Micheál Martin (Cork South Central, Fianna Fail)
Link to this: Individually | In context

Question 9: To ask the Minister for Health following comments that no decision has been taken to withdraw ambulance transport services in the North West and that these facilities will remain, the discussions he has had with the his officials to ensure that these sort of briefings will cease. [17677/11]

Micheál Martin (Cork South Central, Fianna Fail)
Link to this: Individually | In context

Question 31: To ask the Minister for Health if he still stands by the fact that no decision has been taken to withdraw ambulance transport services in the North West and that these facilities will remain. [17676/11]

Michael Moynihan (Cork North West, Fianna Fail)
Link to this: Individually | In context

Question 40: To ask the Minister for Health when he was first informed of the Health Service Executive's intention to cease funding for ambulance transport services in respect of cancer and dialysis patients at Mayo General and Roscommon County Hospital; and if he will make a statement on the matter. [17885/11]

Pádraig Mac Lochlainn (Donegal North East, Sinn Fein)
Link to this: Individually | In context

Question 49: To ask the Minister for Health if he will ensure that ambulance transport services for seriously ill patients will be continued in all regions; and if he will make a statement on the matter. [17900/11]

Pearse Doherty (Donegal South West, Sinn Fein)
Link to this: Individually | In context

Question 50: To ask the Minister for Health if the Health Service Executive ambulance transport service provided for dialysis and cancer patients in the west region will be continued; and if he will make a statement on the matter. [17899/11]

Dara Calleary (Mayo, Fianna Fail)
Link to this: Individually | In context

Question 52: To ask the Minister for Health if he will confirm a statement made by the Taoiseach in Dáil Éireann last week that no decision has been taken on the removal of ambulance transport services for cancer and dialysis patients in the North West. [17884/11]

Billy Kelleher (Cork North Central, Fianna Fail)
Link to this: Individually | In context

Question 60: To ask the Minister for Health if cuts to ambulance transport services for cancer and dialysis patients in the North West are to proceed from the 1 July 2011; and the meetings he has held with the Health Service Executive West and other interested parties to address this matter in the past week. [17877/11]

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I propose to take Questions Nos. 9, 31, 40, 49, 50, 52 and 60 together.

It is not my wish to reduce the level of any service, including patient transport. However the country is facing an unprecedented economic and financial crisis. This is an inescapable reality. The HSE must live within its budget and must prioritise its services accordingly. We must examine the way services are being delivered, make sure they are safe, prioritise services that will meet clear clinical needs and reallocate resources accordingly.

The national ambulance service provides pre-hospital emergency care and emergency and some non-emergency patient transport. Clearly the priority is emergency care, including transporting sick patients between hospitals. The HSE also provides non-urgent care using either ambulances or taxis. Non-emergency transport comprises inter-hospital transfers, patient transport from home to health facility and from health facility to home. It includes both HSE and private transport providers. There must be a clear national approach to non-emergency transport. This is a key point.

This type of expenditure from public moneys must be able to stand up to scrutiny in the new economic reality. There must be a consistent approach across the country instead of the differing practices in place now. Scarce resources for emergency transport cannot continue to be expended on non-emergency transport without clear criteria in place based on clinical need. Supported by my Department and HIQA, the national ambulance service is working to improve the management and integration of its services. This includes the development of standard national criteria on non-emergency patient transport which will be announced shortly. There are a number of systems of support in place for cancer patients who have to travel for treatment and these arrangements will continue on the same basis as previously.

The national ambulance service has undergone significant change 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 are a key part of the Government's work to ensure high quality emergency care.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Does Deputy Cowen wish to speak in place of Deputy Martin?

Barry Cowen (Laois-Offaly, Fianna Fail)
Link to this: Individually | In context

No.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

I am certain Deputy Martin will be pleased that I was present to take the opportunity to speak.

This threatened cut was first revealed by me, interestingly, when we obtained a copy of a letter sent by the Health Service Executive ambulance management to hospitals in the west region stating that from 1 July transport services for people requiring dialysis and cancer care supports and services would be stopped. This concerned the whole west region, from the Cork-Kerry border all the way to Inishowen in County Donegal. This threat has caused serious concern. We were told subsequently that it would not be implemented and we are now told there is a review. I ask the Minister to elaborate on what review is in train. Will he have the final say in the matter?

