Táim ag díriú isteach ar ospidéal na Gaillimhe arís agus ar an méid othair atá ar thralaithe, 62 inniu. Tá daoine ag fulaingt agus ag fáil bháis ar thralaithe fad is atáimid ag caint is ag ceiliúradh torthaí na dtoghchán. I am glad the Minister is here today. He previously served as Minister for public expenditure and reform and he is currently the Minister for Finance. His brief directly relates to the issue I will bring up. As I speak, 62 patients are on trolleys in a hospital that is billed as a centre of excellence. Earlier in the year, there were 73 patients on trolleys, which made it the third-worst hospital in the country. The latter were the worst figures since the Irish Nurses and Midwives Organisation, INMO, started collecting data some time ago.

Why am I raising this issue? It is because no progress has been made at all in respect of the hospital in Galway, other than a temporary accident and emergency department, which costs €15 million or €16 million. The background to this is that in February 2015, when we were told by Deputy Varadkar, who was Minister for Health at the time, that the hospital was not fit for purpose. This happened again in 2016 and up to 2020, with the then new programme for Government. All of the time we were told it was not fit for purpose. We foolishly relaxed because an options appraisal stated we should build a brand-new facility at Merlin Park University Hospital. That did not happen. The appraisal was revised and a decision was made to do up some of the properties at the hospital in Galway. All this time, the staff were struggling through trolleys on corridors and elsewhere. HIQA visited in February of last year. Its representatives thought the facility was grossly overcrowded, with 28 people on trolleys.

Today, there are 62. Think of what that does to the staff, not to mention the patients who are suffering and dying. I would love to ask who here in this Dáil, including myself, has spent any time on a trolley in a public hospital. I asked it this morning and got no answer. I think that if we did spend a little time, there might be more of a push to do something about it.

We are here now looking at a preliminary business assessment case and a strategic assessment review, and all the time I am getting different answers. It would be easier to read The Castle or The Metamorphosis by Kafka, which is extremely difficult to read, in German, Irish or English than to understand the answers that are coming in respect of the hospital in Galway. We need a new accident and emergency unit and a new maternity ward in the hospital, given the current one is functioning in suboptimal conditions, as is the whole hospital. The options appraisal that was carried out in 2019 told us that 64% of the infrastructure in the regional hospital was not suitable, and 99% in Merlin Park, and all of it more than 40 years old. All the time what we are doing is adding to a congested site in a hit-and-miss fashion, with the promise of an accident and emergency unit and a new children's and maternity ward but with no idea of when that is going to happen, except for the Minister's Department and his previous Department telling us there are new rules and we must do this but nothing is happening.

I thank the Deputy. First, looking to the medium to long term and the need to ensure there are adequate facilities and infrastructure at University Hospital Galway, as the Deputy knows, we are making progress on the delivery of major capital projects that are planned for the hospital. A formal project board has now been established. We are finalising a master plan for the development of the Galway city campus, which will enhance the delivery of essential healthcare services for the population. As the Deputy knows, this includes a number of key priorities, such as a new emergency department, which is needed, a women's and children's block, a new laboratory, a new cancer centre and a bed block on the University Hospital Galway campus. The board will also oversee plans for the Merlin Park campus, including the elective hospital for the region and the surgical hub.

Progress is being made. A design team has been appointed, as has a project manager. In addition, the announcement recently by the Minister, Deputy Donnelly, of 228 new beds for the hospital will play a very important role in the improvement of the overall infrastructure at the hospital. The new beds will be provided in separate phases, with University Hospital Galway to benefit from 198 beds between this year and 2028, with a further 30 coming on stream beyond that. In the short term, we have a job of work to do because it is not acceptable to us that that number of patients are on trolleys today. That is why the Government has very significantly increased the resources for the hospital to provide for the growing demand that is there. Staffing has grown by more than 740 to 4,500, an increase of almost 20% since 2020. In addition, the budget over the same period has grown by 21%, so that is a very significant investment by the State and we need to see the return and the performance improving as a result. Notwithstanding the trolley numbers the Deputy quoted from today, which are not acceptable and will need to be addressed, it should be acknowledged that, from January to May of this year, the University Hospital Galway trolley count showed a decrease in the year to date of 15% and we should, in the interests of balance, acknowledge that.

That is part of improvement that is happening at a national level. Progress has been seen across nearly all the acute hospital sites. With the exception, sadly, of University Hospital Limerick, we have seen reductions in the year to date of 20%. The investment is making a difference and we need to deal with the short term, the here and now, the people who are on trolleys today, which is not acceptable to the Government or the HSE, but we also need to have a plan to ensure the infrastructure is in place for a growing and ageing population in order that we can meet the needs, which are increasing all the time.

One almost loses the will to live in regard to this. In 2014, the accident and emergency unit was deemed not fit for purpose. Ten years later, it is still not fit for purpose. The Minister tells me money is going into it. There are 62 people on trolleys. They should not be on trolleys. We live in a Republic. The Government has normalised a situation where patients are on trolleys. I know that each of the Ministers personally thinks that is horrific, but it is time to look at what is happening. The Minister should stop quoting figures to me, please. Sixty-four people are on trolleys; would he or I be on a trolley tomorrow? That is the question we ask in a Republic. What is it we are doing ten years after Leo Varadkar said the accident and emergency unit was not fit for purpose?

We have gone around in circles in respect of a strategic assessment review, with different answers. I was told it had been accepted and approved by the health executive board in November 2023, and then I was told in a different answer that it had gone for approval. How in God's name can we stand over a situation ten years later where we do not even have a deadline for an accident and emergency unit, not to mention the maternity unit, which is going in overhead, in a maternity strategy that is coming to an end in two years' time? Those staff are functioning in suboptimal conditions. HIQA said the hospital had failed on two of four essential standards. I do not want to stand here and lambast the Government. I want a public health service that is fit for us to call ourselves a Republic.

The facilities at University Hospital Galway are not fit for purpose. I have been there in recent months and I am very much aware of the ambitious capital investment plans, which we will support. They need to happen because the scale of demand for services there is only going to go in one direction, and we have to ensure we have not just the staffing but the physical infrastructure to meet that need. That is why the new master plan will involve the new emergency department as well as the women's and children's block and a whole range of other facilities, including a cancer centre. There has been investment in recent times. The new radiation oncology facility opened last year and, in addition, the hospital has been granted a capital allocation for the creation of a third endoscopy procedure room, including additional facilities as part of that.

We should also recognise, to be fair, that overall, trolley numbers are down nationally. The Deputy has highlighted what is happening today in the hospital, and I am saying to her, as Minister on behalf of the Government, that that is not acceptable to us and we will address it both in the short term and with a plan for the medium- to long-term improvement of services there.