Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

The HIQA report has a lot to say about the broader issue of governance. What will the response to that be, in terms of the national ambulance service? Will it oversee the process by which the issues highlighted in the HIQA report are addressed? Will the HSE do it or will HIQA have some role in the continuous monitoring of the issue raised in the reports? The national ambulance service has enough to do in terms of trying to deliver a service. Overseeing the recommendations and observations in the HIQA report would put additional pressure on it.

Some ambulance services and emergency departments in hospitals have closed in rural areas. That has a knock-on effect on the pressures being placed on the national ambulance service in delivering emergency care. Do we have joined-up thinking in terms of the primary care setting, which is critically important and means that patients do not have to travel to and present themselves at emergency departments? Do we have a strategic plan for the closure of emergency departments in some rural hospitals, in terms of putting resources in place rather than waiting for the ambulance service to be bolstered? In doing that, we need to make sure we have a proper, fit-for-purpose ambulance service to pick up the pieces from such closures.

I refer, for example, to Roscommon County Hospital where the emergency department was closed. There has been a similar downgrading of services in Mallow, County Cork. The personnel in the national ambulance service have to travel significant distances to transfer patients on a regular basis under an emergency setting, and often under light.

The HIQA report clearly identifies that as an issue, particular in rural areas.