Jerry Cowley (Mayo, Independent)
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I am grateful for the opportunity to raise this important matter on the Adjournment. It is scandalous that there is a continuing delay in the establishment of an ambulance base for the Mulranny, Achill and Ballycroy areas. I cannot understand how the western area of the HSE and the Minister for Health and Children can stand over the dangerous situation whereby the health of those residing in these areas is at serious risk due to the unacceptable time lapse that exists between when an ambulance is called and when it arrives to take an ill person to hospital.

The failure to locate an ambulance base in the Mulranny, Achill and Ballycroy areas is unacceptable and is not in accord with the established national and international guidelines for patient safety. I urge the Minister to look at this situation forthwith. We are all aware of the importance of the "golden hour" but this is irrelevant when it takes an ambulance as much as two hours to get to Achill from Castlebar. Seriously ill patients would have some chance of recovery if ambulances were based in the areas I have mentioned.

The western area of the HSE is of significant size, measuring 5,500 sq. ft. and with a population of 380,000. It is a predominantly rural area in which ten ambulance bases are currently located. When one compares this with the situation nationally, it is clear the western area has one of the lowest numbers of bases in comparison with other similarly sized areas. The response times are dependent on a number of factors such as the road network, rurality, time of call and the location of the ambulance station.

The latter is the most critical factor. Recent analysis of response times shows that, on average, 68% of calls are dealt with within 20 minutes. However, there are significant variations between urban and rural areas. In Ballina, for example, 58.8% of calls are answered in 20 minutes and the corresponding figures for Belmullet and Castlebar are 55.6% and 58.8% respectively. This is unacceptable in comparison to figures in other areas. In addition, it is a policy of the HSE's western area that all ambulance bases should provide full cover 24 hours a day. It is also policy to ensure all citizens are within a 20-mile radius of the nearest ambulance station. However, an examination of the catchment areas indicates a number of them do not meet these criteria, a situation which is unique nationally.

In 2002, the former Western Health Board pointed to the urgent need for the provision of three new ambulance bases. However, the cost of such provision is beyond the revenue funding of the existing ambulance service and it has made repeated applications to the Department of Health And Children for increased funding. I urge the Minister of State to consider the distance involved. As a doctor, four babies have been delivered inside or outside my own home because an ambulance has not arrived on time to transport the mothers concerned to hospital.

I visited the accident and emergency department in Mayo General Hospital last night and found patients waiting for beds. There are inadequate step-down facilities in the county. The home for elderly persons in Ballinrobe lies undeveloped since 1972. We now have an orthopaedic unit, the campaign for which I started, a wonderful facility with a full complement of staff. All the necessary equipment is there but it is not used for elective work, which means patients must travel to Galway for procedures such as hip replacements. This is unacceptable.

These serious issues are being addressed by Independent Members while Deputies in the main parties merely make noise. The Independents are setting the agenda and dealing with the issues which matter most to people. I hope the Minister of State will have some news on the terrible situation whereby international guidelines on the provision of ambulance services are not being honoured.

Brian Lenihan Jnr (Dublin West, Fianna Fail)
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Under the Health Act 2004, as the Deputy is frequently reminded, the HSE has the responsibility to manage and deliver, or arrange to be delivered on its behalf, health and personal social services. This includes responsibility for the provision of ambulance services. The HSE's western area provides emergency and patient transport ambulance services to a population of more than 350,000 people. As the Deputy correctly points out, this is a very dispersed area and Mayo is probably the most dispersed county in it. It is certainly the most dispersed constituency in this House.

The Department is advised that the emergency ambulance service is provided from ten stations across the catchment area. There has been a significant expansion of this service in recent years. Ten additional crews have been put in place, the number of 24-hour bases has increased from three to five and the overall hours of operation across all bases have increased significantly. In 2004, six new high-specification ambulances were provided. In addition, two new rapid-response vehicles have been introduced as back-up to the new fleet. Facilities at ambulance stations in Ballina, Boyle, Clifden and Roscommon have also been improved.

The HSE has responsibility for the continuing development of the service. In this regard, it is developing proposals for the establishment of a number of additional stations in the western area, including a station in the Achill-Mulranny area. I understand the Deputy's general practice is located in the Mulranny area rather than the Belmullet area. The provision of additional capital funding for these developments is a matter for the HSE having regard to funding provided under the capital investment framework for 2005-09.