are in a dangerous system because of the Government and the Minister for Health’s policies. The crisis has been caused by their decisions. I have no confidence in the Government's ability to tackle the trolley crisis. It has missed its waiting list targets and trolley targets and it has stopped the health service from receiving the funding it requires to recruit the front-line staff it needs. It is stumbling from one disaster to another. The consequences are the 87-year-old gentleman in Limerick and the hundreds of others who are languishing on trolleys and chairs in emergency departments.

The fact is we need 1,000 more hospital beds right now. We need 1,500 more beds by the end of next year and at least 2,500 additional beds by 2030, according to the ESRI. We need a strategic workforce plan to train, recruit and retain health workers. To tackle overcrowding, we need a multi-annual plan. Does the Government have one? Of course, it does not. We have heard many announcements of plans for new beds but the Government decided not to fund them in the recent budget. Indeed, it went further and underfunded health this year because it has thrown in the towel. I want to ask this question because the Government is simply incapable of getting the basics right. Will the Government reverse the disastrous decision not to fund the additional beds that are required and immediately approve the funding for those beds that our hospitals desperately need?

Ní aontaím leis an Teachta. Admhaím ar dtús go bhfuil na hospidéil agus na hionaid éigeandála faoi bhrú faoi láthair ach tá plean ann. Ní plean gearrthéarmach atá ann anois, ach plean don bhliain ar fad. Tá infheistíocht faoi leith curtha isteach in ospidéil na tíre seo ó tháinig an Rialtas seo ar an bhfód. Ní raibh a leithéid d’infheistíocht ann le blianta fada. Is í sin fírinne an scéil.

The investment in health has been unprecedented in theplast four years, with €7.1 billion extra since 2019. The Deputy should not be saying that no one cares or that people have thrown in the towel. That is not correct. We need a reasoned, balanced and rational debate, not just shouting and roaring, getting angry and accusing people of bad faith. There has been a 51% increase in about three years. It is an extraordinary investment. Yes, there have been very significant pressures on emergency departments but trolley numbers have come down by about 22% nationally. What is critical is patient flow within hospitals and discharge policies. I know the HSE has been in touch with Cork University Hospital in respect of patient flow and discharges and there have been some improvements. We saw at Waterford hospital how locally approved and applied policies had a very effective outcome in respect of delays.

No patient should be 100 hours on a trolley and that cannot be just apportioned to national allocation of funding. In my view, no elderly person should be 100 hours on any trolley. There are issues there that are not just about national allocations of funding. We need reforms of how patient flow and discharge are managed. In addition, we need extra capacity, and we have increased ICU capacity by 24% since we came into office and increased the number of beds. There are very significant capital proposals and projects in the pipeline for Cork University Hospital in terms of surgical hubs and a new paediatric unit. We have already had significant investment in that hospital in this respect and we need to do more. We have received proposals in respect of a number of significant projects, including trauma, which we approved. This Government, for the first time, has a major trauma investment programme, which has included Cork University Hospital, along with the Dublin hospital, because Cork is a major trauma centre and one of the largest in the country from that perspective.

We will continue to invest. In the OECD Health at a Glance report comparing Ireland with other EU member states, we ranked second-highest in the OECD for practising nurses per 1,000 population and 12th-highest for practising doctors per 1,000 population among 25 participating EU member states in 2021. That figure has since gone up. We need to put this debate in perspective. Very substantial resources have been allocated to health. The population has increased, which I acknowledge, but along with and in parallel with increased resources, we have to consistently look at how we organise our hospitals in terms of ensuring reforms across the board into the future.

I will say that the Government does not care because a government that did care would actually listen to the ESRI when it says we need 1,000 more beds now.

The Department of Health has a plan for those beds. The problem is that the Government, of which the Tánaiste is a part, made a decision not to fund those beds. There is no way you can slice, dice or spin it around. The Government made a conscious decision not to fund the additional beds. Then the Tánaiste says nobody should be on a trolley for 100 hours. The reality is that in many of these hospitals the bed capacity is simply not there and the Government is making conscious decisions not to allow the Department which has gone out to tender to actually ensure that these beds are in our hospitals in the future. You cannot have it both ways because this rests on the Tánaiste's shoulders. The Government has missed its targets on trolleys and waiting lists and it is blocking the funding for the additional beds that the Department wants to deliver. That is the reality of it. Professor Conor Deasy, not Sinn Féin, is saying that this is costing lives. Other professors are telling us that our hospitals are running at 300% capacity on the Tánaiste’s watch. The hospital in his county is running at that and he is telling us he is doing everything. He is not. What we need is a multiannual plan. We need the Government to allow the Department of Health to fund the beds that are needed and to lift the recruitment embargo to ensure that the staff who are needed in our hospitals are actually recruited. That is a government that cares. I put to him to do those three things and then I will stand up and say, “Yes, this Government does care”.

First, the Deputy’s analysis is wrong, actually. We need a multidimensional approach to healthcare. The Deputy is falling into the old trap. It is about tertiary hospital capacity for him but actually it is not. That is an important part of it but it is about building up community care and primary care. I attended Ballincollig primary care centre two weeks ago. It is a fantastic multidisciplinary facility. It deals with eye diagnostics and treatments, mental health treatment, chronic illness and a whole range of disciplines which will prevent people in the first place -----

Tánaiste -----

Ah, keep quiet, Deputy Gould.

Deputy.

Right now, my wife is in a primary care centre and she cannot get an appointment.

Deputy.

Right now she is there. She is on to me now. She is in a primary care centre in Gurranabraher and she cannot get an appointment for our sick child.

Deputy Gould.

So do not tell me about it. She is up there now.

Deputy Gould.

Talking about primary care centres. I have a sick child at home and cannot get a GP appointment and you tell me about primary care.

Deputy Gould, kindly do not disrespect the Chair. Will you please have the good manners to listen to the reply to the question posed by your acting leader?

It is a well-worn tactic to interrupt me every time I respond. There was very significant investment in Gurranabraher in primary care and enhanced community care. We have to be very careful that we do not lose out on the huge momentum that is being built up in terms of community and enhanced care and primary care because that ultimately helps to keep patients out of emergency departments. Many patients can be treated through these services in a much more effective way, working in an integrated way with the hospitals and with tertiary care. There is no question about that in terms of outpatient care and various treatments that can be done and in chronic illness.

The question was why the Government is blocking funding for the beds.

We are not. We have increased the number of beds by over 1,000. CUH, two or three years ago, was a bit slow in making submissions on the capital projects. There is new governance there now. The projects have come in. The Deputy does not have to lecture me about Cork or investment at Cork hospitals. I was the Minister for Health. It is the only hospital that has a maternity hospital on site with a tertiary hospital because the investment I made over 20 years ago along with a lot more as well.

And lives are being lost because of your policies.

Please, Deputy. We go to Deputy Cairns.