Pearse Doherty (Donegal, Sinn Fein)
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I will begin by wishing our colleague Deputy Jennifer Whitmore a speedy recovery. We look forward to welcoming her back to the House. I read this morning that she was taken to hospital. All of us on these benches wish her a speedy recovery.

Aréir, thuairiscigh "RTÉ Investigates" an mí-úsáid uafásach, an cruálacht agus an drochíde capall ar an seamlas amháin atá againn atá ceadaithe sa Stát seo. Teastaíonn gníomhú láithreach ar an mí-úsáid a thuairiscíodh agus caithfear an dlí iomlán a chur ar na daoine atá freagrach as seo. Ní féidir linn glacadh leis an chruálacht a chonaic muid ar an gclár teilifíse aréir. Caithfidh an Rialtas scrúdú láithreach a chur ar bun. Last night, "RTÉ Investigates" reported shocking abuse and cruelty at our only licenced abattoir at Shannonside Foods Limited in Straffan, County Kildare. This mistreatment was very distressing for many people. It included the repeated beatings of dying horses. In one instance, a fallen horse that was unable to get back on its feet had a pitchfork thrust into its side. The horse died hours later after this suffering had been inflicted on it. These appalling incidents were filmed in the buildings used by Shannonside Foods Limited to house horses before they are sent across to the kill room in the slaughterhouse, which is supervised by the Department of Agriculture, Food and the Marine. That Department has somebody on site.

Professor Chris Elliot of Queen's University Belfast led the independent review of the British food system after the 2013 horsemeat scandal. He said that what he saw was nothing like he experienced before. Involving the breaking of all regulations on the treatment and welfare of animals, he rightly called it out as a scandal.

Anyone who watched last night's documentary will have been distressed and appalled. People in this country have a great love for horses. I know the comfort that those with special needs and autism get from horses. Indeed, many people refer to these animals as angels with hooves. They demand respect and care. What was reported last night demands immediate action and accountability. I commend the journalist who brought this matter to the public's attention and who brought this cruelty and mistreatment to light.

It has been uncovered that approximately 2,000 horses were slaughtered in Shannonside Foods Limited in Kildare last year alone. Two thirds of those animals were bred for the horse racing industry. The Department of Agriculture, Food and the Marine had said it has staff on the premises when those horses were slaughtered. It also indicated that no welfare issues were noted on the days when this mistreatment took place. A question that many people are asking this morning is how this mistreatment happened under the very nose of the Department of Agriculture, Food and the Marine. What is clear is that the law has been broken. I understand that the Department and An Garda Síochána have begun an investigation on foot of the shocking findings of "RTÉ Investigates". I welcome that. However, questions must be asked as to whether supervision at this site was adequate, particularly in light of the cruelty and abuse taking place literally a stone's throw away from the slaughterhouse in which the departmental official was sitting and supervising. People are asking how could it be that this building just yards away did not fall under the remit of the Department. What has also been raised in the context of last night's programme is the potential for compromise of the human food chains with evidence of identify falsification, with one animal welfare officer inserting false identification microchips into the horses.

Will the Minister ensure that the full weight of the law is brought down on those responsible for the cruelty and mistreatment reported in last night's programme? What is the Government going to do to enhance supervision to ensure that this never happens again? Has the Minister been in contact with European counterparts regarding the possible contamination of human food chain as a result of the misidentification and laundering of Irish horses?

Michael McGrath (Cork South Central, Fianna Fail)
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I thank Deputy Doherty. I join him in wishing our colleague Deputy Jennifer Whitmore all the best. I did not realise she had taken ill. All our thoughts are with her today. Briefly, I want to congratulate the fantastic 4x400 m relay team of Sophie Becker, Phil Healy, Rhasidat Adeleke and Sharlene Mawdsley that had phenomenal success winning a silver medal at the European Championships. We are all so proud of them. We have two gold medals and two silver medals now. It is a phenomenal haul. Hearing the young kids on the radio this morning, there is no doubt that they will be inspired by the incredible success of the team. We are all so proud of those involved.

I thank the Deputy for raising the "RTÉ Investigates" programme last night. I had the opportunity to watch the programme and, like him, I was sickened and appalled by what I saw in the context of the mistreatment of beautiful animals. It is important to state that there is no question that the treatment we witnessed on last night's programme is not representative of the wider equine industry or of the love and care that owners of horses throughout the country display for their animals every day. I know all of those people who love their animals and their horses and care for them deeply will have been appalled and shocked by what we witnessed last night. I join the Deputy in acknowledging the tremendous work of Conor Ryan, a fantastic investigative journalist with RTÉ, and the whole team that works on "RTÉ Investigates". The programme is an example of public service broadcasting at its best. We owe those involved a debt of gratitude for the work they have done.

