Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

I join the Chairman in extending congratulations and best wishes to Mr. Quinn in his new role and responsibilities. I ensure him of our co-operation and good wishes always.

I have read the report's executive summary. I would like to know the methodology of the review. Where was the engagement? With whom did HIQA engage? I ask that because I do not get a sense from the report that it considered matters in a geographically dispersed way. I think it might be more particular to the centre, but that may be just my impression. How was it carried out? With whom did HIQA engage? Was it geographically inclusive? I can understand Mr. Quinn saying in his contribution that geographic challenges in rural and sparsely populated areas will always present.

My family have experienced three incidents in the past 12 months. I live in an area within a mile of which there is an ambulance station. There is another one 15 miles away from that and another 30 miles away. In each of the three incidents, one of which resulted in a death as a result of a heart attack, another of which was my heart attack - I am sitting here before Mr. Quinn and the details are all verifiable where it took place in a GP's surgery - and the other, last Saturday week, where I had to kneel before my mother, who had collapsed, and was unable to lift her, in all three incidents and despite the three ambulance stations being close to us that I mentioned, including one in my home town, the ambulance came from more than 45 miles away. I am just one citizen sitting here today. I should be very thankful that I am.

My point is no criticism of HIQA. It is all to do with how it goes about its business. I have gone through the recommendations and I have some comments and questions on those. Mine is just one family. My wife's brother might not have lived in any event if the ambulance had come from any of the other three closer stations than the one from which the ambulance was dispatched. The general practitioner and the support nurse where I had a heart attack last January were incredulous at the time. When they came from Virginia to Monaghan town they could not even find it. It is no reflection on the ambulance crews, who are wonderful people, as I can attest to. My mother is a hospital patient as we speak. Again, only in the past fortnight, I was on my knees because I could not move for a full hour waiting for that ambulance to come.

That experience is replicated for many families throughout the country. We need to get serious about the issue. I do not accept it is about geographic location or anything else. There are no excuses in the wide earthly world for what happened in the incidents to which I can personally attest. This is not second-hand information; I was present at all three.

How was the review carried out? With whom did HIQA engage? I will raise the matter again. In respect of my patience and holding back on making any comment about my experiences, I have just lost it with the third and most recent incident with my mother. It is no longer good enough for me to hold back. I am saying it out and sharing it here today with colleagues as well as with representatives of HIQA.

Will Mr. Quinn explain recommendation No. 2 in the report. There is almost a question as to whether the national ambulance office is to operate as a distinct entity, under the remit of the acute hospitals directorate of the HSE. Does Mr. Quinn still see the national ambulance office as a separate, distinct and continuing entity? What does recommendation No. 2 spell out for the future of the national ambulance office?

On recommendations Nos. 1 and 3, recommendation No. 3 is more prescriptive in terms of the relationship between the HSE and Dublin Fire Brigade. Recommendation No. 4 in the same context uses the words "safe transition of services in Dublin". Is HIQA proposing in the recommendation a cessation of the situation where the greater extent of ambulance cover is provided quite efficiently through the Dublin Fire Brigade service? Representatives of Dublin Fire Brigade have appeared before the committee in the past. It is a big issue.

Recommendation No. 5 refers to reviewing the current practice of 100% delivery to hospital emergency departments. That is worth considering. While not in the three incidents I shared with the witnesses, I can cite other incidents where it might have been more appropriate on the assessment of the individual patient concerned that a more local minor injuries unit in one of the non-acute hospital settings could have been a more appropriate delivery point, rather than adding to the untold distress that is the reality in emergency departments in acute hospitals. I think the review is worthwhile and I ask Mr. Quinn to comment further on it.

Recommendation No. 7 refers to a seven minute and 59 second first response time for patients who are in cardiac or respiratory arrest. The incidents I have cited will have the recorded times for notification and response. They were off the Richter scale. Two of those were cardiac arrests, including mine. I was transported from Cavan initially and then on the St. James's and operated on that evening. Seven minutes and 59 seconds sounds all fine and good. It was achievable if the ambulance had been dispatched from the station closest to each of the three situations I have cited. However, the ambulance passed that station and passed two others also closer than the station from which the ambulance was dispatched. I find that intolerable.

When Monaghan Hospital lost its acute services, we were promised that we would be compensated by a fully staffed state-of-the-art ambulance service to cater for all emergency needs. We have not got within an ass's roar of it. I say that with great vexation.