Micheál Martin (Cork South Central, Fianna Fail)
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Yesterday, I asked the Taoiseach if he had seen the RTE film "My homeless family". I was inundated with calls yesterday from people who were quite shocked by the revelations about the reality of homelessness in Ireland today, and particularly the plight of families in hotels. I do not know if the Taoiseach has seen the programme but it is important that he should do so. Yesterday, he dismissed my arguments on rent allowance, which many of the agencies are saying has driven many vulnerable families into homelessness.

The Taoiseach was also asked a specific question concerning NAMA's plans to build 20,000 houses. He was asked if he would instruct NAMA to ensure that 10,000 of those would be social houses. For some time, Deputy Barry Cowen has argued the case for building social houses and to tell NAMA to do so. When one looks at the sale of 442 apartments at Tallaght Cross West to a major international real estate investor for €83 million, it is extraordinary. It illustrates the bankruptcy in terms of the attitude of the State and the Government to homelessness and the lack of any urgency to get to grips with it. Those 442 apartments were sold for about €100,000 each, which is €90,000 less than the modular homes the Taoiseach cannot get built at the moment. Apparently, NAMA offered those apartments to the National Housing Agency and local authorities, but they decided to take up only 65 of them. Meanwhile, 1,600 children are in emergency accommodation of the kind we saw on the programme earlier this week.

Who is in charge? Why was the offer of apartments not taken up? Why did the State not buy them and get the families out of damp hotel rooms and bed-sits?

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question please.

Micheál Martin (Cork South Central, Fianna Fail)
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It illustrates in one story how this Government does not get what it is like for people to be in hotel rooms all over this city and across the country. There was a great opportunity to do something there with one, two and three-bedroom apartments at €100,000 each, rather than the €190,000 for modular homes. It is time the Government understood the urgency of this crisis and its impact on families. It has been going on for three years. Threshold and Focus Ireland warned the Taoiseach about this.

We have been legally advised that the Taoiseach can instruct NAMA that half the 20,000 houses it is building should be social ones. That would have a huge impact in taking people out of the misery we all saw on RTE on Monday night.

Enda Kenny (Mayo, Fine Gael)
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The Deputy raised this question yesterday in respect of the television programme. I pointed out to him that the disastrous state he left the country in meant that the entire construction sector and the building business has collapsed.

Bernard Durkan (Kildare North, Fine Gael)
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And soon forgotten.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Please.

Enda Kenny (Mayo, Fine Gael)
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I pointed out to Deputy Martin that the Government set about dealing with the scale of that problem by dealing with voided units, reconstruction of places that were not habitable-----

Dara Calleary (Mayo, Fianna Fail)
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Answer the question.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Would you stay quiet please?

Enda Kenny (Mayo, Fine Gael)
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-----and a variety of schemes to prevent people from becoming homeless and being put on the housing list. These include the housing assistance programme and the tenancy agreement for increased rent supplement, which have helped thousands of people. Given that the economy is recovering, and it is important that we keep the recovery going, the Government has put €3 billion on the table for social housing to build 117,000 units by 2020. We have given local authority chief executives money, objectives, targets, facilities and the wherewithal to get on and do this.

Week after week the Deputy comes in here, but he has forgotten any sense of fiscal responsibility. If he wants to take another €2 billion of public services and put it into NAMA housing, then let me hear that proposition from him. He seems to think that he can magically produce another 10,000 social houses out of NAMA but it does not work that way.

Of course, one can have a legal opinion on everything. We all empathise with the people whose children are in hotel rooms, bed and breakfast facilities or other emergency accommodation. Among all those challenging cases, the 123 complaints received in respect of that programme were all dealt with. I note the-----

Micheál Martin (Cork South Central, Fianna Fail)
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The programme was not about those complaints.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Please. The Taoiseach does not need any support.

Dinny McGinley (Donegal South West, Fine Gael)
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Deputy Martin emasculated the Bill for social housing provisions. Does he remember? I remember it. I have been here long enough. He emasculated the Bill.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will Deputy McGinley please let the Taoiseach explain his position.

