Mr. Martin Dunne:

I will group the answers and try to answer them as best I can. The national ambulance service has launched a complete reconfiguration of the way it is doing its job. It dovetails into every statement that has been made here in respect of availability and capacity. What people must understand is that last year, for the first time ever, we got intermediate care vehicles, so they are an addition to the fleet. They are not removing fleet. Why did we put intermediate care vehicles in? Again, this relates to some of the questions that were raised about inter-facility transfers - in other words, bringing people from Drogheda to Dublin or from the Cottage Hospital across to Our Lady of Lourdes Hospital. That is replicated around the country. For many years - I am a paramedic myself - it was done by the front-line ambulance, the yellow or white one. It is widely recognised that the capacity is not available to do that now. The training levels paramedics and advanced paramedics have are geared towards front-line accident and emergency and pre-hospital care. What we have done is to invest in intermediate care vehicles, which allows emergency ambulances to be freed up to a certain degree so that they can be targeted directly at emergency calls. That is growing because, as Ms McGuinness said, it only started last year.

We have also put in what we call rapid response vehicles, which have been mentioned. Again, if one looks at our counterparts around the world - any of the major ambulance services - one can see that they have supplied response vehicles to get to the patient. As I said earlier on, our only goal in life is to get the proper clinician to the patient as quickly as possible. Even in the areas we are talking about, we are starting to advance the service in respect of having intermediate care vehicles beginning to operate, and we are starting to see results coming from it. It is slow but it is in its infancy and we will develop it. We see response vehicles staffed by paramedics or advanced paramedics. It could be cars or four-by-fours. These vehicles can start to administer care immediately to the patient on the scene while waiting for a transport vehicle to arrive. That takes some of the time used in treating the patient by the transport vehicle out of the equation and they are able to load and transport in a quicker fashion. That is way we are going, and it is ongoing in the Drogheda area. There are two ambulances in Drogheda, supported by a response car in Ardee and intermediate care working out of Ardee. On the other side of that, there are vehicles in Dundalk and Monaghan and there is a full station in Navan to complement that area. We carry out dynamic deployment. Vehicles are always moving. Most of the time, the one place one will not get an ambulance call is in the ambulance station. What we try to do is to get the vehicles out to the areas they need to cover as quickly as possible. That is starting to evolve and develop, slowly but surely.