Dara Calleary (Mayo, Fianna Fail)
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I wish to share time with Deputy John O'Mahony. I thank the Ceann Comhairle for allowing this debate and I thank the Minister of State for being here. The patient transport scheme enables those on the west coast who cannot access dialysis or cancer care appointments to get to their hospital appointment. It affects 456 patients from Donegal to the Galway border, 125 of whom are dialysis patients in Mayo, Galway and Roscommon and a further 73 of whom use the service to access cancer treatment generally in the regional hospital in Galway.

People in need of dialysis or cancer treatment are at their lowest ebb and should not need to worry about transport. It may be difficult for those living in an urban or city environment to imagine that we need this service. However, when one lives 100 miles or 150 miles from a hospital or treatment centre, when one does not have access to a car, a neighbour or family member to provide assistance, one needs such a service. One should not need to worry about how to get treatment at such a stage of one's life.

There are many operators on the west coast who give ceaselessly and selflessly to the service. I imagine most of these do not make much profit given the service they provide. Deputy Mulherin is in the House and I cannot let the occasion pass without acknowledging her late father who operated this service wonderfully for many years. The fact that Deputy O'Mahony and I are sharing time shows that we are keen to do this on a cross-party non-partisan basis to try to get a resolution to a letter that issued on Friday to Mayo General Hospital and Roscommon County Hospital that the service for dialysis and cancer patients would cease as of 1 July.

I understand at the HSE Regional Health Forum, West meeting today an indication was given that work is under way to try to resolve this. I call on the Minister of State, who has an interest in this issue, to intervene to ensure that urgent clarity is given to the effect that the service will continue beyond 1 July. The 456 people to whom I referred tonight wonder how they will get their dialysis or cancer treatment after 1 July. We should not allow these people to worry beyond tomorrow.

A review is under way into the quality of the service. That review should continue but I call on the Minister of State to allow the service to continue until the review is complete. Many options could be examined collectively in terms of co-operative transport, rural transport and schemes similar to the Irish Cancer Society scheme.

At issue is a relatively small amount of money. A sum of €500,000 could resolve the issue for this year. Let us consider that in the jobs initiative there remains €200 million underspending from the money being raised through the pension levy. One operator informed me yesterday that he will lay off five people if this decision goes ahead. Lord knows how many people along the west coast will be laid off. Surely, we could take a little of the underspending to save these jobs and, more importantly, give comfort to these people at a low ebb in their life.

John O'Mahony (Mayo, Fine Gael)
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I thank Deputy Calleary for sharing time to discuss this immediate issue which, since it broke in recent few days, is a cause of great concern among the people who use and depend on the service. Deputy Calleary provided the facts and figures but all of us have spoken to people affected by it. Before I came into the Chamber I spoke to an elderly lady who is living with her elderly sister. She does not have transport, she cannot drive and she is living in the south of the county. She must get a lift to Claremorris to get a bus which does not arrive in Castlebar until one and a half hours after the treatment is due to begin. When her treatment is finished at the end of the day there is no bus service to bring her back.

The reality is that the required public transport is not in place but these vulnerable people should not be exposed in this situation. I realise the Minister, Deputy Reilly, has seen many issues fall out of the sky during recent weeks, including accident and emergency issues, hospital doctors, the fair deal scheme and so on and he is dealing with these. However, it is important that this matter is dealt with quickly and that the trauma of wondering whether transport will be available is removed. Earlier this evening, I spoke to the Minister, Deputy Reilly. I realise that in the coming days he will meet senior officials from the HSE, west. I realise he wishes to see this matter solved but I stress to the Minister and all Deputies that it should be done as quickly as possible.

The immediacy of the proposed change requires urgent action. Patients who require this service are suffering enough trauma without having to wonder whether it will continue beyond 30 June.

Kathleen Lynch (Cork North Central, Labour)
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I am taking this matter on behalf of my colleague, the Minister for Health, Deputy James Reilly.

The national ambulance service provides pre-hospital emergency care, as well as emergency and some non-emergency patient transport. Non-emergency transport comprises inter-hospital transfers and patient transport from home to health facility and from health facility to home. It includes both Health Service Executive and private transport providers.

The HSE has not taken any decisions to withdraw services. However, the executive is operating within serious budgetary constraints and must take the necessary actions to live within budget. The Minister has instructed the HSE generally not to withdraw any services from acute hospitals unless and until he receives a full briefing on the details of what is proposed, alternative arrangements to be put in place and the overall implications for patients.

Supported by the Department of Health and the Health Information and Quality Authority, the national ambulance service is working to improve the management and integration of its services. This involves a reduction to two ambulance control centres nationally, with appropriate technology; a clinical lead for pre-hospital care; development and implementation of new performance indicators for pre-hospital care; and development of standard national criteria for non-emergency patient transport.

There are several systems of support in place for cancer patients who have to travel for treatment, through community welfare office services and the Travel2Care scheme. The latter is being implemented on a phased basis in line with the transfer of cancer services to the eight designated cancer centres and the approved satellite centre in Letterkenny for patients for whom the transfer of services would otherwise cause financial hardship. The scheme which is funded by the national cancer control programme and administered by the Irish Cancer Society provides some financial help towards the cost of public transport such as trains or buses, private transport costs, or petrol and parking costs.

The national ambulance service has undergone significant change in order 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 a key part of the Government's work to ensure high quality emergency care. If we are to provide the best of care for patients with high-end medical needs - people who are already worried and stressed because of their condition - we must do all in our power to ensure we do not exacerbate that worry. I completely agree with the Deputies in this regard and will bring the matter to the Minister's attention in the morning.

I take the opportunity to thank Deputy Dara Calleary for his unceasing support and great advice on Adjournment matters. I appreciate his assistance.