In the week that Mary Harney said the current A&E situation constitutes an emergency, Plunkett asked why the plan was not being implemented. A&E workers around the country have had enough of what they say are empty promises from the government and are calling for positive action. Here, they put forward the main reasons why A&E departments around the country are in such a mess.

One of the biggest contributory factors to the ongoing A&E problem is the lack of patient beds. In the past few months, the numbers of people lying on hospital trolleys has spiralled out of control, but as far back as 2002, a report by Dr Mary Codd showed that even if hospitals were to operate at maximum efficiency and utilise nursing home beds by 2011, the country would still be short of 3,000 beds.

"Four years ago, the cabinet read this report and said they were going to do something about it, " said Plunkett, who believes one solution could be the building of one sky-rise hospital to deal with patient numbers.

"We're still waiting."

Plunkett cited the city of Leicester in the UK as an example of how Dublin could operate. "They have a similar population size to Dublin, but only one major hospital, " he said. "The [UK] National Health Service had a huge drive where no patient could stay in A&E more than an hour after a ward bed was requested and it worked. A huge amount of resources went into it of course."

So why hasn't it happened here?

"Because we haven't tried, " he said.

FINANCE The funding available for the health services in 2006 alone amounts to 12.64bn, but general opinion is that it is being woefully mismanaged through endless bureaucracy and delays.

"The Department of Finance really runs the health service, " said Plunkett. "Everything they have tried to do has been double-guessed or buried."

On Plunkett's office wall is a photograph of him chatting with the previous Minister for Health, Micheal Martin.

"That day he told me he had approved a bill for a new emergency department in St James's. To this day that bill is still in the Departmet of Finance."

STAFF MORALE As A&E departments have descended into chaos, the morale of staff has plummeted. Each day there are more than 3,000 attendances at the state's 35 A&E departments and almost every afternoon the number of patients assessed and waiting to be admitted to a ward is in the 200-300s. And this does not take into account the patients waiting to be assessed and discharged.

Staff are overworked, outnumbered and exhausted trying to get through all the numbers and give the appropriate level of care required.

"It is very difficult to be enthusiastic or have any sense of accomplishment if you can hardly see through the exhaustion, " said Dr Garry Courtney, consultant physician and gastro-enterologist at St Luke's Hospital, Kilkenny. "Staff get demoralised very quickly, and then people start fighting with each other and not working together."

"I think it's fair to say that people will die who might not have needed to, " said Plunket. "The way A&E is at the moment, you cannot notice when a patient gets much worse because there's so much noise and it's so crowded. Our staff does their utmost, but when there is no space, and patients are looking at them for hours saying, 'why aren't you helping me?' it's just awful."

LEADERSHIP Both Harney and Drumm have come in for a lot of flak in recent months as the health situation has worsened.

"I am extremely unimpressed with Brendan Drumm, and certainly any of the consultants I have spoken to feel the same way, " said Dr Stephen Cusack, an A&E consultant at Cork University Hospital.

"If he were in any other business, he'd be fired. I cannot get over his lack of innovation and leadership."

"Politicians are the only people who can force the spending of public money, " said Plunkett, who feels Mary Harney has done absolutely nothing for the health service since she was appointed.

"So now, coming up to the 2007 election, the opinion polls will show what people want and the promises will be rolled out. When the election is over, that leverage will be gone and unless a recurring budget has been set in stone it will all come to nothing. If I sound cynical, it's because I am cynical."