Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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As a Government Deputy, I have delivered on my promise to secure the future of Roscommon County Hospital through the roll-out of a substantial investment programme totalling €20 million. We can see the hard evidence in the state-of-the-art endoscopy unit set to be built by the summer and operational by September. When completed, the 14,000 sq. ft. unit will become a diagnostic centre for the western region and facilitate a range of scope procedures, including colonoscopies, for patients. It is also hoped the service will be widened to offer bronchoscopy, cystoscopy and a range of other scope services.

Apart from a range of new development services introduced at the hospital, I am continuing to work hard to progress the other two major capital developments - a 20-bed medical rehabilitation unit and a palliative care centre on the grounds of Roscommon County Hospital. I am delighted that only in the last week almost €8 million has been ring-fenced for the construction of the rehabilitation unit which will operate as a satellite centre for the National Rehabilitation Hospital in Dún Laoghaire to relieve pressure on existing services and waiting times. It will also allow patients to be treated in their own community.

The introduction of the air ambulance service in the summer of 2012 has resulted in many lives being saved. In County Roscommon alone, one emergency a week has been dealt with since the service commenced operations almost two years ago. I am delighted by the great reaction of staff and management who understand these developments have safeguarded the future of Roscommon County Hospital. In the past four years I have attended hundreds of meetings about the hospital. Through sheer persistence, I have succeeded in securing a multi-million euro investment programme to develop and extend a range of services on an enhanced hospital campus. I assured staff in the hospital at all times that their jobs were safe and this multi-faceted investment confirms it. There is capacity in the hospital; the theatres are in place and excellent staff are available.

Like all smaller hospitals in the country, Roscommon County Hospital has a future in serving the community as part of a wider hospital network. It ensures patients who require specialist and complex care receive it in the most appropriate setting, while allowing the majority of patients to be diagnosed and treated locally. However, the fight goes on to improve the ambulance service for the county and clear challenges remain. A new ambulance base is planned for Loughglynn in west Roscommon. Despite continuous pressure on the HSE to advance work on this facility, I am disappointed that it is still not operational. The HSE has simply not delivered in ensuring the ambulance black spot in west Roscommon will be addressed; therefore, I am asking the Minister to expedite the matter. The OPW has agreed a five-year lease with the National Ambulance Service to use the former Garda station in Loughglynn as a regional ambulance base. A year and a half ago Roscommon County Council gave the go-ahead for its development. However, it seems that there has been very little progress on the project since. What is even more disappointing is that the timeline was for the base to be operational last summer.

Last year, in correspondence with the then Minister of Health, Deputy James Reilly, I highlighted the position on the ambulance service in County Roscommon. I made clear the importance of ensuring a sufficient level of ambulance cover across the county. The ambulance base in Loughglynn will be a vital facility for communities in west Roscommon and east Mayo.

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It will significantly help to improve the emergency response time in areas that heretofore were ambulance black spots. There is a need to progress the Loughglynn ambulance base and address issues around the entire ambulance service in the county. That must be an absolute priority for all stakeholders. The future of Roscommon hospital is undoubtedly safe and patients are safer but it is imperative that improvements in the ambulance service can be expedited as a matter of urgency.

Leo Varadkar (Dublin West, Fine Gael)
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I thank the Deputyfor raising this issue. I am very pleased to outline the current developments in pre-hospital services, both nationally and in Roscommon. The national ambulance service is working to ensure high-quality and timely emergency pre-hospital care, using all available resources as effectively and as efficiently as possible. As with any pre-hospital service, development and modernisation is a continuous process, as technology and clinical standards change. A significant and ongoing reform programme has been under way in recent years. In 2015 an additional €5.4 million has been provided to improve technology and clinical audit and to address service gaps, particularly in the west.

It is important to acknowledge that progress is being made. The single national control system, now almost fully operational, is improving our control and dispatch performance. We are continuing to develop the intermediate care service, ICS, which transports patients between facilities, thus allowing emergency vehicles to focus on emergency calls. The ICS now carries three quarters of the non-emergency workload. We are also moving to more efficient on-duty rostering and developing a national rostering system, with 50 additional paramedics being allocated in the west this year to achieve this.