Dinny McGinley (Donegal South West, Fine Gael)
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Deputy Martin is being hypocritical. He emasculated that Bill.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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You will stay quiet or else you will leave the Chamber.

Enda Kenny (Mayo, Fine Gael)
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I note this morning that not only are there objections to the modular housing that Deputy Martin is proposing but that other such schemes have also been objected to. There is a legal process to be gone through here. Deputy Martin wants instant houses. The Government has put public money on the table for every local authority. It has given them their objectives and targets and has told them to get on with this. We are providing help in respect of the housing assistance programme and supplementary welfare, which has helped 5,800 people. Some 2,000 have been housed who were on the housing list last year and are being placed in voided units that are now renovated and comfortable.

If Deputy Martin thinks he can suddenly direct NAMA to put another €2 billion into social housing, let me hear that proposition. The Deputy should tell me what facilities he will take that money from.

Micheál Martin (Cork South Central, Fianna Fail)
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People are fed up with the Taoiseach-----

A Deputy:

And they are fed up with you.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Would you please stay quiet?

Micheál Martin (Cork South Central, Fianna Fail)
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-----and the deliberate decision never to answer questions that are put to him. In 2012, there were eight families presenting as homeless. In 2014, that number had risen to 40 under the Taoiseach's watch. In 2015, it went to 75, and it rose to 90 in one month last year. This is on the Taoiseach's watch. Threshold, Focus Ireland, Simon and the Peter McVerry Trust all warned the Taoiseach about homelessness and the homeless children in this city.

Bernard Durkan (Kildare North, Fine Gael)
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You did not know about it until now?

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will you please stay quiet?

Bernard Durkan (Kildare North, Fine Gael)
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I am sorry, a Cheann Comhairle. He annoys me intensely.

Micheál Martin (Cork South Central, Fianna Fail)
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That is the point I am getting at, Taoiseach. There were 442 apartments out in Tallaght West which the Taoiseach could have directed and ensured were bought.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question please.

Micheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach could have done that but he chose not to.

Derek Keating (Dublin Mid West, Fine Gael)
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It is your fault.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Please. The Taoiseach will answer the question.

Micheál Martin (Cork South Central, Fianna Fail)
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He chose not to spend €83 million. He goes on about modular homes which would cost €190,000. These apartments were sold for €100,000.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will the Deputy please put a question? We are over time.

Micheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach clearly has not watched the television programme to which I referred but I ask him to do so. He might then get a sense of urgency about this issue. He is out of touch with the reality of what life is like on the ground for many vulnerable families in this country. They do not get fairness in terms of treatment because the Taoiseach's philosophy islaissez-faireand to let the market decide.

Arthur Spring (Kerry North-West Limerick, Labour)
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That is the Deputy's attitude.

Micheál Martin (Cork South Central, Fianna Fail)
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Rent allowances for vulnerable families are cut allowing them to fall into poverty. The Taoiseach will not direct NAMA to build 10,000 houses.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I ask the Taoiseach to respond.

Micheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach could direct NAMA to build 10,000 houses.

Bernard Durkan (Kildare North, Fine Gael)
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The Deputy's party could have done it when there was plenty of money available.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Would the Deputy, please, mind?

Micheál Martin (Cork South Central, Fianna Fail)
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In the budget, the Minister for Finance, Deputy Michael Noonan, declared that NAMA would build 20,000 houses.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Deputy is way over time.

Micheál Martin (Cork South Central, Fianna Fail)
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Now the Taoiseach and his colleagues are saying only 10% of them should be social houses.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I ask the Taoiseach to respond.

Micheál Martin (Cork South Central, Fianna Fail)
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I am simply saying-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Deputy should resume his seat.

Micheál Martin (Cork South Central, Fianna Fail)
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----- the urgency of the problem demands an urgent and effective response, not the failure we have had, with local authorities building nothing in recent years. No social housing has been built in recent years.

Derek Keating (Dublin Mid West, Fine Gael)
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Why?

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Deputy Micheál Martin should resume his seat.

Micheál Martin (Cork South Central, Fianna Fail)
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I am asking the Taoiseach to direct NAMA that 10,000 be social houses.

