Colm Keaveney (Galway East, Fianna Fail)
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Today, almost 500 people are lying on trolleys in our public hospitals. The worst public hospital today was Beaumont Hospital, where 45 people remained on trolleys seeking help and support. In my own county of Galway, between Galway University Hospital and Portiunucla Hospital, 36 patient waited for treatment on a trolley. To say this is becoming commonplace, in terms of it occurring week after week, is a complete understatement because today 480 to 500 people are on trolleys seeking help and support in our public hospitals and it is hardly making the news.

Last week we heard the testimony of the Feeney family in regard to their family member who waited for support and treatment in Beaumont Hospital. It took the testimony of that family to garner the support of the public to raise questions again about how we approach the overcrowding in our accident and emergency units. The Minister said he was in touch with the chair of Beaumont Hospital about the Gerry Feeney case. He said last week that he was disappointed and that he was waiting for the outcome of that investigation into the scandalous treatment the Feeney family received in regard to Gerry Feeney's concerns. They said last week in their testimony that there was no dignity in the support Gerry Feeney was given when he was a patient in Beaumont Hospital. That was the case of an 81-year-old man who was suffering from Parkinson's disease and who died on 31 January, three weeks after being discharged from the hospital. He was left lying in a soiled state and his family said he was treated as if he was invisible.

I do not doubt the Minister is disappointed and I am sure his disappointment goes some distance to demonstrate his concern about, and recognition of, the Feeney family's concerns.

How long is this going to go on? How many more Gerry Feeneys will it take before we start getting real in this country about the sense of urgency required to address this situation? People are tired of hearing that it has to get worse before it gets better. The Minister will not get away with dragging this on into a general election in 2016. He will have to get better. I am asking him to intervene in a human way with respect to what is going on in Beaumont Hospital today, where 45 people are struggling to get attention on trolleys. It is completely unacceptable.

Do not think I am trying to score a political point. In his contribution to the previous Topical Issue matter the Minister said he would not comment. I am asking him to act and to lead on this situation. Did the HSE seek €106 million last year to address this crisis? Since Christmas, has the HSE shared with the Minister any interim assessment on the money and resources required to address this crisis? Has the HSE at any point advised the Minister that it requires €130 million, €100 million, or somewhere within that range, in resources? How much of the €25 million announced by him in the service plan specifically to address this crisis has been spent and how much is left?

Leo Varadkar (Dublin West, Fine Gael)
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The Deputy may well believe he is not trying to make political capital out of a particular issue here-----

Colm Keaveney (Galway East, Fianna Fail)
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I am not.

Leo Varadkar (Dublin West, Fine Gael)
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-----but the issue he asked to raise is the overcrowding crisis in emergency departments, which is compromising patient dignity. He went on to raise a specific issue about an individual in a particular hospital, whose complaint relates to the poor care the patient received on a specialist geriatric ward, not in an emergency department.

Colm Keaveney (Galway East, Fianna Fail)
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He was on a trolley.

Leo Varadkar (Dublin West, Fine Gael)
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I have been in contact with the chairman of Beaumont about that matter because it is an issue of public concern and it is always a matter of concern to me when I hear of complaints about how people are treated on wards or in emergency departments in our hospitals, even though the vast majority of people who do speak to me tell me they have a very good experience of our hospitals once they get access to them. I am informed by the chairman of Beaumont Hospital that the individual case is being investigated and there is also a wider review of how elderly people are treated by that hospital. Beaumont is a voluntary hospital and is not a HSE hospital. It has its own chairman and board. It is important that is understood.

On the issue the Deputy gave us notice that he was raising, I acknowledge the difficulties the current surge in emergency department activity is causing for patients, their families and the staff, who are doing their utmost to provide safe, quality care in very challenging circumstances. As of 2 p.m. today, the number of people on trolleys had fallen to 306, with 214 on trollies for more than nine hours. This ranged from one in Cavan and Kilkenny to 32 in Beaumont, where more than 28 were on trollies for over nine hours. In Portiuncula there were three patients on trollies, two of whom were there for more than nine hours. While the numbers have come down during the day, they remain very high. It must be acknowledged that through the hard work of hospitals working together, supported by other HSE services, HSE management and my Department, we have significantly reduced the numbers, which peaked on 6 January. All hospitals have escalation plans to manage not only patient flow but also patient safety in a responsive, controlled and planned way that supports and ensures the delivery of optimum patient care. Triage is operated to prioritise patients so that those with most acute needs are seen and treated as soon as possible.