There has been contact in recent weeks between RTÉ and the Department of Agriculture, Food and the Marine. The Department initiated an investigation into this issue some weeks ago. That work is ongoing. The Deputy asked a specific question about the role of the Department's inspectors. It would appear at this point that the appalling mistreatment that we witnessed on our television screens was happening in a holding building rather than the slaughterhouse, which is a regulated area and where the Department's inspector would have been present. All of that is now the subject of a thorough investigation on the part of the Department of agriculture. That work is under way.

The Government unreservedly condemns the scenes we witnessed. The full force of the law will be applied where breaches are proven in a court of law. We need to allow that process to take its course and not to say anything that would be prejudicial to the investigations being carried out. Clearly, An Garda Síochána is very much aware of what happened in this instance and is taking appropriate action as well.

A number of wider issues came to the fore in the programme in the context of traceability, the use and misuse of microchips and fake passporting in respect of horses. What emerged gives rise to concerns about public health as well as animal welfare. If animals ended up in the European Union food chain that should not have because of chemicals that had been injected into them previously, then that is a cause for real concern. It was evident last night that the European Commission is very actively working on this issue. There is engagement between the Department of agriculture and the European Commission and there is full co-operation by all the relevant national authorities in respect of the work under way at European level. Our priority is to protect animal welfare but also public health. serious concerns have arisen in respect of both following the scenes we witnessed on last night's programme.

Pearse Doherty (Donegal, Sinn Fein)
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I thank the Minister. I agree with him. Anybody who watched that programme last night could not be anything but shocked, appalled and sickened to their core at the distressing images that were presented. This morning I am struggling to find out some information. The Minister may be able to shed some light on it. This is the only licensed abattoir in the State. Is it still operating? Is it business as usual? Is this company still operating this abattoir this week? Will there be slaughtering of animals there? Does the Department of agriculture still only have supervision of the slaughterhouse? Is it the case that it does not have oversight of the building located just a couple of yards away in which the cruelty was happening and images from which were shown to us last night because it is technically not an official part of the slaughterhouse? We obviously have to let An Garda Síochána conduct its investigation, but there is a responsibility on us to ensure that practices such as animal welfare officers - as was shown on the programme - inserting false identification microchips into horses, the beating and the stabbing with a pitchfork of a dying horse, and the whipping of horses are not allowed to happen.

It is absolutely intolerable. With all the other issues that have to be dealt with such as passports and identifications, will this business still continue? Is the Government still happy for the business to continue as it is? Do we now have oversight of all buildings on that yard?

Michael McGrath (Cork South Central, Fianna Fail)
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A full investigation is under way. It has been under way for a number of weeks. The abattoir where the slaughtering is taking place is a regulated environment. I want to be clear that the animal welfare rules apply everywhere. They apply also in the holding area even if that is not the area where the inspection was actually taking place, which is in the slaughterhouse itself. In the holding area, the same animal welfare rules apply. What we saw on our television screens exposed by RTÉ "Prime Time Investigates" was abhorrent to anyone who has any shred of decency. Anyone who has a love of animals will have been appalled by it. That is why the full force of the law will be applied here. This investigation needs to be allowed to take its course. The Department is now on this in every respect that we would expect it to be, including with direct engagement supervision and regulation of these particular commercial premises.

Duncan Smith (Dublin Fingal, Labour)
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Before I begin, I send the best wishes of the Labour Party to Deputy Jennifer Whitmore.

Last night's "Prime Time Investigates" exposed some shocking practices in the Irish horse racing industry focusing on how horses, most of them racing thoroughbreds, are treated in the final period of their lives. After a life which many of them spent in the public spotlight being worked, they then enter what appears to be a very murky chain. It is nearly 150 years since Anna Sewell wrote Black Beauty about the appalling treatment of horses in Victorian England. Yet here we are again with serious questions to be asked about what happens when a horse is retired with traceability issues for up to 20,000 animals a year. There was a famous ad once in Ireland asking "who is taking the horse to France?". This scandal shows that we still do not know and we do not who is watching them.