The Minister has indicated his disposition towards HIQA, which must operate with certain terms and conditions applying to its remit. It is important to remind him of his public statement that he will take back responsibility for the health service and is not abrogating his responsibility, as the previous Minister did, in relation to the Health Service Executive. I welcome that statement and encourage him in that respect. If that is the case, does he agree with the view expressed by the director of operations for HSE west, Mr. John Hennessy, when he referred to-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Deputies may not quote on Question Time.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

With respect, I am not quoting. Mr. Hennessy referred to the indiscriminate transport arrangements which applied heretofore. Does the Minister agree with him? There is no such thing as indiscriminate transport arrangements for people in need of dialysis and cancer care. The definition of the word "indiscriminate"-----

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Thank you, Deputy. I ask you to respect the Chair.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

-----is "making no distinctions". I hope there will be no distinctions made regarding the transport needs of people requiring dialysis and cancer care across the west in future.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Thank you, Deputy.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

You are welcome, a Cheann Comhairle.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I do not appreciate your remarks.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

Will the Minister please clarify his intent in that regard?

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I ask the Minister to give a brief response.

Pádraig Mac Lochlainn (Donegal North East, Sinn Fein)
Link to this: Individually | In context

With respect, I indicated first. My constituency is in the north west.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Deputy Pringle please.

Thomas Pringle (Donegal South West, Independent)
Link to this: Individually | In context

So is Donegal South-West.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

Hurry, Deputy, we are running out of time. Question Time finishes at 4.45 p.m.

Thomas Pringle (Donegal South West, Independent)
Link to this: Individually | In context

Donegal South-West is also in the north west. It is my information that this issue arose from the separation of the ambulance and hospital services that took place within the HSE. It is an indication of the dysfunctional way the HSE works. The separation of budgets between community care and hospital care causes all this friction and huge distress for patients throughout the country. It is vital that these issues do not arise again and I ask the Minister to ensure they do not. The distress it causes for very ill dialysis and cancer patients is unacceptable. Patients are entitled to transport and it should be provided regardless of empire building or empire protection within the ambulance service and the hospital service.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

To correct Deputy Ó Caoláin, the letter went from somebody down the ranks of the HSE and it did not say the service was stopped. It said, and the Deputy's party leader read it out to the House, that it was expended.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

There is quite a distinction there, all right.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

There certainly is.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

He was talking about the budget at that point.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

When money is expended that does not mean the service stops.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

It did. The letter also said it did.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

It did not.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

He talked about the budget being expended.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The proof of the pudding is in the eating.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

It is in the letter.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The transport has not stopped. People who need transport for dialysis and cancer services get it.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

The intent was there. I will send the Minister a copy of the letter.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I wish to point out, notwithstanding the interruptions, that there has been huge inconsistency in the transport arrangements across this island. I must concur with Deputy Pringle's comments. There is a lack of uniformity, although the HSE was supposed to result in uniformity of approach and of care for 4.4 million people, or 4.2 million as it was at the time. There are totally different criteria in the west of Ireland from those on the east coast. While people are entitled in the west, they are not entitled in the east.

We must make a decision on the basis of having so little money. We can argue why that is the case but that is the reality we face. Are we going to meet expectation or are we going to meet need? My view is that we will do damned well to meet need and need is what we should focus on - the needs of those who require this transport and who do not have their own transport because they do not have the income or means. It is a fact that there are many people in the west who currently have their own transport and drive to get dialysis. Furthermore, we are not just discussing dialysis and cancer patients in this context but a range of services that are used to bring people to health facilities. We need clear guidelines and criteria that are fair and transparent. I do not believe that has been the case in HSE west and there is an acknowledgement of that on its part. That is what this review is about.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

Is the Minister saying that if one has a car, one can drive oneself there?

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

I am saying that if one has the means-----

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

Is that what the Minister is saying to people in need of cancer care support?

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

The Deputy can put whatever misinterpretation he wishes on it-----

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

No, it is what the Minister is saying.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

-----but he clearly heard what I said.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
Link to this: Individually | In context

If one has one's own car, one can make one's own way.

James Reilly (Dublin North, Fine Gael)
Link to this: Individually | In context

Only if one is able.

Seán Barrett (Dún Laoghaire, Ceann Comhairle)
Link to this: Individually | In context

I wish Deputies would learn to have some respect in the House, particularly those who have been Members for a long time.