Barry Cowen (Laois-Offaly, Fianna Fail)
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In seeking to discuss the issue of the Offaly ambulance service, I want to focus particularly on Edenderry ambulance service, where the situation is causing grave concern and worry among staff and residents in the general locality and region. Currently the staffing of the service comprises five full-time staff with five other staff available to cover at any time. Up to November last year over a period of almost two years, the service carried out 650 call-outs covering an area of north Offaly, parts of Kildare and Meath. It is particularly important to have this service and we want to have a quality service there given its rural nature.

The ambulance bay was sought after a long number of years. Following numerous representations and lobbying, the bay was put in place about two years ago. Accommodation was provided in what used to be the matron's living quarters in Ofalia House, a community nursing unit in Edenderry, on the future of which we also seek clarification, considering the publication of the HSE Dublin-north Leinster region report this week, which refers to a €20 million cut across the regional community nursing care service. The HSE had given a commitment in regard to facilities in Tullamore, Edenderry and Birr and I hope there will be consistency in that respect in the coming year despite the talk of cutbacks.

In regard to this issue, the facilities consist of one room, a storage unit and one toilet to be used by male and female ambulance staff. The facilities are not adequate. Another example of their inadequacy is that after a call-out when an ambulance has to be cleaned, it must be transported to Tullamore hospital, which leaves north Offaly and parts of Meath and Kildare without an ambulance service. This means lives are being put at risk whenever an ambulance needs to be cleaned. The temporary accommodation for the ambulance service is totally unacceptable and it does not meet the standards required. Permanent facilities are necessary.

The Minister, the HSE and the local authorities have been investigating the possibilities of co-sharing of facilities over a period of time. In my most recent correspondence with the Minister, to be fair to him, he asked that I consult the HSE and the local authority with a view to examining if a facility at the new fire station, built three years ago, could be an option, and there could be a sharing of facilities in the interests of cost-savings but, unfortunately, having consulted the local authority that can no longer be considered an option. It may have been the ideal location but when that fire station was built three years ago the local authority consulted the HSE and inquired if it had any wish to be part of or to take up an offer to locate a facility there and it was declined. It is now deemed that option is unsuitable for a full-time ambulance service and a part-time fire service.

The onus of responsibility now falls back on the Minister and we want him to maintain this full-time facility but we want him to take action to make sure the facility and service that is offered and provided is adequate, meets the standards required and meets the wishes of the locality and regions of north Offaly, Meath and Kildare. To that extent, I ask the Minister to seek to either extend the area within Ofalia House for the use of the ambulance service or to examine the possibility of leasing a suitable vacant unit, of which there are plenty I am sure in the vicinity of Edenderry town.

I ask the Minister of State to respond to this matter. Having considered the Minister's response and all the parties having explored the potential in his response, unfortunately, the option cannot be progressed and the onus of responsibility now falls on the Minister and Government to put this situation right.

Róisín Shortall (Dublin North West, Labour)
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I thank the Deputy for raising this issue. I am responding on behalf of the Minister, Deputy Reilly.

The national ambulance service provides pre-hospital emergency care and emergency transport to the health service. Previously, each health board ran its own ambulance service, with little co-ordination of activities across board boundaries and no clear national leadership on pre-hospital care within the health service. However, the national ambulance service works nationally and regionally, not locally.

It deploys resources on a dynamic basis to meet surges in demand and ensure optimal spatial application of emergency cover. Dynamic deployment of emergency services ensures the nearest appropriate resource is mobilised to the location of any incident. Dynamic delivery, with resources moved around according to predicted demand, based on need and demand patterns, is more flexible and responsive, with better response times for patients and a better service.

