Martin Daly (Roscommon-Galway, Fianna Fail)

I thank Mr. Healy for his very comprehensive presentation. I recognise that the transformation of the National Ambulance Service in the past 20 to 25 years has been unbelievable. I am a community GP and have seen the move from ambulances essentially being driven by drivers to a case where we now have a fully professionalised service providing a whole suite of services in the emergency arena and in the sub-acute arena.

As we know, ambulance calls can be made for cases and issues that would be better served by different pathways of care. I know there are initiatives within the National Ambulance Service to deal with that and I am reading some of them here. I welcome the development of the different pathways, such as the clinical hub pathfinder, the community paramedic service and the alternative pre-hospital care pathways. They have been very helpful to someone like a rural GP on the ground and for acting as that bridge between primary care, as there is sometimes constrained capacity in that sector, along with the house calls that are done by a suite of people from the National Ambulance Service, depending on the priority. The professionalisation of the service has been remarkable. These are highly skilled health professionals and it is a privilege to work with them as part of a cohesive unit, providing care in the community.

I am conscious of time and I will give time for answers but I will ask about some of the things that were developed, such as the community paramedic scheme where a paramedic goes out rather than sending an ambulance because it is a valuable resource. I would like the witnesses to expand upon the question of dealing with people in the community and looking for different pathways into the hospital sector if it is required, or back to the GP if that is required. In my own area, one of the issues is turnaround times for ambulances, especially in the west and north-west areas. That is not the fault of the ambulance service but it has been reported to me that it can take four to five hours. I will not name the hospitals but it can take four to five hours in some hospitals to turn around the ambulance. For people listening to this, that means an ambulance arrives with a critically ill patient and is kept for up to four or five hours, along with the valuable resource of its healthcare professionals, before that patient can be handed over. Will the witnesses comment on that?

Will Mr. Healy expand on the issue of advanced paramedics and the paramedics issue? He referred to it in his opening statements. In the west and north-west region, we know there has been an expansion of training posts but there was no additional funding in 2025. He might expand on that also.

I thank the witnesses.