This sector receives gigantic levels of funding from the Exchequer through a ring-fenced statutory fund. We now have a clear sense of the murky and illegal practices that are going on. Our eyes should have been opened when the horsemeat scandal exploded in 2013. Now we have evidence of alleged illegal activity at the one processing plant in Kildare with microchips being inserted into horses to create false identities. The system is clearly broken and being abused, all under the nose of the Department of agriculture. The safety of the human food chain is not being taken seriously. The only conclusion to be drawn from using false microchips and spray paint to change the hair colour is that these animals would not pass otherwise. Human health is being put at risk and horses are being abused.

We recognise that the Horse and Greyhound Fund supports thousands of jobs in the sector, many of which are critical to the rural economy. However, we must demand the highest standards - standards that are nowhere near being met. What has emerged is a major reputational blow again for Ireland and it calls into question the ongoing approach of the Government to protect the status quo. Over the last two years the Labour Party has tabled amendments to the horse and greyhound regulation. We have asked for a full independent review to see how best to support these sectors, those involved in it and the rural communities it supports, but also critically how the highest standards of animal welfare are implemented and complied with.

What emerged last night raises serious questions for the Department of agriculture and for Horse Racing Ireland which appear to be asleep at the wheel. If RTÉ had not carried out its investigation would anything have been exposed or changed and what would be happening in that abattoir today? We have also called for review to look at how the rights of workers in the sector can be improved and the need for a sectoral employment order to set minimum rates of pay and conditions. Low rates of pay and insecure work leave people vulnerable to unscrupulous practices and pressure to turn a blind eye to what is going on. What will be done to once and for all stamp out illegal practices that have again been uncovered in the horse sector? Will animals be allowed to continue down to Shannonside Foods until we are certain these practices are not ongoing? Are animals going in there today? Does the Minister believe the Department of agriculture and Horse Racing Ireland are fit for purpose? Does he now concede that there must be a review of the Horse and Greyhound Fund including animal welfare practices?

Michael McGrath (Cork South Central, Fianna Fail)
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I can assure Deputy Smith that any legal practices will be dealt with using the full force of the law. I agree with him that the highest standards must apply throughout the equine industry. I know he has not done this and it would be wrong for anyone to seek to portray what we witnessed last night on RTÉ "Prime Time Investigates" as representative of the wider equine industry because I genuinely do not believe it is. The Government supports the equine industry because it is a very important part of the Irish economy and a very important part of our society as well. It contributes almost €2.5 billion in economic output every year and supports almost 30,000 jobs across the Irish economy. As we know, these jobs are particularly important in the regions and around rural Ireland. Almost €16 million of the funding the State gives to HRI is ring-fenced and for welfare and indeed for integrity. Animal welfare and integrity are specifically funded and the Government insists on the highest standards throughout the system. Clearly what we witnessed last night is evidence that that is not the case everywhere, and that will be dealt with.

There is a full-time veterinary presence in the slaughter plant on the days on which slaughter takes place. Ante mortem, post mortem and identity checks are carried out in accordance with the legal obligations. I am assured that the Department takes any issues of non-compliance with welfare or traceability rules extremely seriously. That is why as soon as this matter was brought to its attention through the contact RTÉ had with the Department in recent weeks, a formal investigation was initiated and is now under way. We need to allow that to take its course. We are satisfied that sufficient statutory powers are there and indeed very strong statutory penalties for any proven breach of the rules in this regard. The Department treats this with the utmost seriousness.

Duncan Smith (Dublin Fingal, Labour)
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Can the Minister give a categorical guarantee that this is not happening today and that there are now vets in Shannonside every day, not just when the slaughter is happening? Regarding animal welfare, we are putting €95 million of taxpayers' money into the Horse and Greyhound Fund, with €76 million going into Horse Racing Ireland. Animal welfare is not just about animal welfare on the gallops, the paddocks, the stables or the racecourse. It is from cradle to the end but that has failed here. We do not know if there are other animal rights abuses. We cannot have confidence at all that this is the only place that is falling down. This is a massive issue given the amount of taxpayers' money going into this.

Anyone who watched the "Prime Time Investigates" programme last night will have had their stomachs turned by the practices they witnessed. We need a categorical guarantee that this is not happening today. We cannot wait for an investigation to conclude. This practice must stop now. We have called for the betting levy to be increased to provide funding for other sports and for a fairer allocation of taxpayers' money in this area. What is happening today only adds further power to those calls. We need higher standards across our equine industry.

