Gerry Adams (Louth, Sinn Fein)
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Gabhaim buíochas le oifig an Cheann Comhairle as ucht seans a thabhairt dom caint faoi bhás Wayne McQuillan. I want to extend my condolences and sympathies to the family of Wayne McQuillan, who was stabbed in Drogheda in the early hours of New Year's Day. I am conscious that the raising of this issue could cause further trauma and grief for them. That is certainly not my intention. According to the National Ambulance Service, the nearest available ambulance to respond to this incident was in Ardee. The service has suggested that it took 21 minutes for the ambulance to arrive at the scene. This falls outside the target set in the 2014 national service plan. By the time the ambulance arrived, the Garda had decided to move Mr. McQuillan to Our Lady of Lourdes Hospital, where he died, regrettably. The actual time between the receipt of the first call and arrival on the scene of the ambulance after its despatch was 25 minutes. I understand that an ambulance was available at Our Lady of Lourdes Hospital on the morning of New Year's Day, but it was not despatched. Is this true?

There was another serious incident on Monday of this week when a woman collapsed on West Street in Drogheda. Earlier that day, the Drogheda ambulance had been despatched to Navan even though a local crew was available in Navan. That was in addition to a second crew in Dunshaughlin and an emergency response vehicle in Navan. Why was the Drogheda crew despatched there? As a consequence of that decision, the ambulance had to travel back to Drogheda to deal with this incident. This took more than 30 minutes. These difficulties are not the fault of the ambulance staff or the emergency services. First responders are deeply frustrated about being expected to work in these conditions. I welcome the HIQA investigation into the circumstances surrounding the death of Wayne McQuillan. An investigation of the resourcing, structure and management systems in this area is also needed. We must ensure this investigation is carried out in consultation with front-line staff, including those who provide ambulance services.

Charlie McConalogue (Donegal North East, Fianna Fail)
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Maura Porter from Carndonagh was unfortunately the victim of a road traffic accident on the day before New Year's Eve. An ambulance was called to come to her support after she suffered severe injuries in the accident, which took place on Monday, 30 December. It took almost an hour for an ambulance to come to Carndonagh, unfortunately, because it had to be despatched from Letterkenny. No ambulance based in the local ambulance station in Carndonagh and no local crew members were available at that point in time. Maura Porter's family - her husband, Neil; her son, Brendan; and her daughter, Davina - had to kneel with her while they endured a wait of almost an hour for ambulances to arrive. Local doctors came to the scene, but Maura needed to get to hospital quickly. She died after she got to the hospital, unfortunately. Her family will never know whether it would have made a difference - whether her life could have been saved - if the ambulance service had arrived on time. They are calling for a full investigation of what exactly happened in this incident and for a full review of ambulance services in County Donegal. Such a review is needed in other parts of the country as well.

A full review of the service is needed to ensure ambulances are available when they are needed. It is the wish of the Porter family that no other family will ever have to go through what they experienced on the Monday night in question. I ask for the Minister of State to respond to this request by giving the House an assurance that an investigation will take place and that proper resources will be provided to ensure ambulances are available to respond when calls come in. The staff who do such Trojan work, and were so good when they arrived on the scene on the night of Maura's accident, should be given the support they need to respond to calls in the way that is expected and asked of them.

Kathleen Lynch (Cork North Central, Labour)
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I am glad that Deputy McConalogue finished on the note he did because any of us who have been in receipt of the services that ambulance crews provide know that they are an exceptional group of people, both men and women.

I thank Deputies Adams and McConalogue for raising these issues today. At the outset I express my sympathies to the families involved.

Regarding the response of the national ambulance service to the incident raised by Deputy Adams, the national ambulance service has reviewed the incident and has confirmed that at the time of the call, there was high call activity in the area. However, the national ambulance service is satisfied that the call was appropriately prioritised, using the advanced medical priority dispatch system, and that the closest available ambulance was tasked.

Regarding the incident raised by Deputy McConalogue, the national ambulance service is satisfied that the call was triaged correctly and that the nearest available resource was dispatched. However, the national ambulance service has now established an escalation process with Letterkenny General Hospital to ensure that ambulance control at Ballyshannon is informed early of any capacity or other challenges which might affect ambulance service delivery. This process will ensure that where necessary, national ambulance service resources are diverted to other appropriate destinations to minimise impact on patients, the national ambulance service and the hospital.

In the interest of respecting the dignity and grief of the families concerned, of which both Deputies are conscious, I will make no further comment on these two incidents.

