Ceisteanna ó Cheannairí - Leaders' Questions

I take this opportunity to offer my sincere condolences to the family and friends of the jockey Pat Smullen. His death has brought deep sadness to the horse-racing community and, indeed, far beyond that.

As we all know, Pat fought his own battle with pancreatic cancer but he also raised more than €2.5 million for treatment and research into that disease. It is fair to say that Ireland has lost a champion both on and off the racecourse. Ar dheis Dé go raibh a anam.

Yesterday was billed as the day to bring clarity and forward planning. Instead what we got was chaos, confusion and very considerable anxiety for people. I am glad the Minister, Deputy Donnelly, tested negative for Covid-19. I am also glad that he got that result within a matter of hours. It has to be said that experience does not tally with people more widely across society. I make that point because 24-hour turnaround of results has to become the universal standard for everyone in society.

Last April, the Taoiseach's colleagues in government, Deputies Leo Varadkar and Simon Harris, told us that we would reach 100,000 tests per week. The Taoiseach will know that the Covid committee made a recommendation on the advice of experts that 24-hour turnaround for results would be achieved and observed. Months later, neither of those two important commitments have been met. Disappointingly, the Government's very lengthy plan announced yesterday was very sketchy in respect of testing and tracing. It provides no concrete targets or delivery plans in this area. I emphasise "this area" to amplify the basic public health advice, which is that to deal with this crisis, to get ahead of this virus, to flatten the curve and to keep it flattened we must test, trace and isolate. That is what the World Health Organization tells us and it is correct. In that spirit, when will we get to 100,000 tests per day? What is the target beyond that because 100,000 will not be sufficient? As I said, the all-party committee recommended 24-hour turnaround for results. When will we reach that target? Can the Taoiseach clarify those matters for the Dáil this morning because we need to get this basic central element right.

I am glad that we are back in the Dáil following yesterday's shambles. The public was left with a real sense of unease seeing the Cabinet being unable to work and the Dáil suspended. People have lost confidence in the Government's handling of this emergency, not least here in Dublin, where it has left people hanging in a very cruel limbo. It is not just that people are confused, they are beside themselves. There are people whose businesses are hanging by a thread, people whose jobs are in the balance and people who want to have social contact with friends and family. There is no clarity yet as to whether people can come and go from this city. The message from the press conference was that people should not move outside of Dublin. The Minister, Deputy Donnelly, said the opposite and then the Taoiseach was unclear last evening on RTÉ. This morning, again, we had two senior Ministers, Deputies O'Donohoe and Michael McGrath, contradicting each other within a matter of hours. It is an absolute mess. The Taoiseach needs to be straight with the people of Dublin. He needs to tell them what exactly we are facing. We need that clarity and certainty now. Can the Taoiseach provide that clarity? What are the current restrictions and will we be facing further restrictions when NPHET meets or when the new committee meets? Will the Taoiseach commit, as I have asked, to ramping up seriously, in a concrete way, our testing and tracing capabilities?

I express my deepest sympathies to Pat Smullen's wife, Frances, and his family. He was an iconic figure in the racing world who is deeply mourned by his family and friends. I salute his absolute courage and commitment to cancer care and in taking on what was the greatest challenge in his life.

Just because Deputy McDonald says things does not mean they are true. The Deputy has a habit of deliberately distorting and undermining genuine and significant efforts in regard to dealing with Covid-19 and in her own commentary and contribution tends to evade the hard questions as well, particularly in regard to Dublin. I look forward to the Deputy's support next week in terms of whatever advice comes from NPHET. I would appreciate that support as the Government may implement that particular advice.