Michael McGrath (Cork South Central, Fianna Fail)
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I wish to make clear that the funding that is provided by the State is primarily for thoroughbred horse racing, a very important part of our economy and a really important part of the fabric of regional and rural Ireland. I do not for a moment believe that what we witnessed on RTÉ's "Prime Time Investigates" is representative of the wider equine industry. It is important that we all put that on the record because many people in the industry today are very hurt and angry that the reputation of the wider industry gets called into question because of the practices of a very small number of people.

The holding area in question is under investigation. That is being actively managed at this moment in time. On any day when there is activity in the abattoir, a Department of agriculture vet is present on site. That work continues in parallel with this investigation which is being afforded the level of priority by the Department that we would expect.

Denis Naughten (Roscommon-Galway, Independent)
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In Ireland cancer remains one of the leading causes of death. Timely access to new and effective treatments is crucial for improving the survival rates and the quality of life for patients. However, delay in accessing these treatments has become a significant issue, adversely impacting patients' health and survival rates. Currently the approval process for cancer drugs in Ireland involves prolonged assessments by bodies such as the Health Products Regulatory Authority and the National Centre for Pharmacoeconomics.

Yet, this is after these drugs have already been evaluated for both safety and effectiveness by the European Medicines Agency. As a result, these lengthy and complex approval processes lead to significant delays. According to IDA Ireland, this country is the third largest net exporter of pharmaceuticals in the world. However, it is one of the slowest countries in Europe to make these innovative medicines available to Irish patients. The wait in Ireland for new cancer drugs is, on average, 673 days post authorisation by the European Medicines Agency. That is 22 months. In contrast, other EU countries can make these medicines available to patients in as few as 102 days while still managing budgets and conducting value-for-money assessments. It is important to note that it is only public patients who are left waiting for two years or longer for access to these new medicines. This widens the divide in Ireland's two-tier health system because patients with health insurance can have immediate access to many of these drugs once they are approved by the European Medicines Agency.

If we are serious about delivering on Sláintecare and ensuring that patients receive treatment based on their medical needs, we must raise the access public patients have to lifesaving drugs to the accessibility standard of patients with private health insurance. At least in part, these delays are due to inadequate staffing, resulting in files sitting on desks awaiting assessments, or what is known as “processing dead time”. Tragically, there could not be a more apt phrase because, in reality, these delays mean that patients, particularly those with aggressive or advanced cancers, may not receive potentially lifesaving drugs in time. Consequently, their chances of survival diminish, and their quality of life deteriorates. By addressing these unacceptable delays, we can ensure that patients receive the timely and effective treatment they deserve, improving their chances of survival and quality of life.

Michael McGrath (Cork South Central, Fianna Fail)
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I thank Deputy Naughten for raising what is a very important issue. The first point I want to make is that the Government is committed to ensuring that patients in Ireland get timely access to new and innovative medicines. In my time in the Department of public expenditure and reform, this was an issue on which we consulted and worked very closely with the Minister for Health, Deputy Donnelly, and his Department. We provided ring-fenced funding to ensure that new medicines could be made available in Ireland.

Some 148 new medicines have been approved in the past three years. That is based on the €98 million in new medicines funding, with total expenditure of €327.5 million to the end of 2023. This has facilitated the introduction of 61 new cancer medicines in Ireland, bringing the total spend on cancer drugs in the last three years to more than €600 million. For example, in 2021, we provided €50 million of ring-fenced funding that allowed 52 medicines to be approved, half of which were for cancer. In 2022, there was a further €30 million and that allowed 60 medicines to be approved, 18 of which were for cancer. Last year, of €18 million in funding, 36 medicines were approved, 17 of which were for cancer. Of course, that funding goes into the base. That is permanent funding that recurs every year. Once a particular medicine is approved, it is essentially demand-led and the funding will be provided to meet that demand. Therefore, that funding is in the base.

The Deputy made a relevant point in respect of staffing. We have provided an additional 34 staff across the pricing and reimbursement process. Funding in that regard was provided in the budget last autumn. This year, the HSE will launch an application tracker to increase transparency in the medicines assessment process.

There is very close collaboration and a very good working relationship between Government and industry on this issue. The Irish Pharmaceutical Healthcare Association engages on an ongoing basis with the Department of Health. This issue is raised with me by IDA Ireland clients when I meet with them. I am satisfied that the work is well under way and that the progress we have made so far will be built upon. We will continue to improve access to new, innovative medicines here in Ireland, including those for cancer.

