More than 11,000 patients waited on hospital trolleys last month. University Hospital Limerick again had the highest figure of any hospital in the State, closely followed by University Hospital Galway. The trolley crisis is now a year-round emergency. Our hospitals are under enormous and sustained pressure. Yesterday the Minister for Health, Deputy Donnelly, announced that a HSE support team is to be deployed to University Hospital Limerick. This hospital is in a state of constant crisis, with an emergency department pushed to the brink every single day. A HSE support team is welcome but it is a drop in the ocean when it comes to what University Hospital Limerick needs. It will not alter the hospital’s needs.

The hospital needs 288 extra beds. It needs to hire 200 vital staff, including 20 emergency Department nurses, and it needs the Government to lift the recruitment embargo immediately. This embargo is very dangerous. The system is at breaking point, yet the Government, with its eyes wide open, is choosing to block the hiring of healthcare staff. By imposing and maintaining this embargo, it has chosen to make a bad situation worse. The consequences of the embargo are felt right across the health system. It has consequences for stroke victims. The head of the national stroke programme, Professor Rónán Collins, has said the service is no longer able to adequately staff stroke units, that one in three stroke victims does not get a stroke unit bed and that stroke patients are getting less than half of the recommended therapy time. It has consequences for those in need of mental health care. The Government keeps the embargo in place and the psychiatric care system now has 700 vacancies. Peter Hughes, the general secretary of the Psychiatric Nurses Association, has said the recruitment embargo is seriously impacting the delivery of services, especially services for children and adolescents.

It does not stop there. Radiographers and radiotherapists cannot be hired to deliver the national cancer strategy. The HSE, as the Taoiseach knows, has sought an additional €20 million to deliver the strategy this year. How much did the Government give it? It gave zero. Public dentists cannot be hired, which means 100,000 children are not getting the dental treatment they need. Multidisciplinary teams needed to treat patients at home, in nursing homes and in community care settings cannot be hired. The service is understaffed and under great pressure. I could go on and on. The Government's recruitment embargo is layering crisis upon crisis. While it refuses to directly employ the healthcare professionals our system needs, it is spending a fortune on hiring agency staff. Government spending in this area has more than doubled, to €650 million. You could not make this up. Under the Government, young doctors, nurses and healthcare professionals are being educated and trained to emigrate. The message sent to those who have already left is not to come back, even though we need them now more than ever.

A Thaoisigh, tá an cosc atá agat ar earcaíocht sa tseirbhís sláinte contúirteach, agus tá impleachtaí thromchúiseacha aige d’othair. Caithfidh tú fáil réidh leis go beo. I have outlined for the Taoiseach the very real consequences of his recruitment embargo. It was wrong to impose it in the first place. To keep it in place is now counter-productive, damaging and dangerous, so I ask him to scrap it immediately and allow our health services to hire the staff they so desperately need.

I thank the Deputy for raising important issues relating to our health service. She has touched on a number of topics and made a point about recruitment that I want to respond to as well. She began by referencing University Hospital Limerick. I, too, welcome the decision by the Minister for Health and the HSE chief executive yesterday to send a specific support team to Limerick to help to deal with the current pressures that are being experienced in that hospital and the mid-west region more generally. This team will begin its work immediately and over the next four weeks, it will help to devise a number of actions to ease overcrowding and pressures that are being experienced in UHL. The team is made up of Ms Grace Rothwell, the national director of acute hospitals, Ms Orla Kavanagh, director of nursing and integration at Waterford University Hospital, and a very eminent and, I think, respected individual by Members across this House, and the retired emergency medicine consultant, Dr. Fergal Hickey from Sligo. The team will work with the team in place in the hospital to manage patient flow and to de-escalate the current pressures being experienced.

The reason we are doing that is that we acknowledge the issues, despite very significant investment in that hospital. Those include staffing at the hospital increasing by more than 1,200 since the end of December 2019, going from 2,800 staff to more than 4,000 at the end of March, which is a 43% increase in staffing levels in University Hospital Limerick, including 162 more doctors, 53 more hospital consultants, 447 more nurses and midwives and 119 more health and social care professionals. These are large numbers of additional people working on the front line. Despite their exceptional work and hard efforts, many of us in this House and I, as Taoiseach, have significant concerns about UHL. We eagerly await the report from retired Chief Justice, Frank Clarke, about what I think will be instructive recommendations on how to proceed.

