James Reilly (Dublin North, Fine Gael)

I propose to take Questions Nos. 9, 31, 40, 49, 50, 52 and 60 together.

It is not my wish to reduce the level of any service, including patient transport. However the country is facing an unprecedented economic and financial crisis. This is an inescapable reality. The HSE must live within its budget and must prioritise its services accordingly. We must examine the way services are being delivered, make sure they are safe, prioritise services that will meet clear clinical needs and reallocate resources accordingly.

The national ambulance service provides pre-hospital emergency care and emergency and some non-emergency patient transport. Clearly the priority is emergency care, including transporting sick patients between hospitals. The HSE also provides non-urgent care using either ambulances or taxis. Non-emergency transport comprises inter-hospital transfers, patient transport from home to health facility and from health facility to home. It includes both HSE and private transport providers. There must be a clear national approach to non-emergency transport. This is a key point.

This type of expenditure from public moneys must be able to stand up to scrutiny in the new economic reality. There must be a consistent approach across the country instead of the differing practices in place now. Scarce resources for emergency transport cannot continue to be expended on non-emergency transport without clear criteria in place based on clinical need. Supported by my Department and HIQA, the national ambulance service is working to improve the management and integration of its services. This includes the development of standard national criteria on non-emergency patient transport which will be announced shortly. There are a number of systems of support in place for cancer patients who have to travel for treatment and these arrangements will continue on the same basis as previously.

The national ambulance service has undergone significant change to ensure quality, safety and value for money. In line with other clinical areas, this process is ongoing as clinical needs and standards develop. These developments are in the best interests of patients and are a key part of the Government's work to ensure high quality emergency care.

See this speech in context