When we look at the overall numbers, as I am required to do in my job, we can see that almost €3 billion is being spent on new, better medicines. It is therefore vital that the HSE robustly assesses offers from industry and that it maximises the use of its resources to purchase as many new medicines as possible. That work will continue.

Denis Naughten (Roscommon-Galway, Independent)
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Patients with rare diseases face even greater challenges in accessing new treatments or orphan drugs, as they are often called. On average, they wait nearly 26 months. This delay is especially tragic, as approximately 30% of children with a rare disease will pass away before their fifth birthday. The impact of these delays on patients with rare diseases is profound. How can we defend a situation where these children may wait up to half of their short lives to access Irish-manufactured medications that could prolong their lives? We must prioritise the needs of patients with rare diseases and ensure that they receive timely access to treatments that could offer them the best hope of quality time with their loved ones. Why not use the access for these children to these vital drugs as a pilot case to resolve the blockages in accessing Irish-manufactured drugs for Irish patients? By doing so, we can make a significant difference to their lives and to those of their families.

Michael McGrath (Cork South Central, Fianna Fail)
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This is a priority area for the Government. It is one that I am very familiar with. I know very well of companies, such as BioMarin Pharmaceutical Inc., which operates in my constituency in Cork and which focuses on the manufacturing of drugs for rare diseases, namely orphan drugs. We engage with it and others in the industry on an ongoing basis because we want to ensure that people who are afflicted by very rare diseases and young children whose life expectancy may be limited get access to those drugs as quickly as possible. My role is to ensure that we provide the appropriate funding to achieve that.

Ireland ranks second among OECD countries for the proportion of pharmaceutical expenditure which is covered by the State. We are working to improve the efficiency and the speed of decision-making. We can only make progress on this once companies actually apply through the Irish system, once they have received the necessary authorisation from the European Medicines Agency. This issue is being actively managed. We are making progress and we will continue to focus on that.

Catherine Connolly (Galway West, Independent)
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Táim ag díriú isteach ar ospidéal na Gaillimhe arís agus ar an méid othair atá ar thralaithe, 62 inniu. Tá daoine ag fulaingt agus ag fáil bháis ar thralaithe fad is atáimid ag caint is ag ceiliúradh torthaí na dtoghchán. I am glad the Minister is here today. He previously served as Minister for public expenditure and reform and he is currently the Minister for Finance. His brief directly relates to the issue I will bring up. As I speak, 62 patients are on trolleys in a hospital that is billed as a centre of excellence. Earlier in the year, there were 73 patients on trolleys, which made it the third-worst hospital in the country. The latter were the worst figures since the Irish Nurses and Midwives Organisation, INMO, started collecting data some time ago.

Why am I raising this issue? It is because no progress has been made at all in respect of the hospital in Galway, other than a temporary accident and emergency department, which costs €15 million or €16 million. The background to this is that in February 2015, when we were told by Deputy Varadkar, who was Minister for Health at the time, that the hospital was not fit for purpose. This happened again in 2016 and up to 2020, with the then new programme for Government. All of the time we were told it was not fit for purpose. We foolishly relaxed because an options appraisal stated we should build a brand-new facility at Merlin Park University Hospital. That did not happen. The appraisal was revised and a decision was made to do up some of the properties at the hospital in Galway. All this time, the staff were struggling through trolleys on corridors and elsewhere. HIQA visited in February of last year. Its representatives thought the facility was grossly overcrowded, with 28 people on trolleys.

Today, there are 62. Think of what that does to the staff, not to mention the patients who are suffering and dying. I would love to ask who here in this Dáil, including myself, has spent any time on a trolley in a public hospital. I asked it this morning and got no answer. I think that if we did spend a little time, there might be more of a push to do something about it.

We are here now looking at a preliminary business assessment case and a strategic assessment review, and all the time I am getting different answers. It would be easier to read The Castleor The Metamorphosisby Kafka, which is extremely difficult to read, in German, Irish or English than to understand the answers that are coming in respect of the hospital in Galway. We need a new accident and emergency unit and a new maternity ward in the hospital, given the current one is functioning in suboptimal conditions, as is the whole hospital. The options appraisal that was carried out in 2019 told us that 64% of the infrastructure in the regional hospital was not suitable, and 99% in Merlin Park, and all of it more than 40 years old. All the time what we are doing is adding to a congested site in a hit-and-miss fashion, with the promise of an accident and emergency unit and a new children's and maternity ward but with no idea of when that is going to happen, except for the Minister's Department and his previous Department telling us there are new rules and we must do this but nothing is happening.