Bernard Durkan (Kildare North, Fine Gael)
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There were 100,000 families on housing lists when the Deputy left office.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Is the Deputy the Taoiseach?

Bernard Durkan (Kildare North, Fine Gael)
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I am not.

A Deputy:

He might make a better job of it.

Enda Kenny (Mayo, Fine Gael)
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Deputy Micheál Martin has no credibility on the economy.

Derek Keating (Dublin Mid West, Fine Gael)
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Absolutely none.

Timmy Dooley (Clare, Fianna Fail)
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The electorate will decide.

Enda Kenny (Mayo, Fine Gael)
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When he walked out of here before the general election in 2011-----

Dara Calleary (Mayo, Fianna Fail)
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He is available and the Taoiseach should debate the matter with him.

Barry Cowen (Laois-Offaly, Fianna Fail)
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The Taoiseach should walk into an RTE studio with him.

Enda Kenny (Mayo, Fine Gael)
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-----he left behind a programme, which he has been spouting about around the country and that others have implemented. Let me remind him of some of the stuff the Government of which he was a member included in that programme.

Timmy Dooley (Clare, Fianna Fail)
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The Taoiseach should tell the people about the things in the Government's programme that it will do.

Enda Kenny (Mayo, Fine Gael)
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It included a figure of €3 billion to be paid to Anglo Irish Bank from the taxpayer. It included a figure of an extra €638 million in income tax increases on the taxpayer.

Dara Calleary (Mayo, Fianna Fail)
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The Taoiseach should debate the matter with Deputy Micheál Martin.

Enda Kenny (Mayo, Fine Gael)
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It included a figure of €400 million for water charges without providing any relief for anybody. As the great equaliser, it proposed a cut in the minimum wage.

Micheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach should answer the question.

Enda Kenny (Mayo, Fine Gael)
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That is the Deputy's credibility on the economy. We have had to rebuild all of the structure. The Deputy has no credibility - zero, zilch, nothing.

Timmy Dooley (Clare, Fianna Fail)
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The Taoiseach should debate the matter on RTE.

Enda Kenny (Mayo, Fine Gael)
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We now have €3 billion of taxpayers' money on the table to build social housing. Deputy Micheál Martin did not answer when I said to him-----

Seán Fleming (Laois-Offaly, Fianna Fail)
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It is the Taoiseach's job to answer questions.

Enda Kenny (Mayo, Fine Gael)
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-----that if he wanted to have NAMA build 10,000 units of social housing, he needed to produce €2 billion and tell me the facilities from which he would take it.

Micheál Martin (Cork South Central, Fianna Fail)
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I told the Taoiseach what to do.

Enda Kenny (Mayo, Fine Gael)
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Every local authority in the country has its target and objectives and money and has been given the go-ahead to build social housing.

Micheál Martin (Cork South Central, Fianna Fail)
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Some 10,000 of those houses should be sold to NAMA to be developed in the next five years.

Barry Cowen (Laois-Offaly, Fianna Fail)
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The Government left them high and dry in the past five years.

Micheál Martin (Cork South Central, Fianna Fail)
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The Taoiseach just does not care about people who have problems.

Enda Kenny (Mayo, Fine Gael)
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There were 2,000 units taken from voids to take people off housing lists last year; 6,000 were helped through the housing assistance programme, while 5,800 were helped through increased rent supplement. I do not accept anything the Deputy says about rebuilding the economy.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Deputies are getting nowhere in shouting at each other. Nobody can hear what anybody else is saying. Will they, please, allow the leaders to put their questions and the Taoiseach to answer, without interruption?

Gerry Adams (Louth, Sinn Fein)
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The Taoiseach and the Government were elected because of the widespread anger at how the previous Government had behaved. He clearly knew that the people wanted equality and transparency and they still do.

Patrick O'Donovan (Limerick, Fine Gael)
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The Deputy wanted to bring the Government-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will the Deputy, please, stay quiet?

Gerry Adams (Louth, Sinn Fein)
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The Taoiseach promised to bring this about, but his promises were cynical and not based on any real conviction. It was rhetoric that tapped into the people's hope and desire to have society organised fairly. There is little talk nowadays from the Taoiseach about the Government's five point plan because, of course, it was never a plan but a PR device. On the Taoiseach's watch there has been a drastic rise in the levels of emigration, poverty and inequality.

