Mr. Robert Morton:

That is not actually correct. The ambulance crew is not directed about how to actively care for the patient. That is a decision for the crew. In the case of a retrieval, it could be a doctor and a nurse in the ambulance rather than two paramedics. It could also involve a paramedic. They have full autonomy to decide what is the appropriate course and they have to act and react dynamically to meet the needs of the patient. However, in the overall logistics plan, the missing piece - Mr. Healy touched on this in his briefing note to the committee - is that there is a broader need to examine the availability of aeromedical services. In many of the types of cases that the Deputy is touching on, the patients are being transported by road, which is not the optimum solution. The optimum solution is to transport those patients by air. The availability of helicopters, particularly at night-time, is a limiting factor. As such, patients are quite often exposed to quite considerable journeys. Sligo to Cork is a perfect example. Ideally, we would make that transfer by air ambulance. That will be part of our plan going forward. Part of that learning is coming back in and hearing what works for patients. Where crews are involved in those situations, they are always included. Mr. O'Donnell may be able comment further.