Michael McGrath (Cork South Central, Fianna Fail)
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I thank the Deputy. First, looking to the medium to long term and the need to ensure there are adequate facilities and infrastructure at University Hospital Galway, as the Deputy knows, we are making progress on the delivery of major capital projects that are planned for the hospital. A formal project board has now been established. We are finalising a master plan for the development of the Galway city campus, which will enhance the delivery of essential healthcare services for the population. As the Deputy knows, this includes a number of key priorities, such as a new emergency department, which is needed, a women's and children's block, a new laboratory, a new cancer centre and a bed block on the University Hospital Galway campus. The board will also oversee plans for the Merlin Park campus, including the elective hospital for the region and the surgical hub.

Progress is being made. A design team has been appointed, as has a project manager. In addition, the announcement recently by the Minister, Deputy Donnelly, of 228 new beds for the hospital will play a very important role in the improvement of the overall infrastructure at the hospital. The new beds will be provided in separate phases, with University Hospital Galway to benefit from 198 beds between this year and 2028, with a further 30 coming on stream beyond that. In the short term, we have a job of work to do because it is not acceptable to us that that number of patients are on trolleys on today. That is why the Government has very significantly increased the resources for the hospital to provide for the growing demand that is there. Staffing has grown by more than 740 to 4,500, an increase of almost 20% since 2020. In addition, the budget over the same period has grown by 21%, so that is a very significant investment by the State and we need to see the return and the performance improving as a result. Notwithstanding the trolley numbers the Deputy quoted from today, which are not acceptable and will need to be addressed, it should be acknowledged that, from January to May of this year, the University Hospital Galway trolley count showed a decrease in the year to date of 15% and we should, in the interests of balance, acknowledge that.

That is part of improvement that is happening at a national level. Progress has been seen across nearly all the acute hospital sites. With the exception, sadly, of University Hospital Limerick, we have seen reductions in the year to date of 20%. The investment is making a difference and we need to deal with the short term, the here and now, the people who are on trolleys today, which is not acceptable to the Government or the HSE, but we also need to have a plan to ensure the infrastructure is in place for a growing and ageing population in order that we can meet the needs, which are increasing all the time.

Catherine Connolly (Galway West, Independent)
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One almost loses the will to live in regard to this. In 2014, the accident and emergency unit was deemed not fit for purpose. Ten years later, it is still not fit for purpose. The Minister tells me money is going into it. There are 62 people on trolleys. They should not be on trolleys. We live in a Republic. The Government has normalised a situation where patients are on trolleys. I know that each of the Ministers personally thinks that is horrific, but it is time to look at what is happening. The Minister should stop quoting figures to me, please. Sixty-four people are on trolleys; would he or I be on a trolley tomorrow? That is the question we ask in a Republic. What is it we are doing ten years after Leo Varadkar said the accident and emergency unit was not fit for purpose?

We have gone around in circles in respect of a strategic assessment review, with different answers. I was told it had been accepted and approved by the health executive board in November 2023, and then I was told in a different answer that it had gone for approval. How in God's name can we stand over a situation ten years later where we do not even have a deadline for an accident and emergency unit, not to mention the maternity unit, which is going in overhead, in a maternity strategy that is coming to an end in two years' time? Those staff are functioning in suboptimal conditions. HIQA said the hospital had failed on two of four essential standards. I do not want to stand here and lambast the Government. I want a public health service that is fit for us to call ourselves a Republic.

Michael McGrath (Cork South Central, Fianna Fail)
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The facilities at University Hospital Galway are not fit for purpose. I have been there in recent months and I am very much aware of the ambitious capital investment plans, which we will support. They need to happen because the scale of demand for services there is only going to go in one direction, and we have to ensure we have not just the staffing but the physical infrastructure to meet that need. That is why the new master plan will involve the new emergency department as well as the women's and children's block and a whole range of other facilities, including a cancer centre. There has been investment in recent times. The new radiation oncology facility opened last year and, in addition, the hospital has been granted a capital allocation for the creation of a third endoscopy procedure room, including additional facilities as part of that.

We should also recognise, to be fair, that overall, trolley numbers are down nationally. The Deputy has highlighted what is happening today in the hospital, and I am saying to her, as Minister on behalf of the Government, that that is not acceptable to us and we will address it both in the short term and with a plan for the medium- to long-term improvement of services there.