IT WOULD be a challenging year for the health services, particularly for hospitals carrying a deficit or overrun, Taoiseach Enda Kenny told the Dáil.

“We can pretend things are all right, but they are not.

“We have to change the structures and provide a health system we believe is in the best interests of our people, young and old alike.’’

Mr Kenny said the Government’s objective was to have universal health insurance made available to every person.

This meant focusing on the provision of primary care centres whereby people did not have to go to accident and emergency in the first place.

“Why is it that up to 40 per cent of people who were assessed for long-term geriatric care are never asked where they would like to be?” he asked.

“The vast majority of people I come across, and who we know of from all over the country, want to stay in their own homes for as long as possible.’’

Mr Kenny said they did not want a situation whereby people were being sent from acute hospitals directly into long-stay institutions.

He said they should be in step-down centres until they were better and could go back to their own homes, backed up by proper home-care packages and community care.

Sinn Féin leader Gerry Adams said nothing could be more iconic in what was currently happening than the sight of elderly people in their beds on picket lines.

Independent TD Finian McGrath said he had “nearly choked on my cornflakes’’ when he had heard Minister for Health Dr James Reilly saying there would be no cuts to frontline services.

“How can the Government provide services to our senior citizens when it closes 555 beds in community nursing hospitals?’’