Leo Varadkar’s rather dispassionate approach is driving the Opposition mad.

Dr Leo often sounds like those GPs who, having listened to a patient’s complaint, opine: “Sure don’t I know, I’m a martyr to the same thing myself. It’s terrible. But what can we do?”

The Fianna Fáil and Sinn Féin leaders rounded on him in the chamber yesterday.

The sight of him smirking and whispering to Frances Fitzgerald while they were asking serious questions deeply irritated them. Micheál Martin and Gerry Adams had returned to the seemingly intractable problem of non-acute patients taking up much-needed hospital beds.

This is the crisis of “delayed discharges” where patients – mostly elderly and unfairly labelled “bed-blockers – have to stay in hospital wards because there are no step- down facilities to take them. Despite repeated government pledges of action and a plethora of reviews and task forces looking into the problem, figures continue to rise.

The issue was to the fore in the Dáil again yesterday after an RTÉ Prime Time programme revealed that Dr Tony O'Connell, the former national director for acute hospitals, warned the HSE six months ago that delayed discharges could be putting lives at risk.

Since he delivered his detailed report, the number of patients in this situation has risen considerably.

Leo Varadkar responded in a number of interviews. He didn't dispute the findings. "It only stands to reason that lives could be lost."

Detached approach

Micheál Martin was disgusted. “He was asked this morning about this, and of course, in his usual detached, commentator approach – and in a common refrain now from the Minister – he simply said: “This isn’t new to me and actually, it is going to get worse.’”

Micheál was astounded. “That’s his response to this,” he marvelled.

And it wasn’t as if the Minister for Health and the Government hadn’t plenty of warning, he told the Taoiseach. The alarm bells have been sounding for months.

Leo sat on the front bench, smiling his diffident smile.

“The people waiting on trolleys have gone through the roof again” continued the Fianna Fáil leader, slightly exaggerating things. For now. But the way things are going, it’s only a matter of time before they start stacking the beds like in a capsule hotel.

Does the Taoiseach accept the Government isn’t providing enough funding to deal with the crisis?

It might have been more appropriate to ask if he accepts that they aren’t throwing enough money at it. Because we’ve been here before in the Dáil chamber. There was a time when Micheál, when he was a minister for health, was in Leo’s shoes.

Shouting matches over the state of the health service are a depressingly regular feature of Leaders’ Questions.

Enda’s response didn’t do much to lift the spirits. His tone of resignation pretty much mirrored the earlier reactions of his Minister.

“I accept that this is a very challenging situation . . . I accept what the Minister says that there isn’t anything new in this.”

And then he went on to detail all the money that is being spent in this area and all the beds being reopened and all the plans and projects under consideration.

Never enough

Yet, the more he talked, the more he gave the impression that putting money into the health service is like to throwing buns to an elephant. There will never be enough.

When the Taoiseach, speaking in the usual telephone numbers, pointed to the huge amount of cash provided for budget overruns, Micheál accused him of giving dishonest figures on health spending.

Each year, Government says the money allocated is adequate “when we know that, by the end of the year, they are woefully inadequate”.

Faced with the ravenous maw of the health budget and little sign of a solution, the best that Enda could do was say things are “challenging”.

And then go on the attack.

“You have no health policy,” he repeatedly told to the Fianna Fáil leader.

Which is neither here nor there. Last time we checked, Fianna Fáil wasn't in Government. Tuesday was the fourth anniversary of the general election, which saw Fine Gael and Labour swept to power.

Gerry Adams got short shrift, too.

“Deputy Martin has no health policy and you have no faith. You decide to go elsewhere to get your own health treatment, which is your choice” shrugged a very tetchy Enda.

Gerry Adams pointed out that more people are in a delayed discharge situation now than when Dr O’Connell signalled in September that matters were getting much worse.

Gerry wasn’t impressed by the extra €25 million allocated for Fair Deal. “You gave more to the consultants from Irish Water.”

Where’s the sense of urgency, wondered Micheál Martin, eyes shifting to the seats beside the Taoiseach.

“And it is not a smiling matter, Deputy Varadkar. It is about time we had less of your detached commentary. People are dying here in hospitals because you are putting other options and choices ahead of them,” he snapped.

Enda read out more impressive figures and statistics from the Collected Works of Leo. But Micheál met the litany with the same question: why does it keep getting worse?

Exasperated, Enda retorted: “You ask a question and then you cannot shut up. You have to keep talking.”

Adams annoyed

Then it was Gerry’s turn to get annoyed with Leo.

“What does the Minister for Health say, when he is not talking to the Minister for Justice, when he’s not smirking at Fianna Fáil? He says that this problem is a feature of our dysfunctional health system and that this is nothing new.

“He says that it only stands to reason that lives could be lost. But Taoiseach, he’s the Minister for Health; he’s is not a neutral commentator.”

The Sinn Féin leader wanted the Taoiseach to admit that it was a national crisis.

Kenny’s reply: “The system is actually working better, while it’s still challenged.”

And Micheál repeated: “Why is it getting worse?”

Enda had one good line though. It got a big laugh from across the floor: “The Minister’s got a plan here.”

Leo has a plan.

Micheál, in his day, had a plan.

They always have a plan.

Will it ever end?