Bertie Ahern (Dublin Central, Fianna Fail)

They are getting to see far more specialists. They are working in much healthier workplaces and we are dealing with disabilities and a range of other services far more effectively. Across the cancer, cardiac and paediatric services there are enormous improvements of which the staff involved and the country should be hugely proud. There are well over 1 million inpatients, over 500,000 day patients with more than 1 million going through accident and emergency units. The point is that one important facet, namely accident and emergency, which has traditionally been a difficult area for the health service, is not up to standard we want in all the regions and hospitals. It has been Government policy to deal with that issue. Over a number of years, in different ways, we have dealt with a whole range of issues, for example increasing the number of consultants. This was not formerly the situation. There was only a handful of them in the country in 1997, while now there are dozens in our hospitals. We have not yet got them to work after 6.30 p.m., but these are issues we are trying to deal with. There are additional nurses and in all we have given 35,000 additional staff to the health service, a large proportion of whom have been allocated to accident and emergency departments. We have provided 1,500 beds for respite care to deal with these issues.

However, the population of the country is getting older. Many general practitioners do not want to work after 5.30 p.m. If no GP services are available after 5.30 p.m.and there are no consultants in accident and emergency departments after that time, one can see why there are problems. We are trying to deal with those problems. I have never said there is not a problem in accident and emergency. I have defended the health service and we are trying to put in the resources, staffing and free-flow arrangements in an attempt to improve those areas which still face difficulties. In St. Vincent's Hospital and in hospitals in Blanchardstown, and in Cork and Galway where the excellent facilities have been built, we might not have solved all the problems, but we have seen improvements.

Deputy Rabbitte knows as well as I do that life, time and circumstances are changing. There was a time when families and everyone concerned wanted to get people home from hospital. There are other pressures nowadays, and that is how it is. This means we now have to deal with matters differently. We are doing our utmost and asking people to co-operate with us. We did not realise this today or yesterday. I realised it when I worked in the Mater Hospital 30 years ago, and I am trying to do something about it now.

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