A Deputy:

And employment.

A Deputy:

And the minimum wage.

Gerry Adams (Louth, Sinn Fein)
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We have a more divided society, an ever-worsening housing crisis, the closure of Garda stations and post offices, while the health service is in chaos.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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I ask Deputies to, please, stay quiet.

Gerry Adams (Louth, Sinn Fein)
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The Taoiseach also promised to deliver political reform.

Bernard Durkan (Kildare North, Fine Gael)
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That is great for the economy.

Gerry Adams (Louth, Sinn Fein)
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He promised that every vacancy to fill a paid directorship on a State board would be advertised through the Public Appointments Service. He said the directors of all State bodies would be asked to resign and reapply for their positions within six months of a Fine Gael-led Government taking power.

Arthur Spring (Kerry North-West Limerick, Labour)
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The Deputy should try that himself.

Gerry Adams (Louth, Sinn Fein)
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None of this happened. The Government stole Fianna Fáil's social and economic policies and also perpetuated its culture of cronyism and political patronage. In the past week the Tánaiste, Deputy Joan Burton, chose to appoint Mr. David Begg as chairperson of the Pensions Authority. The arrogant way in which she did this, irrespective of Mr. Begg's suitability, made a mockery of the Taoiseach's promise to deliver new politics, but she is not on her own. The Minister for Jobs, Enterprise and Innovation, Deputy Richard Bruton; the Ministers of State, Deputies Gerald Nash and Joe McHugh, and the Taoiseach have done the same. The Taoiseach conspired with the Minister for the Arts, Heritage and the Gaeltacht, Deputy Heather Humphreys, to appoint the Fine Gael candidate, Mr. John McNulty, to the board of the Irish Museum of Modern Art in order that he would qualify to seek election to the Seanad. Does the Taoiseach agree that all of this cronyism is in contravention of the pledges he made to the electorate?

Patrick O'Donovan (Limerick, Fine Gael)
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The Deputy might like to congratulate-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Taoiseach is well able to answer the questions asked.

Enda Kenny (Mayo, Fine Gael)
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I take Deputy Gerry Adams's comments about cynicism and conviction at the distance warranted. The Government wants to ensure the recovery under way will continue and be spread throughout the country. To do this its priority is to continue to create more and better jobs such that work will clearly be seen to pay. To create more jobs one will have to strengthen the economy to invest in public services provided by teachers, nurses, gardaí, prison officers, special needs assistants and resource teachers. We are not relying only on the reduction of taxes to make the economy strong. It is actually both because it leads to the creation of more jobs which generates the strength to invest in public services.

The Minister for Public Expenditure and Reform has introduced the Public Sector Standards Bill. Deputy Gerry Adams spoke about political reform. The Government has held more referenda than any previous Government. It set up the Convention on the Constitution and some of its recommendations have been implemented. Some will be implemented and others may the subject of future referenda.

The Government got rid of corporate donations. We have made changes to how business is run here, including giving the right to individual Deputies to introduce Private Members' Bills, complete independence and authority to Members of the House in the election of a successor to the Ceann Comhairle, Deputy Seán Barrett. These are just some of the issues on which the need for political reform is mentioned.

On appointments to State boards, I support the Tánaiste in the motion against her as a capable person in her work and duty as Tánaiste and Minister for Social Protection. On public appointments, the criteria are now drawn up between Departments and the Public Appointments Service for the range of qualifications needed by individuals who apply directly to and are vetted independently by the Public Appointments Service.

Michael Healy-Rae (Kerry South, Independent)
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That is rubbish.

Enda Kenny (Mayo, Fine Gael)
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Ministers do not even know the names of the individuals who actually apply. In the case of chairpersons to be appointed, they all have to appear before the relevant Oireachtas committee to make their case.

Timmy Dooley (Clare, Fianna Fail)
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It is a coronation again.

Enda Kenny (Mayo, Fine Gael)
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That represents a major change from what applied previously. Every Minister is entitled under law to determine if a person with suitable qualifications might be available and accept the appointment of a chairperson of a particular board. That applies under the Act. All chairpersons are required to go before the relevant Oireachtas committee to make their case.

