Go raibh maith agat, a Cheann Comhairle. This winter has set yet more alarming new records for people on trolleys in our emergency departments. That means more people whose care may be compromised because there is no space for them or no one to admit them. It means more risks for patients’ conditions to worsen in a place where they should expect to improve.

I welcome the new efforts the Minister for Health announced to tackle overcrowding. These are long overdue. In yesterday’s press release from her Department, she identified two issues exacerbating the problem. The first, she said, is the ongoing lack of capacity in hospitals. The second, she tells us, is the increased number of people on trolleys over weekends and on bank holidays due to lower discharge rates. She spoke strongly on radio about this earlier. These are serious issues but the single largest problem, in reality, is the continued chronic shortage of healthcare staff, including nursing, support and medical staff. The continued pause on recruitment is having a real and serious impact on healthcare in our communities and our hospitals and everyone knows this. Anyone who has recently visited a hospital knows this, so it is not just our view in the Labour Party.

Last week, the Irish Nurses and Midwives Organisation released its first Behind the Trolley Numbers survey conducted by nurses working in acute hospitals and treating patients on trolleys or in hospital corridors. This is the real-world experience of those on the coalface of the crisis. Their view is overwhelming. When it comes to ending overcrowding, 83% identified bed capacity and 80% said recruiting more staff are key to addressing the issue. When it comes to building hospital capacity, clearly there are a great many measures that must be taken. Some of these have been announced, in fairness, by the Minister. We would welcome these, such as the digitising of health records, which is long overdue, and new methods to increase productivity and forward planning in advance of weekends we know will place more strain on the system. Ultimately, however, these measures will come to nothing until the Taoiseach’s Government acts to recruit more healthcare workers and until it introduces ways to improve conditions for staff who are already there so we have better retention rates, because staff do not feel they are being treated with respect.

We have an ageing population, we have more complex needs than before and demand for emergency care has increased, but that is no excuse for outrageous gaps and delays in the system. Last week I raised the case of an elderly woman in my constituency. She was left waiting three hours for an ambulance to take her ten minutes up the road to a hospital. I have received contact from so many other paramedics and ambulance workers since then about they care they provide being compromised by staff shortages. When will we hear more about the new healthcare plan, specifically on staffing and working conditions? Crucially, when will the Government urgently act to carry out the necessary recruitment drive to ensure we have enough staff working in our healthcare system?

Admhaím go bhfuil brú ar na seirbhísí éigeandála, go háirithe ar na hospidéil. Bhí sé sin le feiscint ar Lá Fhéile Bríde agus an deireadh seachtaine sin. Níl sé sásúil agus tá sé sin ráite ag an Aire Sláinte. I acknowledge first of all the very significant challenges facing emergency departments, especially over St. Brigid's weekend, the pressure on people and the distress that causes to people waiting long hours in our emergency departments. The overcrowding on St. Brigid's weekend, however, which the Minister was right to highlight, was directly linked to low weekend discharges and subsequent high numbers on trolleys. This has been an issue for quite some time. The introduction of the public-only contract, which was a very significant development achieved last year, was very much linked to a changing roster arrangement and deployment of senior decision-makers in our hospitals to give weekend cover.

Historically in the public health service, weekends are the worst times to be admitted to a hospital. The House needs to engage with that. There has been enormous investment in health in the past five years by any standard, both in recruitment and infrastructure, and there needs to be more. Parallel with that investment we need to analyse forensically the deployment of people with a view to getting the optimal outcome for patients and people who attend our hospitals. We have wonderful people working in our hospitals but we have long said it cannot be five days. There has to be rostering of senior decision-makers to enable better discharge so we do not get this issue at weekends, especially bank holiday weekends, which have been a feature.

Who is in government?

There have been some successes on that front.

How long is the Taoiseach in government?

Some hospitals, like Waterford, Tullamore and Connolly, for example, had zero or low trolley numbers as well. There is therefore a management issue as well as one of resources.

Managers not consultants.

We need an increase in resources and we have been recruiting extensively. Funding has been allocated for further recruitment of staff this year, especially medical staff, nurses and allied healthcare professionals. These are issues we need to discuss and engage on with hospital management and representative bodies. It is not just about increases and increases on their own. We have to analyse deployment and ensure we get the best outcomes for patients. That is what the Minister has been highlighting in her comments and in the data she has received, especially in relation to St. Brigid's weekend.

I have acknowledged there are issues with discharge rates at weekends. Clearly there are issues with workflow and management practices, but changes in workflow and management practices are no substitute for properly addressing the real issue underlying the crisis in healthcare, which is the issue of staff shortages. We are hearing from hospitals that know they need to recruit more staff, that have identified gaps and engaged in recruitment but are not getting the go-ahead from the HSE to be able to offer the jobs. Thus, we hear from healthcare workers who are leaving for other countries because they are so chronically overworked due to staff shortages. This is not just in emergency care but across our healthcare system. The shortage of public health nurses in the community is causing babies to miss key developmental checks and the HSE has confirmed it has had to scale back its service, thereby leaving children and babies at the mercy of a postcode lottery in terms of key developmental checks.

I thank the Deputy.

I will ask the Taoiseach again-----

I thank the Deputy.

-----when will the Government carry out the necessary recruitment drive?

I thank the Deputy and call the Taoiseach to respond.

When will it end the pause on healthcare recruitment so our communities can get the healthcare we so badly need?

First of all, there is ongoing recruitment. There are now 25,000 more people working in the health service since 2020. That includes nurses and consultants. The number of consultants employed in our health service has gone up 42%. We are continuing to recruit, there is ongoing recruitment and funding was put into the Estimates for additional numbers in 2025. However, the attendances are also going up. An ageing population is putting pressure on our emergency departments. What is working best is a whole-of-hospital approach to emergency departments.

It is producing results in several hospitals. There has been analysis of certain hospitals of what has been happening within them and so on. Recruitment is ongoing and we are committed to affordable recruitment of nursing staff as well as investment in capacity-----

Thank you, Taoiseach. Time is up.

-----and elective facilities such as surgical hubs and elective hospitals.

That is not true.

That is not true.

That has not been approved.

We now move to Deputy Cian O'Callaghan of the Social Democrats.