Enda Kenny (Mayo, Fine Gael)

The problem is that we did hear it all before. When Professor Drumm addressed the Fine Gael parliamentary party in Portlaoise last year he said that of the 140,000 people who had worked in the health boards, at least 3,500 did not know what their jobs were or where they fitted into the service.

We have heard this all before and the Taoiseach has put the taxpayer to considerable expense producing another consultants' report to identify problems which he knew existed for the past nine years. While the Taoiseach sits here beside the Tánaiste, he has done nothing about after-hours GP care, step-down facilities or getting value for money. The State and the system cannot cope with elderly and vulnerable people who need emergency care. They are not deemed to be a priority and that is the scandal.

When, on 12 October last, I asked the Tánaiste to identify her main target during her Ministry in 2004, her response was accident and emergency care because, as she rightly said, it is unacceptable that people have to spend up to 12 hours on a trolley. Before the report was published, hours before the "Prime Time Investigates" programme was shown, the Tánaiste said that the latest consultants' report on accident and emergency services showed there was no crisis in that area. It seemed to be a case of lurching from a national crisis to a national emergency to no crisis at all, simply because the taxpayer was put to the expense of having another consultants' report to show the same problems that have existed for the past nine years, with which the Government has not dealt.

There is no point blaming nurses, doctors and consultants. This is a problem of Government. The Taoiseach said the spend has gone from €4 billion to €12 billion, but while the extra money is being spent, patients are not seeing the value. The Government has failed to deal with step-down beds, GP out-of-hours care and the provision of acute emergency care as a priority for elderly people when they arrive in accident and emergency units. As we are told, the chaos in such units costs lives — someone's husband, wife or child.

Tomorrow is the fourth anniversary of the last election. The Government has been in office for nine years, with three Ministers for Health and Children and a Tánaiste in charge of that Department and, while, as the Taoiseach rightly pointed out, the spend has been increased to €60 billion, the issues of out-of-hours GP services, step-down beds and medical priority for vulnerable, elderly people in particular who need emergency care are not being dealt with. The Taoiseach is responsible for that and, as head of Government, was he not ashamed to see the carry-on involving elderly and vulnerable people in some of our accident and emergency units around the country? The television programme showed that what happens in a number of our hospitals is disgusting. The Government has failed to deal with this problem, which it has known has existed for the past nine years.

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