Michael Healy-Rae (Kerry South, Independent)
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They are also required to be from Fine Gael or the Labour Party.

Bernard Durkan (Kildare North, Fine Gael)
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How did the Deputy get on a board?

Derek Keating (Dublin Mid West, Fine Gael)
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What board was the Deputy on?

Michael Healy-Rae (Kerry South, Independent)
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Who asked me to move off it?

Barry Cowen (Laois-Offaly, Fianna Fail)
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It is the chopping board that Deputy Derek Keating will be on.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Being a temporary Chairman, Deputy Derek Keating should know better.

Michael Healy-Rae (Kerry South, Independent)
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Who asked me to move off it, Gerry?

Micheál Martin (Cork South Central, Fianna Fail)
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He was politically removed.

Michael Healy-Rae (Kerry South, Independent)
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I was.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Do not excite yourself.

Michael Healy-Rae (Kerry South, Independent)
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It is called hypocrisy of the worst type.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Deputy should show some respect for the House.

Gerry Adams (Louth, Sinn Fein)
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In my question I tried to contrast the rhetoric as the Taoiseach tapped into widespread public anger and his failure to deliver on the promises he had made.

He avoided answering that when he responded and is skirting around the issue. He made detailed promises on political reform. He promised a public appointments Act that has never materialised. Why? The Taoiseach promised a vote in presidential elections for Irish citizens living abroad and a more transparent system of political funding. He promised to create an electoral commission. He has ignored numerous recommendations of the Constitutional Convention. It has been broken promise after broken promise. People still want fairness, equality and transparency.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question, please.

Gerry Adams (Louth, Sinn Fein)
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They want a caring society and they want to be treated as citizens but the Taoiseach treats them as fools. He has blustered and bluffed his way through all of this. Apart from the demographic that Fine Gael is targeting at the next election, increasing numbers of people know he will not bring this about because he has no conviction about these issues.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will the Deputy put his question?

Gerry Adams (Louth, Sinn Fein)
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Yesterday, and again today, the Taoiseach expressed confidence in the Tánaiste. He has little choice, however, as they are in this together, recycling the old politics of cronyism and insider machinations which are the opposite of the democratic revolution the Taoiseach promised. It is time for the Taoiseach to go. I said it yesterday.

Derek Keating (Dublin Mid West, Fine Gael)
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"I was never a member of the IRA", of course.

Gerry Adams (Louth, Sinn Fein)
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The Taoiseach has run his race and failed the people. Will he please let the people have their say on the past five years of failed politics, particularly, but not exclusively, on this failure and refusal to bring in the type of reform which he promised?

Bernard Durkan (Kildare North, Fine Gael)
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Five years spent restoring the economy.

Derek Keating (Dublin Mid West, Fine Gael)
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Five years of growth.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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We have an awful lot of taoisigh here this morning. Are they all going to take on Deputy Adams?

Enda Kenny (Mayo, Fine Gael)
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Deputy Adams’s central charge is about failure to deliver. The mandate given to this Fine Gael-Labour Party Government was to fix our public finances and put our country back to work. Five years ago, we took over these benches by mandate of the electorate. Interest rates were more than 15% and unemployment was 15% too. We had a haemorrhage of emigration, 300,000 jobs lost and a total collapse of our banks. People's ambitions and their life careers were all gone because of the antics of, and maladministration by, the previous Government.

Patrick O'Donovan (Limerick, Fine Gael)
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Sinn Féin wants to go into government with Fianna Fáil.

Enda Kenny (Mayo, Fine Gael)
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Deputy Adams has never supported anything that ever came from Europe. He wanted them to go away, get lost and go home. When he speaks about equality, the actions of the Government were not just rhetoric. The first action we took was to reverse the cut in the minimum wage imposed by the previous Fianna Fáil Government.

Deputies:

Hear, hear.

Enda Kenny (Mayo, Fine Gael)
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The second action we took was to reduce VAT from 13.5% to 9% in the hospitality sector, stabilising that industry and creating 35,000 jobs.

