Unfortunately, long waits for basic healthcare are now the norm. That should trouble the Taoiseach, especially as a former Minister for health. Waiting lists are no longer a backlog - they are the system. Ireland has become a country of waiting lists, a nation where a health challenge is all too often met with a letter and not with the necessary care. The new figures from the National Treatment Purchase Fund, NTPF, are stark. We know from these that 900,000 people are waiting for outpatient care or an operation. This is a crisis unfolding on the Taoiseach's watch.

The Government's Waiting List Action Plan 2025 has patently not worked. The number of people waiting more than six months has increased by 12% in just one year. That is a stunning figure. Nearly one in six adults waiting for outpatient care has languished on a waiting list for more than a year. For children, it is even worse, with more than 17% waiting more than 12 months. It is not just outpatient care either. We learned this week that several children with mental health or developmental difficulties had been left waiting up to, or even in excess of, 11 years for a psychology assessment. As waits get longer, patients get sicker, our emergency departments get more and more crowded and our healthcare staff burn out. We all hear about it every day. Over the weekend, for example, we heard of a stroke victim in her 90s who spent hours on a trolley in the corridor of a Dublin hospital. Her family was unable to contact her or anyone who could reassure them or give an update. That is unacceptable. There is nothing normal about a modern hospital being unable to treat the sick because of capacity constraints, and capacity is at the heart of this crisis.

The problem is not a lack of money; it is a lack of urgency. There is not a lack of plans - we are seeing lots of plans - but a lack of delivery. The HSE national service plan for this year proposes just 134 additional hospital beds. That compares with the 297 beds committed to last year, a target that was missed. Two thirds of our hospitals are operating with unsafe bed occupancy levels and this lack of capacity has real consequences for real people, with overcrowded departments, cancelled procedures, exhausted staff and patients left waiting far too long for care they need.

This is not a surprise. Capacity constraints and chronic understaffing are well known. The public has gone past the point of shock when it comes to our shambolic health system. Ask anyone how they think the system is performing and they will say they have no faith in the plans coming out of the Department of Health. They will shake their heads and roll their eyes if asked. The problem is that when failure is normalised, accountability disappears. Therefore, I am asking the Taoiseach to take responsibility and answer some straightforward questions. Why has a €420 million waiting list action plan failed to deliver on its minimal targets? Why is the 2026 service plan retreating on bed capacity? What changes will we see to ensure improvement this year?

Ar dtús báire ní aontaím leis an Teachta go hiomlán mar ar an taobh eile den scéal tá dul chun cinn le feiscint i gcuid mhaith nithe sa córas sláinte agus caithfear é sin a adhmháil mar aon le gach scéal eile. The key issue with waiting lists is waiting times and that always has to be the target. The shorter the time someone has to wait for an operation or other intervention, the better the outcome, and that is always the priority in respect of capacity and waiting times.

Over the last while, we have had the biggest expansion of access to free GP care in the history of the State, so it is not a shambolic health service. We have had a 12% reduction in patients on waiting lists exceeding 12 months and a reduction in average times from 7.2 months to 6.5 months at the end of 2024. That is the average waiting time. That is against the backdrop of a 9% increase in outpatients and a 5% increase in inpatient and day case attendances. There is a lot more to achieve and we have a lot more to do here. I acknowledge that. We want to get to the ten-to-12-week waiting time under Sláintecare objectives, and funding has been allocated, but I do think we need to see things in perspective. The Deputy describes it as "shambolic". It not shambolic.

Hear, hear.

It is wrong to say that because when you look at our overall outcomes as a country, there is huge funding that has gone into health and I am sure the Deputy will acknowledge that. She has said it is not an issue of resources and significant funding has gone in, but in terms of key health outcomes over the past decade, there have been significant achievements. Ireland is now among a small group of only seven European Union countries where life expectancy is above 82 years. Our mortality rate fell by 11% over the decade 2014 to 2023. The mortality rate for all circulatory system diseases fell by 20% in that period, with heart disease and stroke falling by 28% and 37%, respectively. The Deputy had a cut at the stroke services and every individual case is terrible and traumatic when it happens, but surely she must acknowledge the progress that has been made on stroke and interventions over the last number of years with the new stroke centres and so on. It has been quite dramatic and transformative in the treatment of stroke in the country. The mortality rate for all cancers dropped by 15% in that period, with cancers of the trachea, bronchus and lung and breast cancer dropping by 21% and 22%, respectively. The mortality rate for all respiratory system diseases has fallen by 15%, with chronic lower respiratory diseases and pneumonia falling by 9% and 41%, respectively.

Thank you, Taoiseach.

I do not say that to minimise any trauma any individual goes through but we need a balanced debate in perspective and to acknowledge the progress that has been made while resolving to do even better in respect of other issues.

Try as the Taoiseach may to dissemble them, the figures do not lie. They point to failure and are indefensible, and I stand over the comment of "shambolic". Anyone watching the news last night will have seen shambolic overcrowding and anyone watching or hearing of the experiences of the patient I referenced, or other patients whom we all know, will know that, while there is of course progress being made in some areas and that is great to see, it is still shambolic for all too many patients and they are still waiting too long.

The Taoiseach talked about waiting times. Of course, that is crucial and the Taoiseach's own plan set a relatively modest target, that 90% of outpatients would wait less than a year by the end of 2025, but that target was missed. Look at the number waiting more than 18 months for an inpatient appointment. That number rose by more than 25% last year. By any measure, the 2025 waiting list action plan failed. Meanwhile, we are hearing advertisements from private hospitals like Kingsbridge Private Hospital in Belfast. That is no way to run a healthcare service, to see private hospitals from other jurisdictions touting for business in this way.

Thank you, Deputy.

Can we expect an improvement this year for those who are facing these long waiting lists?

They are doing a good job.

Yes, we can. Indeed, over the last number of years, we have dramatically increased capacity. Deputy Bacik mentioned the beds but she forgot to mention that, by the end of 2024 alone, we had 1,300 additional beds in the system. As the Deputy will know, during the Covid period, we took the opportunity to dramatically increase bed capacity in our hospital system, particularly in the critical care area, where there was significant increase in the number of beds. We expanded our ICU capacity by about 28%, which is significant.

Obviously, health is a comprehensive area, so primary care is critical. We now have 180 primary care centres - that is 51 extra since 2020 - and we will continue to work on that. We are progressing the development of four elective hospitals, which I think will be very important in the context of waiting times, and the surgical hubs that the Minister has committed to. As the Deputy will know, the first surgical hub at Mount Carmel has opened and that has already had a very significant impact on waiting times in that area.

Thank you, Taoiseach. The Social Democrats are next, with Deputy O'Callaghan.

Four more are due to open in 2026.