The Government has provided additional funding of €3 million in 2014 and €25 million in 2015 to address delayed discharges. The HSE is accessing all suitable non-acute accommodation to the maximum extent possible to allow those who have been clinically discharged to leave acute hospitals. Actions currently being taken to address emergency department overcrowding include the provision of 900 additional transitional care beds in nursing homes, with 500 opening in January and an additional 400 in February. Some 173 short-stay public beds are being opened across the country for a three month period. There have been difficulties in staffing these, although we continue to try to do so. Up to 300 overflow beds have opened in acute hospitals; 400 additional home care packages are being provided, along with 300 additional fair deal places and there will be an extension in community intervention teams. Anyone opposite who thinks I am only interested in engaging in commentary and analysis can see it is possible to take action as well as engaging in commentary and analysis. They are not mutually exclusive activities.

The HSE has the capacity to recruit where it needs additional staff. Arrangements are in place in the HSE to allow the recruitment of such staff where it has been established that there is an urgent service requirement. This year the number of nurses directly employed by the public health service will increase by at least 500. There will also be additional mental health nurses.

The Deputy will all be aware that I convened the emergency department task force to find long-term solutions to overcrowding by providing additional focus and momentum in dealing with the challenges presented by the current trolley waits. It is made up of relevant stakeholders such as senior doctors, lead hospital consultants, GPs, HSE national directors, union representatives and senior officials from my Department and the HSE. The HSE is currently finalising an action plan under the auspices of the emergency department task force with a view to delivering a significant reduction in trolley waits over the course of 2015. I am determined that the action plan be completed as soon as possible, taking the views of the task force into account, and then made operational without delay. The task force is due to meet again on 9 March.

I want to reassure all Members present that we are working hard to find workable solutions to the management of emergency care, with optimum patient care and patient safety at all times remaining a Government priority.

Colm Keaveney (Galway East, Fianna Fail)
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I welcome the Minister's response, particularly the confirmation that he will recruit additional staff in the area of mental health. I want to acknowledge that, considering that he is operating with 1,000 fewer staff than in 2011. There are 1,000 fewer of the support, caring and other staff required in the mental health service to deliver A Vision for Change. Has the HSE advised the Minister that it requires more money, somewhere in the region of €100 to €130 million, for the action plan? Has the Minister costed the action plan involved in the statement? He says the action being taken would provide for 900 additional transitional care beds in nursing homes, that there would be 173 short-stay beds and that there will be 300 overflow beds and an additional 300 in the fair deal scheme. What is the cost of that? Has he spent the €25 million that was provided for in 2015? Is that satisfactory or will he need more to provide for the action plan?

Leo Varadkar (Dublin West, Fine Gael)
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The €25 million is not all spent but it is all fully employed and committed. When provision is made for an additional 300 fair deal spaces and 400 homecare packages, they do not get turned off at a certain point. They must be funded throughout the year. The €25 million is not all spent, but it will all be spent because we are not going to take away those fair deal spaces or those additional homecare packages during the year. Any additionality, more fair deal spaces, for example, would cost more.

Colm Keaveney (Galway East, Fianna Fail)
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Is there additionality?

Leo Varadkar (Dublin West, Fine Gael)
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As I confirmed several weeks ago, when the HSE put in its bid for 2015 it requested an additional €1.4 billion, to solve pretty much all our problems in the health service, if one believes that money alone can solve all the problems in the service. I imagine other agencies, like the NRA or the Department of Education and Skills, also put in very high figures for what they would like to get. Ministers then try to secure as much as they can. I managed to secure a supplementary of €680 million, as well as the first increase in seven years in the budget, after four years of cuts under Deputy Keaveney's party and three years of a budget freeze under this Government.

It is undeniable that we are struggling. We still spend €1.5 billion less than we did seven years ago, we have 15,000 fewer staff and there are more patients. They are older and they have more demands. I assure the Deputy that everyone in the Department of Health, including the Ministers, everyone in the HSE and everyone working in the health service is doing everything they can with limited time and resources to alleviate this situation.