Deputies:

Hear, hear.

Pádraig Mac Lochlainn (Donegal North East, Sinn Fein)
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What has this got to do with the question that was asked?

Enda Kenny (Mayo, Fine Gael)
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The Government reduced the levels of universal social charge introduced by Deputy Martin when in government at the lower ends and capped the benefit of universal social charge at €70,000.

Pearse Doherty (Donegal South West, Sinn Fein)
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Up to €12,000 is what the Taoiseach will benefit from that. That is what he will pocket from that one.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Will Members stay quiet?

Enda Kenny (Mayo, Fine Gael)
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I am already committed to the abolition of the universal social charge over the next several years as a matter of equality.

It ill behoves Deputy Adams to talk about confidence when he stood up in public and said he had wonderful confidence in a person called Slab Murphy.

Deputies:

Hear, hear.

Derek Keating (Dublin Mid West, Fine Gael)
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"I was never a member of the IRA", of course.

Finian McGrath (Dublin North Central, Independent)
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I want to raise the important issue of health and the urgent need for action in this country. Yesterday, we had 522 people on hospital trolleys. Beaumont Hospital in my constituency had 44 people on trolleys. These are our people, our senior citizens and our sick on trolleys. We have a crisis in this country. Does the Taoiseach accept we have a crisis when it comes to the health system, particularly in accident and emergency departments?

What is the Taoiseach's vision and plan for the health service? I also strongly challenge the Taoiseach on the gross misrepresentation of the beds issue. Between 300 and 350 people have died as a direct result of overcrowding in our accident and emergency departments. There is a desperate situation and crisis in our health service. That is twice the number of people who die on the roads each year. The Government spin comes out with claims that it is not about beds but that it is a more complex issue than that. Dr. Fergal Hickey, an emergency medicine consultant at Sligo General Hospital, recently said:

Undoubtedly we need a sustained programme to develop additional bed capacity both in acute hospitals but also in community facilities. More suitable facilities for those with chronic medical conditions and a greater capacity to better care for those elderly patients who need more acute, though not necessarily hospital care, are also urgently required.

It is about beds.

Six months ago, I walked the accident and emergency department at Beaumont Hospital with a group of doctors and nurses. They were looking for between 80 and 100 beds. The Minister for Health last week was bragging on radio and television that he was going to give Beaumont Hospital 30 beds. That will not even take the 44 people off the trolleys there. What is the Taoiseach going to do about the health service and, in particular, the people on trolleys in our hospitals?

Enda Kenny (Mayo, Fine Gael)
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Overcrowding in emergency departments is always a serious issue. Over the past short period, the Government has focused on addressing this issue by making extra capacity and facilities available. It is not just a beds issue.

Finian McGrath (Dublin North Central, Independent)
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The Taoiseach is wrong. Medical professionals are telling me the Taoiseach and the Minister for Health are wrong.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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The Deputy can come back in with a supplementary.

Enda Kenny (Mayo, Fine Gael)
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Some 1,000 beds were taken out of the system. These have to be put back in again. This requires investment in facilities, nurses, doctors and other staff. That means one needs an economy that can actually drive that.

An extra €117 million has been put in to this area, along with extra staffing put in place. There is a three-pronged approach to addressing the problem. These include measures to reduce numbers of people coming into hospitals, the expansion of the community intervention teams to deliver services outside of hospitals and in communities, as well as the use of community hospitals, such as Mount Carmel, a new facility to assist in that regard. There are also measures to expand capacity to change work practices in different hospitals. As of 14 January, 111 beds were opened out of 154 which had been closed. Some 200 out of 326 new beds have now been opened with the remainder to open this month and in early February. A further 750 additional nurses in the health service were employed more than a year ago. Since September 2011, more than 300 additional consultants have been appointed to acute hospitals, including 78 appointments made last year. There has been real investment in the fair deal scheme, bringing the waiting time down for a nursing home place from 16 weeks to between two weeks, which is satisfactory. Other measures include reducing the level of delayed discharges in our hospitals, freeing up a further 300 beds; the opening of 170 community beds all over the country; 1,200 additional home care packages which apply where people want to stay at home, and rightly so.

