Bertie Ahern predicted that waiting lists will be a permanent feature of the health services as he came under renewed Opposition pressure yesterday.
"There will always be people on waiting lists," he said.
Fine Gael leader Enda Kenny said consultants and nurses had told him that people on the end of waiting lists were dying because they could not get treatment.
He challenged the Taoiseach to say the Government was spending €15 billion on a world-class health service. He claimed that the Government could not be believed.
"Can the Taoiseach say how the 41,000 patients on waiting lists can have any confidence in what they hear coming out of the mouths of Ministers in this Government?" he asked.
Mr Ahern said that 120,000 people worked in the health services, dealing with 100,000 patients every month.
"Both the adult and children's waiting lists, as produced by the HSE, are at record lows right across the system. Some 100,000 inpatient and daycare procedures are carried out in public hospitals every month - in excess of one million annually," he added.
"Even if 41,000 is the figure - as I said yesterday, I do not know if it is - it is comparatively low against the figures from last year, three years ago, five years ago or 10 years ago. It is a much smaller proportion of the total figure."
Mr Ahern said the National Treatment Purchase Fund, which had issued a report recently, stated there had been a consistent pattern of reducing surgical waiting lists in the public hospital system in recent years.
The report had pointed out that, for most common procedures, adults and children now waited between two and five months, compared with between two and five years in 2002.
The HSE had exceeded its budget of €14 billion by €222 million, he said. At the end of August, its accounting officer had said it had to take corrective measures, like any other agency or department.
Mr Kenny insisted the figures put forward by the fund were sanitised. "They refer only to surgical cases," he added. "They do not refer to medical cases." Mr Kenny said that the HSE had nine national directors and 61 assistant national directors.
"That is nearly seven-to-one. When Prof Drumm addressed this parliamentary party a number of years ago in Portlaoise, he said there are 2,500 persons working in our system who do not know what their job is, who do not know where they fit into the system and who will be paid for life," he added.
Mr Kenny said the Taoiseach had agreed with him earlier this year that there was an "obscene bulge" in the administrative recruitment sections of the HSE, compared with the number of nurses and doctors on the frontline.
Labour leader Eamon Gilmore said that the Minister for Community, Rural and Gaeltacht Affairs Éamon Ó Cuív had rightly described the HSE as an impossible organisation.
He asked if the Government was taking responsibility for the HSE. "If Minister Ó Cuív is correct - I believe he is - what will the Government do to ensure the HSE delivers the type of health service for which it receives all the money about which the Taoiseach keeps telling us?" he asked.
Mr Ahern accepted that issues remained over HSE structures. "However, it is striving to bring together an enormous organisation which is different from that which existed a few years ago. The operation of such a large organisation and management of 120,000 people is not easy."
