Séamus Kirk (Louth, Fianna Fail)
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I thank the Ceann Comhairle for the selection of the matter and for the opportunity to raise it.

In recent times, I have received complaints about the ambulance service in counties Louth and Meath being somewhat erratic. Whether or not that is because of some organisational difficulty, I do not know.

Pre-hospital emergency care is vital. If there is to be a dependable health service, the pre-hospital emergency care is vital to the provision of that service. The ambulance response time is critical. Where somebody is unwell and needs to get to hospital quickly, the ambulance must be available with the qualified personnel on board.

If the service is understaffed, response times will suffer accordingly and one will finish up with a diminished service as a result. The key performance indicators recommended by HIQA include appropriately trained personnel attending patients with life-threatening cardiac or respiratory arrest incidents within eight minutes in 75% of all cases.

A number of parliamentary questions have been submitted here in this House and they indicate that those targets are not being met on a regular basis. It begs questions about the position in the Louth-Meath ambulance service area. Is there an issue with staff shortages and is there a truncated ambulance service as a result? Is there sufficient paramedical staff available?

Is there sufficient staff available where staff, for one reason or another, are not in a position to come to work? If that is the issue, what is the plan of the HSE and, from now, the Department of Health? This is a vital service. The emergency hospital need can arise unexpectedly for anybody right across the country.

It is fine to reform the health service, building the structures of the hospitals and the reconfiguration of the services within the hospitals, but the vital linkage is the ambulance service and the response time in that regard is equally important. I look forward to hearing what the Minister of State has to say on the matter.

Brian Hayes (Dublin South West, Fine Gael)
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On behalf of the Minister for Health who, unfortunately, is unable to take this important issue, I thank Deputy Kirk for allowing me to address it. I very much agree with Deputy Kirk, who has correctly highlighted the importance of having an ambulance service in place, not only in the north east but throughout the country, which is reliable and fit for purpose in terms of the requirements of a modern Irish health service.

The national ambulance service, NAS, operates nine ambulance stations across the north-east region. These provide emergency response services which include telephone assistance, assessment, treatment and stabilisation at the scene of an incident, and ongoing treatment during transport to the nearest appropriate medical facility.

Emergency service staffing includes trained control and dispatch staff and highly qualified paramedics and advanced paramedics. An emergency ambulance crew consists of two clinical staff, who will be paramedics, advanced paramedics or a combination of these, depending on the nature of the call out, availability and rostering. In addition to the regional resources of the NAS, a memorandum of understanding is in place with the Northern Ireland Ambulance Service. This provides for operational day-to-day co-operation and resource sharing in responding to 999 emergency calls on both sides of the Border.

The emergency ambulance service provided by the NAS is not a static one. The NAS deploys its resources in a dynamic manner, which means ambulance services are provided on an area and regional basis, as opposed to a local basis. Ambulances and paramedic staff are no longer restricted to particular locations, stations or areas, as was the case under the old health board service arrangement. Resources are also deployed across the area according to predictive analysis, so they are not necessarily in a station but where activity patterns indicate they are most likely to be required during a shift. Accordingly, the emergency resources for a particular location include all available vehicles and personnel within the wider area.

The dynamic deployment of emergency resources ensures the nearest appropriate resource is mobilised to the location of any incident. In the north-east area, this is achieved by the dynamic dispatch of resources from surrounding stations in the first instance. In Drogheda, for example, the emergency resource immediately available for deployment in response to a 999 call includes all the surrounding stations.

In responding to 999 calls, ambulance dispatchers prioritise resources according to clinical status. All life-threatening conditions - cardiac, respiratory and other - receive first priority and the closest appropriate resource will be dispatched to these incidents. The Deputy will appreciate what this means, namely, on occasion, an ambulance responding to a lower priority call will be diverted en route to respond to a clinically more urgent incident. However, all efforts are made to then secure resources in the wider area to respond to the lower priority call.

The Deputy will note that approximately 60% of all 999 calls made to the NAS are neither life threatening nor potentially life threatening. Approximately 10% of all 999 calls to the NAS are inappropriate for an emergency ambulance. These statistics are consistent with international experience and evidence.

Séamus Kirk (Louth, Fianna Fail)
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While I do not say this very often, I am particularly disappointed with the response. The script the Minister of State has read could be used in response to any query about an ambulance service anywhere across the country. The query I submitted was specific and referred to serious concerns about the rostering and manpower in the ambulance service in the north east. I wish that those who prepared the response would address the particular points that are being raised because they are raised for very good and genuine reasons. Concern does prevail about the matter. I am not blaming the Minister of State and I admire his versatility in taking responsibility for a number of responses today. However, the situation is very unsatisfactory. I ask the Minister of State to go back to the Department of Health and ask it to re-examine the matter. I would appreciate it if the Department would come back to me with a more detailed and specific response to the query I raised.

Brian Hayes (Dublin South West, Fine Gael)
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The Deputy has a very high standing in this House and has considerable experience on both sides of the House. He has rightly highlighted the issue of the lack of detail in the reply, and I agree with him on that. I have at my disposal a more detailed briefing note which I intend to hand to him at the end of this debate and which sets out the issues in Drogheda and the region. If there are specific issues around that, he might dialogue with the Minister for Health on them, which I hope will answer his questions more fully.