On testing, today the HSE has surpassed the 1 million test mark in this country. Last week, there was a 70% increase in community testing requests from general practitioners, GPs. The system has managed to deal and cope with that. Obviously the return of our schools has created additional pressures, as is the case all over Europe. Interestingly, the positivity rate for children tested between 0 to 14 is less than 1%. There is a daily capacity of 15,000 for community and acute hospitals. The HSE will say that this is more crucial than the 100,000 weekly figure. Some 11,000 is for community tests where spikes are identified and the remainder is for capacity in our acute hospitals. It is quite significant in terms of what has been achieved to date. This week, thus far, there have been further increases in testing requests but there is more swabbing capacity in place and testing sites ready to deal with it. On average, there will be 10,000 community swabs per day alongside 3,000 in hospitals. In terms of serial testing, 12,000 tests are expected from nursing homes, 4,000 from meat plants and 3,000 from direct provision. This week, the HSE will reach its highest ever number of swabs taken and tests processed and this will continue to improve. Let us acknowledge the significant ramping up of the testing system. There is road to go yet. The system was set up mid-flight as the pandemic took hold.

Deputy McDonald made the statement that the plan is sketchy. The plan is not sketchy. It is very specific in terms of creating a dedicated workforce for testing in the country. The Deputy would know that if she read the plan. A 3,000 strong workforce is to be employed. That is provided for in the plan. That specific figure is in it. Currently, the HSE is recruiting 700 people to take swabs and 500 contact tracing staff. Those are specific figures that are in the plan. The Deputy knows that yet she chooses deliberately to distort and seek to mislead in regard to it. The plan provides for 30 test centres, a minimum of one test centre per county, six pop-up fleets, a number of dedicated contact tracing centres and the response to clusters as they emerge. The situation on testing is comprehensive. There is a clear plan to expand and ramp up testing further.

On the overall plan, it is a good plan in terms of the five levels. Ireland is one of the first EU member states to come up with a comprehensive plan of this kind. On Dublin, the advice presented to us by NPHET has been adopted by Government and made public. NPHET, as I said yesterday, may come forward with further advice in that regard on Thursday.

The Taoiseach may have heard Dublin-based GPs this morning on the media setting out their concerns around the delays in accessing tests and the further delays in results being returned. He may choose to adopt a defensive posture and to attack me but I am working on the supposition that he will take the word of medical professionals who are not inventing these scenarios. These are doctors who deal with patients who present when they are sick, as I did. I had this experience.

They are not in the habit of making up things. The only people engaging in wishful thinking, it seems, is the Taoiseach and his Government.

I want to know when we will get to 100,000 tests per week. I have my app here and it reflects the testing done over the past seven days. We are way short of that number. It was the same last week, the week before and the week before that. The Government made the commitment of 100,000 tests per week so when we will it reach that number?

Thank you, Deputy McDonald.

There is also the matter of the 24-hour turnaround in testing. As for Dublin, the Taoiseach's words today add to the confusion and anxiety across the county.

Please, Deputy. You are way over time.

NPHET gave information and advice to the Government and it was put into the public domain. All the Taoiseach has achieved is confusion and he has not been on his own, as other Ministers have also caused confusion. The Taoiseach should clarify matters now by precisely and succinctly setting out the travel advice for people in Dublin.

The Deputy knows it.

Deputy Martin is the Taoiseach and should set it out. His Ministers do not know it.

The Deputy knows it.

Please, Deputies.

The community does not know it. The Taoiseach is the head of the Government so instead of snapping at me he should do his job and set out the information.

We have prescribed time for these questions and I do not wish to be at odds or take issue with anyone. Additional time has been allocated to Sinn Féin and we have gone over that allocated time. Could we please, all of us, try to stay-----

That additional time is based on our parliamentary numbers by the way. I state that for the record.

That is obviously why it is happening. Why else would it happen?

That is just to be complete in the explanation.

Deputy Mac Lochlainn should calm down.

We are not operating on the basis of favouritism.

In the seven days to 13 September, there were 74,796 Covid-19 tests completed and that is the highest number of tests in a single week since the beginning of the pandemic.

It is also not 100,000.

It is a significant ramping up of testing. There has been quite significant pressure since schools returned, which is normal and to be expected. The system is coping with that. The Deputy knows full well the advice for Dublin. I stated that advice yesterday in the Dáil.

