Jim Daly (Cork South West, Fine Gael) | Oireachtas source

I thank Deputy Smyth for the sincerity and appropriateness with which she has brought this issue to the House. I extend my sincere sympathies to the family of that young gentleman and for the harrowing story and circumstances they endured. I am very conscious that no mealy-mouthed words I will issue today with statistics or figures will go any way towards answering the what-ifs, the maybes and the buts the family has to live with every day of their lives. Listening to me speak about the global macro picture, the response times in the Cavan-Monaghan area and what percentages of calls have been achieved satisfactorily and within an appropriate response time, will go nowhere towards solving the anguish of those people. When we talk about ambulance response times, the reality is that we are talking about life and death. We cannot afford to get them wrong. I absolutely accept this from the outset.

I ask the Deputy to not assume this response is a defence; it is by way of background and explanation from the Department. Ambulance response times are helpful for performance measurement, however, it should be recognised that sole reliance on response times does not provide a comprehensive picture of modern ambulance service performance. Response times tell us how fast the service was provided rather than how well the patient was cared for. Response time performance is being globally reviewed as to whether it is the only appropriate measure of pre-hospital patient care. While rapid deployment and timely arrival is accepted as being necessary, patient outcome indicators are now being viewed as a more appropriate measure of patient care and experience. The National Ambulance Service has developed a suite of key performance indicators to measure patient outcomes and experiences and these are currently being piloted to be included in the national service plan.

That said, I am aware that the Delta response times in the north east have been below target. I note, however, that Echo response times are on or above target in the period September to December 2017. A number of developments have been made by the NAS in order to address the issue of response times. I am also aware that in Border counties the NAS works closely with the Northern Ireland Ambulance Service to provide a more responsive service for patients.

The capacity review published in 2016 identifies particular difficulties serving rural areas such as this region. The capacity review indicated that the only practical way to improve first response times in rural areas is through voluntary community first responders, CFR, schemes. The NAS continues to work with local CFR groups across the north east region to enhance services. There are currently 25 CFR groups in the north-east region.

I have also been advised by the NAS that it is improving regional coverage and deployment across rural areas including Cavan and Monaghan. The National Ambulance Service is moving away from ambulance provision from fixed bases to dynamic deployment. This means that resources can be used across a region so that if demand increases in one area, other resources can provide cover as required. In addition, the National Ambulance Service has developed the intermediate care service to provide lower-acuity hospital transfers, which frees up emergency ambulances for the more urgent calls. A permanent emergency aeromedical support service has also been established to provide a more timely response to persons in rural areas.

Over recent years, year on year, additional investment has been directed towards the National Ambulance Service. This year, an additional sum of €10.7 million has been made available, which includes €2.8 million to fund new developments. New developments include the development of alternative pathways to care, as well as the hear and treat clinical hub that is expected to go live soon in the national emergency operations centre. This will divert some lower-acuity patients to alternative care pathways and will free up some emergency capacity. In time it is hoped that such initiatives will help to improve response times around the country including in the Cavan-Monaghan area. I assure Members that the National Ambulance Service is focused on improving ambulance response times throughout the country.

I reiterate my earlier comments that I do not mean to be insincere by giving those facts and figures. They do not do a service to the individuals involved.

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