The HSE is running from one disaster to another. The budget overrun last year of up to €1 billion still goes unrecognised by the State as though it were a few hundred euro. Overcrowding in our hospitals in 2023 was the worst on record. The number of patients on trolleys in University Hospital Limerick in 2023 was 21,143; Cork University Hospital, 12,487; University Hospital Galway, 8,914; Sligo University Hospital, 8,094; and St. Vincent's University Hospital, Dublin, 6,555. These are astonishing figures, which go unnoticed year after year by this and previous Governments, leaving HSE hospital staff burned out. The shortage of GPs is a cause of huge concern, with many GPs reluctant to take on new medical card patients as it is simply not viable. In my constituency of Cork South-West, SouthDoc services are gone in most parts of west Cork. The only remaining SouthDoc service is in Bantry. Dentists are reluctant to take new medical card patients as it is no longer viable for them. In west Cork, the school dentist practices in Castletownbere, Dunmanway, Schull and Skibbereen have been closed down leaving parents travelling all over the country to get dental services for their children. Podiatry services for older people are on a very limited basis, now disqualifying many elderly people who genuinely need foot care. We have a severe shortage of HSE occupational therapists, OTs, forcing people to pay for a vital service that many cannot afford. We have huge waiting lists for physiotherapy, forcing those who again cannot afford it to pay for a private practitioner. The home help situation is at an all-time low, with carers who mind loved ones pleading for more home help hours and more patients awaiting discharge, who cannot go home as they await a homecare package to be put in place due to a lack of home help services. Now, changes to home help services in parts of west Cork will see people who had two home-helpers a week now having four without any extension of time, which upsets many people because they have built up relationships with their home helpers. Parents of children with additional needs are now waiting lengthy periods to get services such as OT, speech and language therapy and psychological and psychiatric services. Respite for carers of adults with intellectual and physical disabilities has not been available since before the Covid-19 pandemic.

This is a factual list that surely every politician has. Last week I spoke with a man in St. Vincent's University Hospital, Dublin who spent 18 hours in a chair and the following five days on a trolley. I also spoke to a Clonakilty lady who spent nine days on a trolley in CUH last week. Who is in charge? Where is the HSE budget going? Where did the €1 billion overspend go last year? Does the Tánaiste accept that the HSE, as a delivery vehicle for the services I mentioned, has failed the people miserably? Will we have any accountability?

I thank the Deputy for his presentation and for raising the issue of health services.

On the question of who is in charge, factually, I presume the Deputy will be aware that Bernard Gloster is the CEO of the HSE and Deputy Stephen Donnelly is the Minister for Health.

There are 26,172 more staff working in our health service now than there were at the beginning of 2020. That is 26,000 additional staff the Deputy did not refer to in his opening remarks, including more than 8,000 midwives, which is a 21% increase. According to the OECD frameworks and assessment of various health services, we are one of the top countries in respect of the number of nurses per patients. We have an additional 4,000 health and social care professionals and close to 3,000 additional doctors and dentists. We have cut costs for patients across the board, as the Deputy will be aware. We have removed inpatient hospital charges. We have had the biggest expansion of access to free GP care in the history of the State, to 500,000 more people. That means that up to 60% of our population is now eligible for a GP card or medical card. We have reduced the drugs payment scheme cost. We have significantly funded diagnostic scans for patients. We introduced free contraception for women up to the age of 31. For the first time, we have providing funding for assisted human reproduction, including in vitro fertilisation, IVF, and we agreed a new consultant contract, which is significant with respect to increased activity. More than 1,700 consultants have signed up to that new contract. The Deputy must also be aware that in the past two years we have built up an entire new community health service from scratch, including primary care, chronic disease management, older persons services and ambulance services, employing of thousands of new people in the community. We have increased our acute hospital bed capacity by 1,126 beds in the past three years, expanded our intensive care unit, ICU, capacity by 25%, and new primary care centres have opened up all over the country. We increased college and training places to deal with what were challenges in getting new recruits and so on. Some 662 student places have been provided in the higher education sector on health-related courses this academic year, including 200 student places in nursing, midwifery and therapy professions in Northern Ireland. Today for every GP who retires between one and a half and three new GPs are starting work. Waiting times are coming down and we have provided a significant transformation in women's healthcare, with more CIN3, gynaecological and fertility hubs and specialist menopause clinics.

The context of what the Deputy said is that the population is rising. It has risen significantly-----

Time is up now please.

-----and I acknowledge that continues to place strain on services but the Deputy has to acknowledge the enormous increase in investment and resources that has occurred.

I thank the Tánaiste for his reply. He mentioned 26,000 additional staff but he admitted in the end that we have had huge population growth. The problem is, as he said, the Government is cutting costs. It is certainly cutting costs and I told him where all the costs were cut and where people are finding it extremely difficult to access services. Up to 1 million people are on waiting lists, some of whom are waiting two, three, four or five years for simple procedures. That is where the problem is. The new Silverwood unit was opened in Clonakilty hospital last week, which patients are being moved into. That is positive but the staff have come to me and told me they were under extreme pressure. I acted on that and I want to find out whether the old units that were closed will be filled with the same number of people as before. It is the same with the mental health unit in Bantry, which we were led to believe would be completed in January 2024. It has been put off until July. With the children's hospital in Dublin getting an increased budget of €510 million this week, bringing the total build cost to €2.24 billion, although it was initially estimated to cost €1.73 billion,-----

Time is up now, please.

-----surely what I have told the Tánaiste today shows that something is seriously wrong with the HSE. What will the Government do about it?

I welcome that the Deputy acknowledged the Government funding for Clonakilty Community Hospital. It is not a normal pattern of political behaviour on his part to acknowledge Government funding where it happens. I welcome that Government funding has enabled what we both agree is a fantastic service and facility for the people of Clonakilty agus an dúiche mórthimpeall.

The children's hospital is potentially for every child in Ireland and it is certainly for children in west Cork who need access to specialist treatment.

They cannot get in there. How will they get there?

It has been a long saga, without question. Issues arose about structures and all the rest of it, but I am in no doubt that in the context of our current services in Crumlin or Temple Street, the sooner we get this hospital built and operational, the better. It will be transformative for children in terms of having single suites, the theatre capacity, infection control and, especially for children with conditions that make them vulnerable, it will be transformative.

I understand the negativity. Accountability is important, but equally, we need to focus on what this will mean for the children of the country, including those from west Cork who will have to avail of these services.

€2.4 billion.

There was no accountability in all this.