Jerry Cowley (Mayo, Independent)

I was strongly in favour of the penalty points system. Its introduction had a major effect because drivers believed they had a good chance of being caught. However, they have become complacent and this has put an end to the effectiveness of the penalty points system. In a recent parliamentary question, I asked the Minister for Justice, Equality and Law Reform about the appointment of more gardaí for front line duties and he indicated this would happen. I hope this is the case because resources have always been a difficulty.

Fairness is essential. If the people can be convinced by a policy, its chances of success are much greater. It is unfair that a motorist who drives one mile per hour above the designated speed limit is given two penalty points. The lack of fairness and proportion puts people off, creates unease and interferes with the success of the law and the penalty points system. I call for an intermediate zone in which a monetary fine would be the appropriate penalty.

I am glad to raise again the need to introduce a system to reduce the number of road traffic fatalities. We need a system to retrieve people who are dangerously ill and rapidly transfer them to a so-called centre of excellence. It has been proven internationally that if one can provide essential treatment within what is known as the golden hour, one can save lives and prevent people from leading a life of disability. It is estimated that a helicopter emergency medical service, which can provide essential treatment within the golden hour, would cut both the mortality rate and the rate of long-term disability by 50%. We do not have such a service.

I feel sympathy for anyone involved in a road traffic accident, including the Minister for Community, Rural and Gaeltacht Affairs, Deputy Ó Cuív, who was involved in a bad accident yesterday. We are delighted he is all right As he pointed out, his concern is for two American citizens involved in the accident. We hope they will make a full recovery.

When seriously ill victims of accidents require services not available in a local hospital, a helicopter emergency medical service is essential. Provision must be made for such a service as part of the strategy to save lives on our roads. We share with Northern Ireland the dubious distinction in Europe of not having such a service.

For more than a decade I have been involved in a campaign to introduce a helicopter emergency medical service. I met the former Ministers for Health, Deputies Noonan and Martin and the former Minister for Health in the North, Bairbre de Brún MLA, on this issue. I also met the cross-Border working group on pre-hospital care established under the Good Friday Agreement in Newry. As a result of this meeting, a recommendation was made to the North-South Ministerial Council that an all-Ireland feasibility study be carried out. This study was completed in 2002 but was not published until April 2004. To date, nothing has been done on foot of this good report, which clearly states that an inter-hospital retrieval service providing intensive care in flight is necessary. This requirement was flagged in a report on the ambulance service produced in 1993 and reiterated in 2000. Like doubting Thomas, the Minister wanted and was given proof. Now that the baton has been passed to the Tánaiste, Deputy Harney, it is for her to decide on a helicopter emergency medical service. Having been jigged around between Departments, the issue needs to be grasped.

We are the poor relation in Europe as regards helicopter emergency medical services. When large numbers of Ministers from other European countries visited Ireland during our EU Presidency, we did not have such a service, which is a shame, particularly given that it could save many lives.

Through no fault of its own, the Air Corps, which currently provides a service, is not capable of doing the job because its service is not dedicated and its equipment reflects its multi-purpose role. The Air Corps spends more time bringing Ministers from A to B than taking part in mercy missions. The average time it requires to reach a hospital to collect a patient in desperate need of air transport is 12.25 hours, which is a long time to wait for an essential service. What happens to the golden hour in such circumstances? The Bill and the road safety strategy should provide for such a service, without which people who would otherwise survive will die.

If the findings of the Hanly report are implemented — I do not believe they will be — the provision of helicopter emergency medical services will be an imperative. Although they are currently essential, they will become even more important if 24 hour services in local hospitals are closed. If the west does not have a neurosurgical centre, it must have a helicopter emergency medical service. International research has proven that the more one moves a person who has suffered a serious head injury or fractured spine, the greater the chance the person in question will die or lead a life of disability. Patients are currently removed from hospitals such as Mayo General Hospital and placed in the back of an ambulance for 12 to 16 hours, during which they are not connected to the intensive care equipment they need to sustain their oxygen levels and so forth. I am not criticising the ground ambulance service as it is an excellent though unappreciated service. I recognise it has received investment but it is still an incomplete service. No matter how good a ground ambulance is, it simply cannot make the time an air ambulance can. Time can be of the essence in treating victims of serious accidents. A ground ambulance, attempting to reach essential treatment services for patients in Dublin city, is forced to compete with traffic gridlock. If the Government wants to save more lives on the roads, an air ambulance service is one way to do so. Research proves that if accident victims receive treatment in the golden hour, death rates can be halved. Many patients with high sickness scores — the means by which levels of illnesses are measured — cannot be transported in ground ambulances. They should be transported by a helicopter emergency medical service. Introducing such a service would do wonders in reducing death rates and the numbers of people who are disabled for life because of road accidents.

