Jerry Cowley (Mayo, Independent)
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I am grateful for the opportunity to raise this matter on the Adjournment. There are two matters to mention here, the first of which is to state this is an essential service and make the case for that. The second is the failure of Government to even recognise its responsibility and the utter ease with which it has been able to pass the buck to the HSE. Our worst fears about the Health Act 2004, that there would be no transparency or accountability, have come true. If the funding is not provided, the HSE can do nothing. As long as the money is not provided, the position will remain unacceptable.

The former Western Health Board area is very large. It includes three areas unique in Ireland, in that there is no ambulance base within 20 miles of them. The criteria laid down indicate there should be an ambulance base within 20 miles of all areas so people can get the help they need within the golden hour, a period recognised and laid down in medical circles as the time needed to give a person the best chance at life. Outside of the golden hour the chances of things going wrong are much greater and the chance of recovery less.

The issue for those who protest against the Hanly report and other changes is about getting services within the golden hour and getting essential definitive services that will make the difference between life and death, or life with disability or a cure. We face this difficulty through the lack of an ambulance service in the Mulranny-Achill area, which has a scattered rural hinterland. It takes two hours for an ambulance to come to Achill, never mind the chance of a person getting treatment within the golden hour. This is an utter scandal and has been raised with both the current and the previous Minister.

We put the same questions and get the same answer every time that this is a matter for the HSE and has nothing to do with the Minister who has no responsibility for the people of Mulranny and Achill who are dying. While Nero fiddled, Rome burned. While the Minister for Health and Children evades responsibility patients die. I got involved in helping set up a voluntary ambulance service in our area, but because of legalities etc. this service is no longer available. We are dependent on the State to provide a service. There is an onus on the State to provide an ambulance service that will provide service within the golden hour.

The situation is the same in Roscommon and Tuam, the two other areas that do not have an ambulance base within 20 miles. Four babies were born in my house because mothers could not make it to the hospital in time. People have died because of the distances involved and because of the delay in getting to the services in Mayo General Hospital, a considerable distance away.

We have been getting the same answer from the Minister since I came into the Dáil that the HSE is responsible for this area, not the Minister. For what has the Minister responsibility? What is the point in having a Minister for Health and Children if she will not take an interest in this issue and provide the necessary funding to ensure we get an ambulance service for the Mulranny-Achill area?

Tom Parlon (Laois-Offaly, Progressive Democrats)
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I am taking this Adjournment matter on behalf of the Tánaiste and Minister for Health and Children, Deputy Harney. I thank the Deputy for raising the matter as it provides me with the opportunity to outline to the House the facts relating to this issue.

The Deputy mistakenly alleges certain failures on the part of the Tánaiste and Minister for Health and Children. It is important, therefore, to clarify for the House the follow-up action taken by the Department and the Health Service Executive pursuant to the particular parliamentary questions which the Deputy tabled and which were replied to by the Tánaiste on the basis that the matter was one for the executive and had been referred to it for direct reply.

The Deputy's question of 14 June was referred to the executive and resulted in it issuing a letter to the Deputy on the matter dated 6 July. The Deputy raised the same matter in a question on 29 June and this was also referred to the executive in accordance with the Tánaiste's reply on that occasion. The executive replied to the Deputy by e-mail on 9 September, reiterating the position as conveyed to him previously. I am advised the Deputy was in telephone contact on the morning of 29 September with the executive to discuss the matter with the person who wrote to him on 9 September.

This sequence of events demonstrates that the Deputy's question to the Tánaiste was promptly referred to the executive and elicited responses to the Deputy setting out its current position on the provision of the particular service concerned. There was no failure on the part of the Tánaiste or her Department in regard to this matter.

Jerry Cowley (Mayo, Independent)
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Will the Department provide the money?

Tom Parlon (Laois-Offaly, Progressive Democrats)
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The Tánaiste's actions were fully in accordance with the provisions of the Health Act 2004, particularly subsection (4) of section 7 which expressed the decision of the Oireachtas that the executive "shall manage and deliver, or arrange to be delivered on its behalf, health and personal social services".

Jerry Cowley (Mayo, Independent)
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If it gets the resources.

Tom Parlon (Laois-Offaly, Progressive Democrats)
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The executive has its own Vote for which its chief executive officer is the Accounting Officer. In that context, it must make its own decisions on the use of resources and the setting of priorities for service development in Mayo or anywhere else in the country.

The Tánaiste has put particular emphasis and importance on the executive providing timely replies and information to Oireachtas Members. This is an initiative on which her Department has been working with the executive and which led to the establishment of the executive's parliamentary affairs division. A primary task of this new division is to ensure questions referred to the executive are responded to as soon as possible and that the issue of replies is monitored and followed up where necessary. The Department continues to work with the executive to develop its parliamentary affairs capability.

I emphasise that while these arrangements facilitate referral of questions to the executive, they do not give a role to the Tánaiste in the decisions which inform the replies provided directly to Deputies, as these are a matter for the executive in accordance with its responsibilities under the Act.

Jerry Cowley (Mayo, Independent)
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It is no use having priorities if they cannot give the funding.