I draw the attention of the House to the very significant reform programme which is under way to reconfigure pre-hospital care services in Ireland. This reform programme will ensure a clinically driven, nationally co-ordinated system, supported by improved technology. Development funding of €3.6 million and 43 additional staff have been provided in the national service plan 2014.

A key measure in this programme is the national control centre reconfiguration project. The national ambulance service has operated in eight ambulance regions, with no interconnection of radio and computer systems. While this seems incredible, it is a fact. This has delayed improvements in emergency response times, particularly at regional boundaries where the nearest ambulance may be in the neighbouring region.

The control centre project is moving to one national centre on two sites, with significant investment in new voice, data and mapping technologies. This will allow the national ambulance service to deploy emergency resources more effectively and efficiently, regionally and nationally, rather than within small geographic areas. The national centre will be located in Tallaght and Ballyshannon, with the project expected to be completed next year.

In co-operation with staff, the national ambulance service is successfully moving from on-call rostering, where staff are off-site waiting to be summoned, to on-duty rostering, where paramedic crews are in their stations or vehicles during shifts. This leads to faster deployment as the crew is in position to respond immediately to calls, rather than the average on-call deployment of over 20 minutes. The on-duty system is now in place across most of the State.

A key performance issue has been the use of emergency ambulances for routine inter-hospital patient transfers. The national ambulance service is developing dedicated non-emergency patient transport, through the intermediate care service, for routine transfers. This frees up emergency resources for emergency tasks, improving response times and performance.

The national ambulance service will continue to modernise and reconfigure its services to ensure emergency pre-hospital care is delivered in an appropriate and timely manner.

Gerry Adams (Louth, Sinn Fein)
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I thank the Minister of State for her answer. She must be concerned that the amount of time it took the ambulance to get to where Wayne McQuillan had been stabbed falls outside the national service plan 2014 target. I entirely agree with the Minister of State about the sterling work done by paramedics, ambulance crews and front-line services. Like the Minister of State, I have had use of those services. However, since Wayne McQuillan died it has been revealed that the State has one paramedic for almost 4,000 citizens, whereas in the North and in Scotland there is one paramedic for every 1,500. There is something wrong there. Any investigation should also look at the resourcing structure and management systems of the ambulance service, particularly in the north east.

Charlie McConalogue (Donegal North East, Fianna Fail)
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I thank the Minister of State for her response. She stated that Mrs. Maura Porter's case was triaged correctly and the nearest available resource was dispatched. It is clear that in this instance the nearest available resource was much too far away. Carndonagh ambulance station, which serves the Inishowen Peninsula, was less than half a mile from where Mrs. Porter's accident took place. We need to ensure that two ambulances are available so that if one is called away and a second call comes in, it is responded to immediately. We cannot allow such an incident to happen again. The national guidelines indicate that an ambulance has to be at a scene within 19 minutes, which is the target. In this particular incident it took almost an hour. I ask the Minister of State to give an assurance to the family that there will be a full investigation of what the situation was in this instance, that the service levels available are reviewed to ensure this cannot happen again, and that the proper resources are put in place.

The particular ambulance station I referred to is the third busiest in the north west after Sligo and Letterkenny. One ambulance based there is not enough. If the family have one wish it is that this be the last time that such an incident would happen. I ask the Minister of State to ensure there is a full investigation and a full review to ensure the resources are put in place. The public need to have confidence that this cannot happen again. The service level needs to be in place in order that this family can at least have the comfort of knowing that this will not happen to any other family.

Kathleen Lynch (Cork North Central, Labour)
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I compliment both Deputies on the respectful way this issue has been dealt with. While the assurances any Government might give might be some small comfort, it is not a great comfort for people who lose a loved one. I cannot guarantee Deputy McConalogue that there will be a full investigation. However, whenever there is a critical incident it is fully investigated. In this unfortunate episode, two people lost their lives.

The national ambulance service is undergoing major reform. Isolated areas will be greatly helped by the process of hospitals contacting the national ambulance service base, one of which will be in Ballyshannon which is not too far away from the area we are discussing. If there is, for instance, a high alert or a high call-out rate, the national ambulance service will know that that is in effect. It will be able to make provision to ensure there is a backup service available. That will have a significant impact.

Both incidents, as critical incidents, will be fully investigated. As Deputy McConalogue pointed out at the end, the only thing that families can seriously request is that in the event of some other family going through this, the response will be appropriate.