Will he state it again?

The Deputy knows full well what is the advice. I will state it again. Those living in Dublin are encouraged to limit travel outside Dublin if possible. When outside the county they should not meet with more than one other household. That is the advice from NPHET that we have endorsed. It is the advice out there right now. There is no regulation or legal restriction but it is the advice. We encourage people not to travel outside Dublin. Of course, the Deputy knows this but she just wanted to come here and say there was confusion, chaos, this and that.

Thank you, the time is up.

I did not have to. The Government has done it by itself.

The Deputy keeps on doing it. It is a mantra. It is what the Opposition does.

The time is up.

I facilitated a briefing with the HSE on testing and the Deputy was presented with the figures from the HSE chief executive officer. The Deputy is doing a disservice to the work of the HSE in this.

Please, Members, the time is up.

I genuinely believe the Deputy is. The Deputy's entire approach to this is not to seek clarity but to undermine; it is not to amplify public health measures but rather to undermine them.

No. Testing and tracing is the core of this.

Members, please. Do you know what? We can tear up the rule book and do what we like in here if we are not going to adhere to the rules that Members themselves put in place.

I plead with Members to adhere to the time limits.

I wish to commence by discussing the rules. Yesterday was one of the most bizarre days we have ever put down here on a number of fronts. As a country, we have a limited Judiciary in operation. Yesterday, the Executive basically went into self-isolation and this Chamber, the Legislature, stopped for a period. These are the three arms of the State.

I would like to know what happened yesterday, so will the Taoiseach write to the leaders in the Opposition detailing how the Dáil ended up being suspended? I asked the Ceann Comhairle to do the same and, in fairness, he has written to me on the matter. I would like the Taoiseach to do the same. I would like to know what happened. I rang the Taoiseach and, in fairness, he returned my call, considered the matter and the Dáil recommenced. I would like to know the detail.

I ask the question because this could happen again and we just need a contingency plan. For example, the Minister for Foreign Affairs and Trade, Deputy Simon Coveney, is going through some really detailed negotiations on our future as it is affected by Brexit. We need to know that there is a contingency plan for the Executive and these Houses. Can that be communicated to us?

I will also ask about what was launched yesterday. We need to move on and get the country behind us. The Labour Party and I support the plan. However, I do not understand why the Taoiseach did not come to us all before yesterday to say the Government was not ready but it wanted to align with NPHET advice and slot everything into five levels. There could have been a heat map for every county indicating which stage the county was at instead of having a hybrid position for Dublin. I did not know what to tell people in Dublin yesterday.

I would like clarity on the following matters. I know people who are going to weddings outside Dublin. Should they go? There is a coach operator in my constituency who has 14 people who have been re-employed and who cannot go back to the pandemic unemployment payment. The bookings are for the west of Ireland but the majority of customers are from Dublin. Should they go? The Taoiseach should be clear about this. Should those people taking trips down the country, probably people without children who waited until September, go? The Irish people will support the Government if it is just clear.

Will the Taoiseach come out with a communication plan for everybody in the country? We should remember that the majority of infections now are present in people under 45 so how we communicate with them is different from traditional media. Fair play to The Irish Times for producing a graphic detailing the plan, although I know the Taoiseach's party tried to jump on the bandwagon. It is the best example of how to communicate the plan. Will the Taoiseach put together a plan to communicate this across social media and into every house in Ireland for the next six months?

On the first point, I took the phone call from Deputy Kelly.

He did, in fairness.

I fully appreciate his concerns, which I believe are genuine. The Dáil was adjourned for two hours.

The Taoiseach has some brass neck on him.

The Deputy should remember this is Leaders' Questions.

The Deputy should calm down. He is very excitable. He is interrupting non-stop.

The rest of the people of Ireland are very excitable when they listen to the Taoiseach these days.

