The problem of patients on hospital trolleys would have been fixed years ago, if it was a question of money, Taoiseach Enda Kenny has told the Dail.

“It is a matter that arises regularly and the issue is to be able to manage it effectively in the interests of patients,’’ he said. “That will be the priority of the Government.’’

He added it was not something which could be fixed overnight and the Government did not have endless resources.

The special unit dealing with trolleys in emergency departments, he added, would continue to meet and access whatever beds were available.

He said 400 people were on hospital trolleys at 8 am Wednesday. “That will, obviously, decline during the course of the day,’’ he said.

The Taoiseach was replying to Sinn Féin leader Gerry Adams, who said there were 472 patients on trolleys in emergency departments and wards. For the third consecutive day, Our Lady of Lourdes hospital, Drogheda, had the highest number of people on trolleys, he added.

"It is clear the Government is not providing adequate resources,'' said Mr Adams.

He urged Mr Kenny to consider a scenario whereby a patient presented at a hospital and a clinical decision was taken to admit them. However, Government policy prevented them from receiving proper medical attention.

“Instead, they are left for several hours or days on a chair or a trolley,’’ he added.

Mr Kenny said there was an acute shortage of beds in Drogheda for dealing with delayed discharges from the hospitals.

He said the Government took the issue very seriously, adding it was not in the best interests of anybody to have people, particularly the elderly, on trolleys.

Fianna Fáil leader Micheál Martin said the Taoiseach had apologised on the issue of discretionary medical cards last year.

"He stated that the Government had announced a new plan that would bring flexibilities, local input and discretion,'' Mr Martin added.

While there had been improvements, and many people had their cards restored, there were still serious issues relating to children who had very serious conditions and illnesses.

Mr Martin referred to the case of a nine-year-old girl with B-cell lymphoma, a very rare cancer.

“She has had surgery and intensive chemotherapy but, despite considerable submissions to the HSE, she has been denied a discretionary medical card,’’ he said.

Mr Martin said the girl was under medical care in Crumlin which had also made submissions to the HSE.

“The mother has had to give up work and the issue has caused immense strain and anxiety,’’ he added.

Last week, he said, a family travelled from Mayo with their 18-month-old son, Ryan, who had a number of illnesses, and was seeking a card.

This year, said Mr Martin, it was intended to roll out free GP care for children aged under six years. Many people could not comprehend how sick children could be denied medical cards, while perfectly healthy children were to received free GP care towards the end of the year, he added.

Mr Kenny said although he did not want to comment on a particular case, a card was refused on the basis of income in some cases.

“The Keane report, commissioned by the Minister, considered whether medical cards could be granted on the basis of an illness and it indicated this was not morally, ethically or in any case justified,’’ he added.

Mr Kenny said there had been an increase from approximately 52,000 discretionary cards, issued in the middle of last year, to over 77,000 at the end of last year.