In Beaumont Hospital, alone, it is reckoned four lives per year would be saved by such a service and 16 less people would be disabled for life. For every life saved, it is estimated that €1.27 million is saved on insurance payouts, loss of income and so forth. Multiply that figure and a major saving of more than €25 million per annum could be made through an air ambulance service, more than one would pay for it. It would also lead to the better use of intensive care units with time spent in them reduced by one third, as proven internationally.

The feasibility study spells this out and it should be part of the national road safety strategy. This goes beyond the concerns of individual Departments and is an important recommendation. The Minister for Health and Children in a reply to a parliamentary question on the matter informed me that it would have to be discussed with the Department of Defence. However, this must be a dedicated service. There is no point in having the Air Corps bringing a Minister to the Blasket Islands when an individual involved in a road traffic accident is in need of transfer to a treatment centre. The Garda received a dedicated helicopter service because the then Minister for Justice, Ms Owen, said that such a service would be of assistance in responding to crimes. All Members know the valuable work done by the Garda helicopter and the force will now get a second one. If a case can be made for a dedicated service to catch criminals, why not one for saving lives?

In the Western Health Board area, three ambulance stations are needed to reach the international standard of a centre for each person within a twenty-mile radius. No matter how well developed the ground ambulance is, it still cannot make the time a helicopter can. Take the scenario of a young man involved in a road traffic accident in the west, suffering with a delicately bleeding brain. Can one imagine taking him the distance on the rocky road to Dublin? That would not be proper treatment for an individual with a bleeding brain, clinging on to life in the hope of reaching the treatment centre in time. International research shows this is when the golden hour comes into play. Reducing services in local hospitals entails a greater risk of serious consequences.

The report presents a wonderful opportunity for saving lives on the roads. I know of people confined to wheelchairs after accidents because they could not be sent to a treatment centre in time. I know of the case of one young man who fell from his tractor on his farm. When his GP saw him lying in the field, he knew he needed urgent treatment in the national neurosurgical centre. However, as he did not get there in time, he is now confined to a wheelchair for life. He was taken by ground ambulance to the local and then regional hospital. It was not until the next morning that he was flown by Air Corps helicopter to the national rehabilitation centre in Dún Laoghaire. Why could he not have been flown from the scene of the accident rather than on the following day? That man will never walk again and there are many similar cases that GPs come across. I can give the names of people who have died because of the lack of an air ambulance service.

The campaign for such a service has gone on for some time. I made a submission to the national road safety strategy on this issue but was disappointed when it was not examined. However, it is never too late. Dr. Jack Philips, chief neurosurgeon at Beaumont Hospital, said that every weekend he sees many young people on life support machines for whom he can do nothing for he knows they are brain dead. So many of these people could have been saved if they received essential care in time. It is criminal not to act on this report. The service could be provided on a North-South basis as Ireland and Northern Ireland are the two places in Europe not to have this service.

There are many cases of babies from Donegal and Tralee, born with congenital heart disease or suffering from meningococcal meningitis, struggling for life and requiring urgent operations in, say, Our Lady's Hospital for Sick Children in Crumlin, who have died due to the delays of ground ambulances. Another alternative is to open a neurosurgical centre in Galway, but this will not happen. If the recommendations of the Hanly report are introduced, a hospital emergency medical service will be needed more than ever.

The alternative is to build good roads but again this will not happen, particularly in the west. In the mid-term review of the national development plan, 69% of the planned western roads were developed, while 34% more roads were developed than planned in the south and east. The number of road deaths can be reduced at the cost of €12 million for an air ambulance service. Along the west coast, there are already 24 hour helipads. With an annual budget of €10 million, this service could be provided. This is an insignificant amount in contrast to the money spent of e-voting.

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