More generally, the Deputy talked about the recruitment embargo. A recruitment embargo would suggest that nobody is being recruited and gives the impression that staff numbers are not growing in the health service. Of course, as she and I have discussed many times over the past few weeks, they are. When you talk about an embargo, you are actually talking about asking the health service to hire more doctors, nurses, speech and language therapists, occupational therapists, more people to work in disability services and more people to work in our mental health services. There will be more people working in each of those areas at the end of this year than there were at the end of last year. We are also saying there has to be some reality and some correlation between the funding given to any public organisation and the number of people it employs. Actually, for anyone watching at home, please know that this Government has given the health service enough funding to hire 2,268 additional people this year. When disability services are included, for which the Minister of State, Deputy Rabbitte, has responsibility, the Government has provided funding to hire 3,000 additional people this year. Unless we want to adopt an approach where we bring the Ministers for Justice and Education in and tell them they do not have a budget anymore, living within a budget and having some correlation between a workforce plan and a budget is something that many taxpayers watching will see is a responsible thing to do.

We have significant challenges with overcrowding. In a number of hospitals, we have seen significant improvements over the course of this year and last year. Now, the Minister for Health, with the HSE, is eager to see how the good practices in terms of patient flow can be embedded in some of the hospitals, particularly UHL, which are not going nearly as well.

The Taoiseach may well talk about living within budgets. He is hardly a poster boy for that. I quoted the €650 million a year on agency staff. I could also quote the €140 million a year on management and legal consultancy at peak in 2022. Heaven forbid that I would go near the €2.2 billion on his children's hospital that has yet to be delivered.

The Deputy will be at the opening.

Save the homily on living within budgets for someone else. The facts are these; at University Hospital Limerick, as was confirmed to the Oireachtas committee, every single day, there are patients who are deemed sick enough to require admission who cannot be admitted. That is the reality day-on-day.

Hear, hear.

The hospital does not have enough beds or the required level of staff. The Taoiseach quoted a figure of 2,268 additional posts. He knows full well that in previous years, that has been as high as 7,000. The system is stripped bare. I have set out the facts for him. These are facts from people on the front line with regard to dental services, mental health capacity, and all across the system, yet the Taoiseach insists on this embargo. I have asked him to lift the embargo and I put it to him again that that needs to happen. It is foolish to imagine that this embargo is a money saving device. It is not. The Government's spend on agency staff and outsourcing reflects that fact.

Hear, hear.

Am I to take from that that the Deputy does not believe there should be any cap on recruitment in the health service at all?

No.

You can hire whatever you want whenever you want. Is that this week's Sinn Féin health policy? If it is, can the Garda Commissioner hire whoever he wants? Can the Minister for Education? I am just wondering where this ends.

The Government did not have an embargo in place last year.

For a party that now aspires to be in government, Sinn Féin has to tell people what it is going to do every year. This year, we are very honest-----

The Taoiseach should read our budget, so he can see what we proposed.

You do not let young women die on trolleys or lying across chairs. That is what you do not do.

Please let the Taoiseach answer.

I am looking forward to-----

That is my policy. You do not allow young women to die in a hospital, lying on chairs. How is that for a policy?

Hear, hear.

Please let the Taoiseach answer without interruption.

Sinn Féin does not actually develop policy. Its Members just shout. What they actually need to do is explain to people how they would reform the health services. I thought we had an all-party agreement in this House called Sláintecare about how to do it and I thought Sinn Féin signed up to that too.

Is the embargo in that?

You think that, every single year, you can just promise people everything and anything without actually showing them how it will be delivered. I ask people listening at home to please not fall for the misinformation, disinformation and noise.

Look at our actual health budget.

The Taoiseach is distracting.

Some 2,268 more people will be hired into the health service this year-----

It was 7,000 last year.

-----and probably more than the 2,268. When disability services are included, 3,000 people will be hired into the health service this year. That is important. I am quite sure when the national children's hospital is built, the Sinn Féin Deputies will want to be at the opening and will see how good it is for children's health in this country.