When news emerged that the Minister for Health, Deputy Stephen Donnelly, was to be tested, the Secretary General of the Department contacted the acting Chief Medical Officer and he, to use his own language, in an "over-abundance of caution", said that Ministers should restrict their movements. The Secretary General was anxious that the Chief Whip would get the message and communicate it to the Clerk of Dáil Éireann. It transpired there were ramifications for the Dáil in that senior Ministers were told it would be unwise to attend, given the substantial number of meetings attended by the Minister, Deputy Donnelly, with other Ministers the day before. If he had tested positive, there could have been a risk involved. The call was made and the people involved did not want to expose any other people to risk. It is as simple as that.

Everybody acted in good faith. When I became aware of the situation, the point was made that Ministers of State could cover for senior Ministers. That said, it could not happen in all cases. I communicated, I think it was with the Clerk of the Dáil, with the Chief Whip present, and said I was of the view that the Dáil should resume, with Ministers of State available to take business. I signed the summons to enable that to happen. That is it.

We are in a Covid-19 pandemic. I had to change an interview with RTÉ, for example, which was due to take place in my office. I contacted the acting Chief Medical Officer and asked if it was advisable to go ahead with the interview. He felt it was not, in that context, so I we went outdoors by the fountain and had an interview with RTÉ at a distance.

The distance you might get in a football stadium.

Correct. I am just making the point that everybody acted in good faith. The motivation was precaution in trying to prevent risk.

There is no big mystery to it.

The next question concerned the plan itself. The plan is fundamentally about protecting lives and livelihoods. That is its ultimate test of its sustainability. It is there for the long haul, that is, the next six to nine months. The National Public Health Emergency Team, NPHET, advice came in advance of the plan for Dublin and we felt it was better to implement that advice right now. NPHET raised various issues in its advice to the Government, but it was very clear that it did not advise moving to level 3 at this time because the current epidemiological data does not support such a move.

In the short time I have I call on the Taoiseach, working with the Ceann Comhairle, to put in place a contingency plan for the future the Executive and the Houses of the Oireachtas.

We are not here to catch the Taoiseach out so he does not have to do so here, but I ask him to please tell the people of Dublin whether they can go to hotels and weddings and whether tour operators can operate. It is a very simple "Yes" or "No" question. I challenge him to answer. People have to make decisions.

Will the Taoiseach take on board my suggestion concerning a communications strategy? Again, this is a simple "Yes" or "No" question. If it has been done, it is a disaster. This document is the best example we have seen.

I have the letter of advice written to the Minister of Health, Deputy Stephen Donnelly, by NPHET on 11 September. At the time, the 14-day incidence rate was at 42.34%. It is now at 53%. The letter gives different recommendations on some activities, such as sports, the operation of pubs, etc. If the Government is going to follow the advice of NPHET, that is fine. In future, when it deviates from the advice, can the Government publish that advice and outline where it proposes to differ from it?

I do not have an issue with the Government deciding not to follow some of the advice for socioeconomic reasons. In fact, in many cases I would support that decision. However, the Government should at least be clear about what it has been advised to do and what it is actually doing. Those two things are not the same.

I have made it clear that people should not travel outside of Dublin if possible. That is the NPHET advice. I said it to the Deputy and I am saying it again today. I said it publicly on the "Six One News" and the Tánaiste said it later on "Prime Time". A leaflet is going out to every household. That had already been decided as part of the communications plan. There has been very extensive planning around the communication of plan, the significance of the various levels and so on.

What about the new communications company?

I have outlined the very specific NPHET advice for Dublin, which the Government has decided to follow. There have been differences from the beginning. The original roadmap was not 100% identical to the advice of NPHET. There is a natural interface there. Deputy Kelly was among the first to come into the House and say that NPHET was too influential. I do not entirely agree. Public health advice is key to dealing with the pandemic. That was the original position which we all adopted in this House.

The Taoiseach cannot say he is following public health advice.

When I was in opposition I took a very strong position in support of public health advice from the outset of the pandemic. I did not seek to play politics with it, though I am not saying Deputy Kelly is doing that.

We will now hear the view from the sunny south east.