The NAS is committed to the provision of pre-hospital emergency services in Offaly, Westmeath, Laois and Longford. There is a staff complement of 160, with seven ambulance stations and 17 emergency ambulances. A command and control centre operates on a 24-hour basis. Following a statistical and spatial analysis of the region in January 2011, the NAS made an evidence-based decision to decentralise resources to improve services in the area. This clearly demonstrates the flexibility of public services to respond to local need. Dynamic deployment in the Offaly and Laois areas is achieved by initial dispatch of crews from Birr, Tullamore, Edenderry and Portlaoise and dynamic dispatch of resources from surrounding stations, namely, Mullingar, Athlone, Tullamore, Naas, Maynooth or Navan. Supporting this deployment model is an advanced medical priority dispatch system in control centres, which uses internationally recognised protocols and standards to ensure an immediate and appropriate response. To provide a high quality ambulance service, the NAS operates with a range of statutory and voluntary and community organisations. It has co-responder systems in place with the Laois and Offaly fire and rescue services and 32 community first responder schemes to provide first responder assistance in an emergency prior to the arrival of the NAS. Last year, the NAS responded to approximately 650 emergency calls in the Offaly area. The monthly percentages of category 1 "Echo" emergency calls responded to within a target timeframe of less than seven minutes and 59 seconds were some of the highest in the country in ten of the 12 months of 2011.

The Deputy raised the issue of ambulance facilities in Offaly. I am aware that, as in any part of our health service, there are particular locations where the infrastructure may not be appropriate to the development of a modern service, and the NAS is moving to remedy this where possible. However, in the current situation, it is clear that expectations must be adjusted and existing State capital assets must be fully optimised. In particular, local fire service facilities offer an opportunity to provide solutions to inadequate or doubled-up facilities, in Offaly and elsewhere, where such solutions are feasible in maintaining and improving ambulance services. The NAS will continue to engage with local authorities on this issue in order to secure the future of services in Offaly and other places.

The NAS 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. I believe these developments are in the best interests of patients and that they are a key part of the Government's work to ensure high quality emergency care. I thank the Deputy for raising the matter.

Barry Cowen (Laois-Offaly, Fianna Fail)
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I thank the Minister of State for her response. However, it raises more questions. I do not wish to be parochial with regard to this issue; I recognise the fact that we must spread across a region. I do recognise that the base in Edenderry represents a region that covers not only north Offaly but also parts of Kildare and Meath. The Minister of State mentioned the potential for doubling up of facilities. As I said in my initial speech, this is something that has been explored to the nth degree in recent times with regard to the new fire station that was built three years ago in Edenderry. Even during the initial phase of the design of that fire service, the HSE was asked by the local authority if it wished to avail of a facility within that complex, but it declined the offer, which left the local authority with no option but to design it to meet its own demands, which was that of a part-time fire service with two bays. That looks after the local authority's requirements. It cannot, unfortunately, provide the necessary accommodation or facilities to suit the ambulance service. Thus, the responsibility falls firmly back on the HSE. It must recognise, as I do and as the locality does, that the facilities and services within the complex in which they now operate are not suitable or practical and cannot meet the standards required. The staff cannot continue to be expected to work in these conditions. Not only is it detrimental to their daily working lives, it also poses a threat to the general population which puts lives at risk. I ask the Minister of State to ask the Minister to attack this issue urgently in order to provide either improved facilities at the present location or a new facility that can be accommodated at very reasonable cost.

Róisín Shortall (Dublin North West, Labour)
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As with the last issue, it is important to remind Members, lest they have forgotten, of the extremely difficult financial circumstances in which we are operating. I am not going to go into the reasons for that; I am sure Deputy Cowen would not want me to do so. The fact is that €750 million has been taken out of the health budget this year because of our extreme difficulties. That poses enormous challenges within the health service in terms of maintaining an acceptable level of service where demand for services is growing. That is the climate in which people are trying to function and, in fairness, staff are doing their utmost to plug the holes left by a lack of funding.

As the Deputy has said, it is accepted that the current facilities are temporary and are not suitable, although it is recognised that the staff are nonetheless providing an excellent level of service in circumstances that are less than optimal. There have been discussions with the fire service, and the NAS is of the view that the proposal it has advanced has potential. It believes it is possible to accommodate the ambulance service within the fire station, and it has made proposals in this regard which are under consideration at the moment. It is not realistic to think in terms of building a new centre at this point, but the NAS has put forward a proposal and it believes it is possible to reach agreement on a shared arrangement with the fire service.