There have been some improvements since mid-November in the number of patients on trolleys in emergency departments. An analysis performance through a 30-day moving average shows a 10% improvement in the overall numbers. Although it is not as satisfactory as one would wish, it is heading in the right direction. It is important to note that on average 3,000 patients present to emergency departments every day, a 7% increase on last year, with some 200 patients presenting at larger emergency departments every day. Up to 83% of those patients are typically discharged or admitted within nine hours of registration, which includes patient assessment, acquired diagnostics and treatment. It is an ongoing challenge and extra resources are being provided, as well as extra personnel.

Deputy Finian McGrath will be aware that the Minister for Health introduced the escalation policy if numbers increase above a certain level in emergency departments. That was the subject of intense discussions between management and the Irish Nurses and Midwives Organisation, INMO, recently. I hope that is proving of benefit in emergency departments where it applies.

Finian McGrath (Dublin North Central, Independent)
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I am very disappointed with the Taoiseach's answer; he has again come out with the usual response that it is a more complicated problem. I have three questions for the Taoiseach. Does he consider it is acceptable that people over the age of 80 are languishing on trolleys for 24 to 48 hours and suffering in severe pain? These are our senior citizens who paid their taxes all their lives. Can I bury the myth in regard to the response he spun a while ago about primary care? I will quote a senior consultant. He said, "Those calling for investment in primary care as a purported solution to emergency department [overcrowding] ... miss the point that the current difficulty is caused by the warehousing of admitted hospital inpatients in [emergency departments] ... not the patients who could be more appropriately treated in [a] primary care [group] ... who certainly do not end up languishing on trolleys". The Taoiseach needs to listen to the front-line workers. Again, he and his Government seem to be totally out of touch.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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A question, please, Deputy.

Finian McGrath (Dublin North Central, Independent)
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Will the Taoiseach for once and for all and listen to the nurses and the doctors but also accept the reality that in order to deal with the accident and emergency crisis we need to increase bed capacity? Thirty beds in Beaumont Hospital is not enough, 80 are needed, and that is the reality. If the Taoiseach was to go around the country and visit Deputy Halligan's constituency in Waterford, he would find that is also the reality there and in other hospitals. We need to increase bed capacity and to ensure that the necessary resources are put in place. We need to take the tough decisions and not give tax cuts to wealthy people while we have people dying on trolleys. Some 300 to 350 of our citizens die every year because of the current crisis. People need to wake up to that reality.

Arthur Spring (Kerry North-West Limerick, Labour)
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Where is the Deputy's health policy document?

Finian McGrath (Dublin North Central, Independent)
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Sorry.

Enda Kenny (Mayo, Fine Gael)
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Extra resources are being pumped into the health system-----

Arthur Spring (Kerry North-West Limerick, Labour)
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Where is the Deputy's health policy?

Finian McGrath (Dublin North Central, Independent)
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How is that relevant? Some 300 people are dying on trolleys.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
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Deputies, please desist.

Enda Kenny (Mayo, Fine Gael)
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-----and extra staff are being appointed, including 750 extra nurses and 300 consultants. With 1,000 beds having been taken out of the system bed capacity is an issue, which brings me back to the central point that with our economy recovering, we need to be able to keep that in focus in order that investment can take place to provide for these very facilities that people need.

I do not agree or say it is acceptable that persons of senior years should have to wait for very long periods on trolleys in hospitals. Much of the focus is on ensuring that does not happen. It was the focus of intense discussions between the Irish Nurses and Midwives Organisation, INMO, and management in hospitals in the recent past. An agreement was reached on that and I hope that management will be able to put in place the changes for the facilities within those hospitals that staff need and that staff have complained about in the sense of not being able to look after their patients to the level to which they have been trained.

Primary care is a central feature of Government policy on health and the more people who can be treated in the community and at primary care centres and not have a requirement to go hospital in the first place, the less pressure there will be on accident and emergency departments. It is a part of a three-pronged approach to provide facilities as close to people as possible within the primary care system and, within a recovering economy, to be able to invest where possible. That includes bed capacity and staff and personnel who are trained to deal with these matters. It is always a challenge, as the Deputy is well aware.