I think it is sunny everywhere today except in the Dáil.

I got a very disturbing email yesterday containing photographs of a queue in Dover. The Port of Dover has apparently instituted migrant checks which meant it took commercial traffic three hours to travel 1.8 km. The effects of Brexit are still four months away.

In recent weeks the UK Government introduced the United Kingdom Internal Market Bill 2019-21. By the UK Government's own admission, this breaches Article 4 of the EU-UK withdrawal agreement, an international treaty. In so doing, the UK Government has decided to breach its international obligations under an international treaty in order to safeguard national interests. It has admitted this to the entire world. The UK's reputation for dealing in good faith has been irreparably damaged worldwide, and it does not appear to have taken a feather out of the political leadership.

With this in mind, there is grave concern that the UK will also renege on its commitments to the transit arrangement concerning the UK landbridge. There is no guarantee that the UK will honour the Common Transit Convention, which allows the passage of Irish trucks carrying valuable Irish exports through the network of UK roads and ports to mainland Europe. Every year more than 150,000 trucks come and go from Dublin Port and Rosslare Europort and use the landbridge. This trade has an estimated value of more than €18 billion. Many of these trucks are carrying fresh produce such as beef and lamb from Wexford factories like Slaney Foods International in Clohamon, Irish Country Meats in Camolin and Kavanagh Meats Ireland in Enniscorthy. These three factories employ 1,100 workers, not including farmers, hauliers and service providers. Just a fraction of that cohort has been in touch with me to voice their concern that the UK's actions could signal the end of the landbridge transit arrangement.

Can the Taoiseach tell the House whether this transit arrangement has been secured as part of the withdrawal agreement? Moreover, what preparations has the Government made to safeguard Irish exports, jobs and businesses if the UK reneges on the Common Transit Convention and prevents Irish trucks from using the land bridge?

I thank the Deputy for raising this very important and pertinent issue. Maintaining the UK landbridge as an effective route to market has been a key priority in the Government's Brexit planning. The Irish Maritime Development Office estimates that there are approximately 150,000 landbridge movements annually, with an estimated trade value of €18.2 billion. This is a very important connection. As the Deputy outlined, many of these goods are agri-food products with a short shelf life, such as fresh fish, which makes the landbridge particularly valuable. It is the most viable route to market for many of those goods.

The UK's accession to the Common Transit Convention is welcome. For the information of Members, that allows goods in transit to move through the United Kingdom without undergoing full import or export customs formalities on entry and exit. We have engaged in substantial talks at official and political levels across the European Union to ensure that EU goods in transit via the landbridge will not be subject to additional and unnecessary checks and controls. We have worked especially closely with our French, German, Dutch and Belgian counterparts to understand each other's operations and plans for the post-transition period.

The Deputy has raised the question of the UK Government's commitment to this in light of its introduction of the United Kingdom Internal Market Bill 2019-21, which runs counter to and represents a disavowal of the withdrawal agreement, a binding international treaty, and the Northern Ireland protocol. I have spoken to the UK Prime Minister and pointed out in no uncertain terms that this is unacceptable. It breaches an international treaty and raises questions about the UK Government's commitment to any further agreements that might be concluded. We are working with our EU colleagues in that regard.

I asked what preparations have been made.

I will come to that. I wish to state that in that context, we get no sense from the UK Government that there will be any attempt to undermine such trade. London is still adamant that it wants a comprehensive free trade agreement and does not want disruption. We have had no indication whatsoever of any negativity around the landbridge, or any attempt to undermine its importance to Ireland's exports to mainland Europe.

The Department and those involved in the sector are of the view that we have sufficient capacity to deal with this.

Obviously, it is something we will continually monitor. As the Deputy is aware, there is significant investment going into Rosslare Europort, including the €30 million plan and, in terms of Brexit, the 10-acre site that was acquired and developed to provide inspection facilities and so forth.

