Dr. Cathal O'Donnell:

I will follow on from what Mr. Morton has been saying. Clearly, the time an ambulance takes to get to a patient is important, but we also need to balance that with what happens when the ambulance gets there and where we bring the patient after that. We have a very highly trained workforce. All of our paramedics are highly trained. It is exactly the same for Dublin Fire Brigade because we operate to the same standards. They are all very highly trained healthcare professionals and bring significant clinical assessment skills and treatments to patients.

I should preface that by saying that the treatment, in some cases, starts before the ambulance arrives because our call takers give what are called pre-arrival instructions to the caller in order that we can coach through the person on the other end of the phone, depending on the situation, to help the patient. The quality of the care we deliver when the crew gets there is as, if not more, important than how long it takes us to get there.

The other point is we have a very sophisticated system of hospital bypass procedures in order that we will bring the patient, not necessarily to the nearest hospital, but to the best hospital for their needs. For example, in the west of Ireland, if one is having a heart attack in Mayo, Castlebar is the nearest hospital, but one might be better served by going to Galway to the specialist cardiac unit there. We have procedures and protocols to do that and also access to a helicopter network that can get those patients to those centres in as timely a manner as possible. Without going on about it too much, the point I am trying to make is that speed of response is clearly important, but what happens when we get there is equally important and needs to be considered.