Catherine Murphy (Kildare North, Independent)
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Clearly, the Minister of State, Deputy O'Dowd, is not the Minister for Health. I accept that this week is an extraordinary one in that there is a Committee Stage debate so I ask the Minister of State to pass on my comments to the Minister and I would welcome a response if there is a further one. I tabled this Topical Debate matter on a number of occasions, possibly eight or ten, and it has now been selected. What prompted me to do so was the fact that on 19 May 2013, a 46-year-old man died in Naas. This individual may well not have survived but there was a very long delay in the ambulance arriving at the scene. He was with his 14-year-old daughter, which makes the situation even more tragic. Gardaí were on the scene quite quickly and were able to revive him but the delay in the ambulance getting there certainly did not give him the chance he needed. I am told by people working in the ambulance service that one must get to somebody within the first eight minutes or get them to a hospital within eight minutes for them to stand the best possible chance of surviving.

There have been some modifications to the ambulance services in Kildare. On this occasion, there were two ambulances available. The hospital is only a kilometre from where this happened. One ambulance was out on a call while the paramedic in the second one had to go home ill so that second ambulance was not available. The delay happened because there was no back-up ambulance.

People might not understand how large County Kildare is but it is the fourth most populated county in the country with a population of 210,000. I fully accept that developments like the call centre and other examples of centralising services can produce efficiencies but one must have an ambulance and a back-up ambulance within a realistic distance and properly staffed to make sure this scenario does not happen.

Is there a modelling system for the changes in ambulance cover which have taken place? I have no doubt an inquiry will take place into this tragedy and we will await the report.

I certainly do not want to give any indication I am criticising the ambulance workers. They can only drive and staff what is in front of them. If there is no ambulance they cannot magic it up. I wonder whether they are being put at risk when they try to arrive within the designated call-out time.

There is little point in us developing our hospital services when there is a question as to whether the ancillary services are capable of getting people to the hospital in time in an emergency. Some of the cover in Kildare has been withdrawn and it is quite difficult to figure out what ambulance cover is now available. Some of it comes from hospitals in Blanchardstown and the fire brigade service. We need to know what is the cover. We must examine the call-out times and receive assurance there is backup if someone is out sick. People are being put at risk.

Fergus O'Dowd (Louth, Fine Gael)
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I thank the Deputy for raising this matter and I ask her to accept the apologies of the Minister for Health and the Ministers of State at that Department. Like Deputy Murphy, I extend our deepest sympathies to the family of the deceased. The loss of a loved one is hard for family and friends at any time, but a sudden and unexpected death is particularly difficult.

The response of the HSE national ambulance service to the incident was incorrectly reported. In addition, claims have been made, based on this incorrect information, which can, unfortunately, only deepen the distress of this poor person's family. I will outline the facts. The ambulance service received a 999 emergency call at 7.47 a.m. on 19 May 2013, concerning an incident on the ring road between Naas and Newbridge, near a Garda station. Local gardaí, as the first personnel on scene, provided first response treatment. An emergency ambulance was available and was dispatched to the incident. The ambulance arrived at 8.03 a.m. which was within 16 minutes of receipt of the call. A second emergency ambulance, with an advanced paramedic, was also dispatched, arriving within 19 minutes of the call at 8.06 a.m.

The response time of the first emergency ambulance was within the national response time target of 18 minutes and 59 seconds for a patient-carrying vehicle, as set by the Health Information and Quality Authority. The newspaper involved subsequently printed an apology and retraction, admitting its claims on the ambulance response time, staffing levels at the time of the incident, staff management and plans for coverage in the area were incorrect. Similarly, inaccurate claims have been made in the media in a number of recent tragic incidents, contributing further to the distress of the families and staff involved. In one of these other cases, a national newspaper published a retraction and an apology to the ambulance service.

A significant reform programme is under way to reconfigure the way the HSE manages and delivers pre-hospital care services, to ensure a clinically driven, nationally co-ordinated system, supported by improved technology. This includes progressing a number of efficiencies arising from Labour Court recommendations on rostering arrangements. The ambulance service and trade unions have concluded discussions on roster changes at 30 ambulance stations throughout the country, including 11 stations in Dublin, Kildare and Wicklow. The new rostering arrangements have been implemented in a large number of stations, including Tallaght, Swords, Maynooth, Kildare and Wicklow, and these are operating successfully.

These changes mean resources can be deployed dynamically, based on need and demand patterns, rather than simply by station location. The greater flexibility and responsiveness will produce better response times, and help to ensure a clinically driven, nationally co-ordinated system to support all pre-hospital emergency care activity in the State, as set out under Future Health: A Strategic Framework for Health Reform in Ireland 2012-2015.

I assure the Deputy the Minister for Health, Deputy Reilly, will receive her comments and I fully acknowledge she is not criticising the service with regard to the facts as she saw them and as she raised them here.

Catherine Murphy (Kildare North, Independent)
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I accept the information delivered by the HSE on the time the call was made and the time the ambulance arrived. I do not dispute this information but having to wait 16 minutes when one is 1 km away from a hospital, which one can almost see, while a number of gardaí are at the scene trying to revive somebody knowing they do not have the equipment which would be in an ambulance does not give a person the best possible chance. I am using this tragic case to question whether this could happen again.

There seems to have been a failure with regard to the back-up. I wish to know about the back-up provided in general and not just in this particular case. It is all very well to speak about dynamic rostering but if extra ambulance cover for Naas needs to be provided from the far side of Dublin or Athy then the system is failing. How is this modelled? Must we wait and see whether tragic outcomes arise and then state it is a failure? This is the wrong way to go about it. I would like reassurance on how the process works with regard to the deployment of people to cover sick leave because this will happen.

The ambulance service in Maynooth has been taken off each Thursday and instead a paramedic on a motorbike is deployed. This is better than nothing but it is not the same level of cover and it may be inappropriate cover in some situations. The ambulance service is a critical part of the health service and if we do not get it right it does not matter how high-tech the hospital is because if one does not arrive at the hospital one does not have a chance. I ask the Minister of State to come back to me on the process for deploying people where the back-up service ceases to be available.

Fergus O'Dowd (Louth, Fine Gael)
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I again acknowledge what the Deputy has stated and assure her the questions she has asked will be brought to the attention of the Minister for Health. I do not have the expertise or the specific knowledge she requests but I have no doubt it will be made available to her as soon as possible. I will ask immediately whether it is possible and I appreciate the Deputy accepting this explanation.