I did not hear the relevant provisions. There should be a provision for capacity, which is currently on the UK side, to be diverted in the event that the UK carries on in the way it did in the past week and reneges on the common transit convention. The convention means that businesses must put financial guarantees in place just for the privilege of crossing the UK. If it will take three hours to travel 1.8 km, as was the case yesterday, that effectively will mean the drivers' regulation will be kaput and the land bridge will be defunct. I am asking the Taoiseach why we have not invested the necessary €100 million or €150 million in Rosslare Europort to safeguard €18 billion in trade. That investment should be made to put direct ferry services in and build a port of the future at the most strategic port in the country in order to get goods to mainland Europe and circumvent that three-hour delay. It would mean that drivers would have certainty in their planning. As a result of the driving regulations, they must plan every minute of their day from the time they leave the meat factory or fishing port. They have a 15-hour period within which to start and finish driving. The three-hour delay experienced yesterday meant that drivers spent nine or ten extra hours in the UK. That is putting trade and jobs at risk. Rather than supporting businesses, the Government is putting them at risk. By failing to make provision for a daily service, we are putting ourselves in the hands of the UK. It will be able to pull the rug out from under us and tell us we will not be able to use the land bridge. I am asking the Taoiseach to make provision for direct daily services immediately.

I have discussed Rosslare Europort with the Deputy and she is aware that there are issues relating to its capacity to move very quickly or immediately on a €150 million project. Its planning application in terms of the master plan which involves an investment of more than €30 million in customer facilities, port infrastructure, assets and new technology by the port authority has already been lodged with Wexford County Council. There will be further resources under the Brexit plan. As far as we are concerned, whatever measures are necessary will be undertaken in relation to-----

Daily direct ferry services are needed.

-----the capacity that is required but-----

I am seeking a commitment to daily direct ferry services.

The Taoiseach without interruption.

The Government will do what is required in terms of our export trade-----

Daily direct ferry services are required.

-----but we need to get what is already planned and initiated done and delivered.

The Government is leaving us wide open.

There are issues on the ground there in terms of getting things moving. The planning application has just been lodged.

I know that. The €150 million needed for daily services-----

It cannot be done overnight.

One cannot have daily services if------

I will take on board the Deputy's comments.

When the Taoiseach's predecessor and now Cabinet colleague announced a lockdown, we were all clear as to what was required of the public and the public did what was required of it. Hospital capacity was an issue across Europe, even in Germany and Italy which have much better healthcare systems than Ireland does in terms of preparedness. We were told that our capacity was particularly low and, as such, we had to be particularly careful. At the start of the year, this country's permanent adult critical care capacity was 255 beds. Funding was provided in March for an additional 40 adult beds and two paediatric beds. Have those beds and units now been built? Are they ready for this autumn as we face into winter?

As I reminded the previous Minister for Health, Deputy Harris, when he slipped out of the Chamber a few moments ago, in May he accepted that the overcrowding in University Hospital Limerick, UHL, was unacceptable and that, if not addressed, would be a disaster this winter. He accepted that additional procedures would be required to be carried out in the tier 2 hospitals that surround UHL, namely, Ennis Regional Hospital, Nenagh General Hospital and St. John's Hospital. I did not hear any more from the Minister, Deputy Harris, on the issue because he changed portfolios. The Special Committee on Covid-19 Response heard from Dr. Liam Woods, who confirmed that plans were under way to increase the number of procedures. However, instead of that happening, all surgeries were cancelled a couple of weeks ago at Ennis Regional Hospital. Thankfully, they have since been reinstated. In direct response to overcrowding in UHL, all elective procedures have been cancelled this week. That is putting further pressure on waiting lists and leading to deterioration of quality of life, as well as affecting life expectancy in many cases.

Swabbing and testing is essential, as the Taoiseach and Deputy McDonald have agreed. However, up to now, public health dentists, speech therapists and other trained professionals in our healthcare system have been diverted to testing. I am not saying testing is unimportant. On the contrary, it is extremely important. However, six months into this crisis, those workers need to go back to their normal jobs. It is inexcusable that people have not been trained and put in place to carry out testing such that dentists, speech therapists and so on are not being diverted to testing.

