Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Deputies for their contributions and will do my best to cover them. As of 8 a.m. this morning, the position on emergency department overcrowding is that there were 372 patients on trolleys in emergency departments or on wards. Of those, 183 had been on trolleys for more than nine hours. As such, it is a significant improvement on the position earlier in the week. That ranges of course from no patients on trolleys in Wexford and Tralee to as many as 37 in Tallaght, of whom 12 were on trolleys for more than nine hours.

The situation is certainly worse than it was this time last year and nobody is trying to say otherwise. It is due to a combination of factors. There is a higher level of delayed discharges than this time last year with perhaps 100 or more. It has also been difficult to recruit senior decision-making doctors in some hospitals. Junior doctors who are less experienced are more likely to admit patients to be safe than more experienced doctors. That is definitely a feature in some of the more peripheral hospitals where more than half of patients are being admitted, whereas the statistic should be approximately one quarter. In some hospitals, we have an influenza-like illness, Norovirus, which is adding to numbers and causing beds to be closed for infection control rather than monetary reasons. The situation has been worse in previous years than it is now, but it remains very bad. Aside from the discomfort and lack of dignity, having anyone waiting many hours on a trolley creates an infection control risk and there is a risk of treatment being delayed. It is also a patient safety issue.

In terms of actions, 300 additional fair deal places have been allocated as have 400 additional home care packages. Approximately 500 transition and community beds have been reopened or funded and we are working on getting another 200 beds opened in the next two weeks across the State. We are not taking anything for granted or assuming that things will get better as the spring comes in. In addition, Mount Carmel will be opened as a community hospital for Dublin in March. We will keep plugging away at this. As Mr. Liam Doran of the nurses' union said yesterday, this is the most sustained effort we have ever seen to tackle this issue. We are not succeeding quite yet but will keep at it until we do.

The targets on waiting times have not been changed and the 20-week target for children and the eight-month and one-year targets for adults remain in place. They will be reported on every month in the HSE's PAR as they always have been. When one cannot do what one wants, one does what one can. We can deal with those very long waits where people are waiting 15 and 18 months from within existing resources. That can be done in particular by adherence to chronological order. Unfortunately, there is evidence in a number of institutions of failures for whatever reason to stick to the chronological order. GPs will tell one that they send patients in with the exact same condition, some of whom get their operations within three or four months while others are on a waiting list for a year. We do not know why that is, but it is something that will have to be focused on very carefully to ensure that urgent cases are prioritised and then everyone else is seen in chronological order. Queue skipping is not ethical or acceptable and it has to stop.

There were no targets on waiting lists when Fianna Fáil was in power. There were newspaper reports that people were waiting six years in some cases for treatment under the then Minister, Deputy Micheál Martin, at a time when there were endless amounts of money in the health service. As such, Deputy Billy Kelleher could be a little less shrill in his criticisms, particularly if he wants that man to be the Taoiseach. Obviously, I would like there to be more money.