Michael Lowry (Tipperary, Independent) | Oireachtas source

In medical emergencies every second counts. When the misjudged decision to close accident and emergency hospitals such as Nenagh Hospital was being fought, we all became familiar with the term "golden hour." The golden hour determines the appropriate treatment, and is critical within the first 60 minutes from the time of injury or the appearance of serious medical symptoms. It is based on the informed belief that once this time has lapsed, the risk of death or long-term complications significantly increases. This was back when ambulances were staffed by a nurse and a driver who were tasked with getting a patient to hospital urgently. There were fears that increased distances to accident and emergency departments could prove fatal. Nowadays highly-qualified paramedics are trained to administer on-the-spot emergency medical care to people who are seriously ill or injured. Their job is to stabilise the patient before they are transferred to hospital.

I support the suggestion from Deputy Naughten to expand the role of paramedics. The National Ambulance Service saves lives. However, time is still of the essence. Delays cost lives. Last week, during a meeting of the Joint Committee on Health, Dr. Cathal O'Donnell stated that there has unquestionably been harm to patients due to ambulance delay. This harm is due directly to deterioration in response times to life-threatening incidents. Ireland has a rapidly growing older population. It is also experiencing significant population growth. This is substantially increasing demand for all forms of healthcare. In 2022, there was a doubling of pedestrian deaths. Drivers accounted for 39% of road fatalities. Some 1,300 people were seriously injured on our roads. Throughout Ireland, an average of 6,000 people suffer heart attacks annually, while 7,500 suffer strokes. Each of these people, along with thousands of others we do not hear about, require prompt emergency care. We need a properly resourced and fully staffed ambulance service to meet these demands. This fact can no longer be ignored. People's health is not a can that continue to be kicked down the road. People deserve the security of knowing that if an ambulance is called it will arrive in the fastest time possible.

Much has been written about people calling ambulances when circumstances do not require one. The public is urged to contact their GP or out-of-hours service for medical treatment and to only call an ambulance in a true emergency. In an ideal world, most people would do this willingly. However, many out-of-hours services do not provide the access many people require. When daily GP surgeries close in north Tipperary, Thurles and Roscrea are covered by a mobile doctor. Patients are seen by appointment at respective centres in both towns until 11 p.m. From that time, until GPs reopen next morning, the overnight Nenagh centre takes over. That is approximately 20 miles from both Thurles and Roscrea. Not everyone is in a position to drive 20 miles in the middle of the night, with a child, an adult or an elderly person who may require medical attention. In many cases, it is not wise or safe to do so. In other cases, people do not have transport. Their only access to medical care is to call an ambulance, and in times of illness people will do whatever it takes to get help. They cannot be faulted for taking the only choice open to them. I have been raising the ongoing issues with our ambulance service in this House since 2001. I have highlighted escalating crises with out-of-hours medical care in County Tipperary. Neglect of these services has been steadily allowed to reach this crisis point. Failure to take immediate action to address those critical issues risks the health and lives of every person in the country.

Regarding University Hospital Limerick, UHL, we were told that the injury unit at Nenagh and Ennis would be upgraded, developed and expanded to cater for patients who do not necessarily need to go to the overcrowded UHL. Yesterday the Nenagh unit was closed due to staff shortages. UHL has cancelled 600 surgeries in the past six weeks. This beggars belief. If the injury unit at Nenagh were properly developed and utilised, it would have the ability to reduce pressure on UHL. We received assurances this would happen. Instead we get the opposite. It is impossible to believe, or have confidence, in the content of briefings or statements on behalf of the University Limerick Hospitals Group. The situation appears to be out of control and can only be described as chaotic. The Minister of State, and her Department, need to get a grip and do whatever it takes to restore a safe, adequate and proper healthcare service to the people of Tipperary and the mid-west region.

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