Six months on from the announcement of the lockdown, what is the current permanent adult critical care capacity? What is happening with regard to the UL hospitals group? What is happening with regard to those carrying out testing?

First, the current number of total adult critical care beds open and staffed is 278. There are 30 paediatric critical care beds open and staffed, 218 occupied adult critical care beds and 23 occupied paediatric critical care beds. There are 13 adult critical care beds reserved for patients and one paediatric critical care bed reserved for patients. The €600 million agreed by the Cabinet this week as part of the winter initiative is essentially a Covid winter initiative to take us through specifically the next six months. It is designed to allocate resources to reduce pressure on emergency departments and innovate around community respiratory clinics, for example, as a preventative mechanism to intervene in order that people do not end up in emergency departments as was the case in the past. It will create more bed capacity in acute facilities, but also in non-acute facilities which will facilitate people coming out of hospital in a timely manner once their treatment is completed. It makes provision in terms of community diagnostics and, where it is possible to continue with elective procedures separate from the trauma hospitals, for that to be done and accelerated. The HSE knows that any capacity it can deliver in the short term and medium term will be funded and resourced. It is probably the largest winter initiative for some time and it is necessarily so because we are anticipating significant challenges on that front.

I agree with the point made by the Deputy with regard to testing. I have been in office for 12 weeks. I believe a permanent workforce is required for testing and tracing and that is what is happening. That is what is detailed in the plan we published yesterday. It sets out that we will have a dedicated testing and tracing team that will work side by side with health service personnel. When the testing and tracing regime was originally established in response to the pandemic, people were drawn from various disciplines within the health service. There was a view that in the initial phase a clinical decision maker was required. There is no doubt that as we expand and ramp up testing and tracing even beyond its current level, a dedicated workforce will be required. A figure of 3,000 personnel to be employed in testing and tracing is identified in the plan. That is a significant number of people, but it is what is necessary.

There are, without question, significant pressures in University Hospital Limerick and the mid west. I have been in contact with the Department of Health, the Minister and the HSE with a view to implementing measures to alleviate the situation in the mid west.

I note what the Taoiseach plans to do over the next six months but my question was more about what was done over the past six months. The public is justifiably sceptical about Ministers with plans. We have been hearing about what is planned for the health service since the Taoiseach was Minister for Health and Children. It begs the question of how many health ministers it takes to change a health service. There are four current or former health ministers in the Cabinet.

The shortage of critical care beds was the most significant shortage that we had in this country relative to others. Of the 40 funded six months ago, if I understand the Taoiseach's figures correctly, only 23 have been provided - a little over half. It seems nothing concrete is planned for UHL other than aspirations. I appreciate that the Taoiseach is three months in office, but these were three months when we were looking down the barrel of the gun of a winter crisis which, hopefully, will not arise. If the medics and the predictions by NPHET are incorrect, it will not happen. If they are correct, then we are facing a calamity and we need to move. We do not need to hear much more about plans. We need delivery and the delivery over the past six months does not inspire confidence in what can be delivered over the next six.

In terms of testing and tracing, the recruitment campaigns are already under way. These are not just plans. This is happening and the staff are being recruited.

Those are the figures open and staffed now. They may not be exactly what is available. The Deputy will be aware that during the pandemic a significant number of acute care beds and critical care beds were made available.

There was surge capacity. I accept that.

A surge capacity was created and that applies here as well.

We do not know what that is.

I just wanted to give the Deputy the most up-to-date operational details as provided by the HSE for the number of critical beds available. There is ongoing work on procuring additional capacity on an initiative-by-initiative basis in terms of the private sector capacity to make sure we can get some elective procedures done and that elective procedures are not suspended as a result of overcrowding in the emergency departments and trauma departments.

I intend to engage with all concerned, in particular, in the mid-west. If one looks back over the past two years, there have been without question ongoing pressures on the mid-west, and particularly University Hospital Limerick.