Services in Roscommon have been enhanced significantly since 2011. Roscommon town currently has three emergency ambulances during the day and two at night, as well as a 24/7 rapid response vehicle crewed by an advanced paramedic. It is important to say that we are changing our model of service delivery. We are moving away from the model of care where services are provided locally from a fixed ambulance base in that area and we are moving towards dynamic deployment, where all resources are deployed as a fleet across a region. Within the wider region, the Roscommon area is supported from the north by Boyle and Carrick-on-Shannon, from the east by Longford and Mullingar and from the south by Athlone. New service capacity in Tuam and Mulranny stations will enhance the coverage across north Galway, west Roscommon and east Mayo.

The Deputy will be pleased to know that refurbishment of the ambulance station in Loughglynn, where ambulances can be based during shifts, is now complete and staffing issues are being progressed. The ambulance service expects the station will be operational in the coming months. For Roscommon and the surrounding region, we also have the emergency aeromedical service, EAS, based in Athlone. The EAS allows swift transfers of seriously ill or injured patients to the most appropriate hospital. Over 1,000 missions have been completed since it began in June 2012. Counties Roscommon and Mayo have among the highest numbers of EAS transfers.

These are all significant achievements but we intend further improve the service. In the next few months I expect to receive the independent capacity review to determine current and future service needs. Areas being examined include staff numbers and skill mix, as well as resources and deployment locations. I am confident these reforms and reviews will lead to further improvements in our pre-hospital emergency care services to the benefit of the people of Roscommon and the rest of Ireland.

Frank Feighan (Roscommon-South Leitrim, Fine Gael)
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I thank the Minister for his response. What has gone on in the area has been incredible. The emergency aeromedical service is doing sorties every day and at every Gaelic football pitch, local field or by the side of a road, the service has undoubtedly saved many lives. At one time if a person was in an accident or had a cardiac arrest, he or she would be brought by ambulance to an accident and emergency department to be stabilised before being brought to another accident and emergency department. We are now able to utilise services and modern communications in this way.

This issue has gone on for a long time, but I am not blaming the fact that sometimes more funding is required. Have elements been agreed under the Haddington Road agreement or is there some issue of staff refusing to go to Loughglynn? I have raised the matter on many occasions and I am very concerned about the safety of patients in the Castlerea, Ballaghaderreen, Loughglynn and Ballyhaunis areas. As I stated, when I became involved with politics, I was often told that the fight is never what the fight is about. Now is the time to get all the stakeholders together, including members of the ambulance service, personnel from the HSE and the unions in order to try to address this very difficult issue. For too long, there has not been a service in west Roscommon and for too long I have been the Deputy bringing this to people's attention. We have delivered the ambulance service but I want the ambulance base to be staffed by personnel in the area. Will the Minister ensure that he brings on board all the stakeholders in order that we can try, once and for all, to get through this logjam that is effectively stopping an ambulance service in west Roscommon? The people of west Roscommon want and deserve it, and they will be much safer when the ambulance base is open in Loughglynn.

Leo Varadkar (Dublin West, Fine Gael)
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I am not au faitwith the details of the staffing arrangements for that particular ambulance base and those matters are dealt with by the director of the national ambulance service and his team. Under the Haddington Road agreement, any public servant can be redeployed to a new site within 40 km of a previous base. Those rules apply to all public servants and it certainly would not be possible to make exceptions for any one group or county. That is not being proposed. The base has been renovated and the national ambulance service and I are very keen to get it open. We will do anything we can within the rules to do so.

I echo the Deputy's comments about the air ambulance service, which has been an enormous success. He is absolutely right as in the past, an ambulance would have come to a person's house, picked him or her up and treatment would have started in a local accident and emergency department. Often, a patient had to be transferred to another department, leading to a delay in treatment. Treatment now begins in the back of the ambulance, which would be staffed by paramedics or advanced paramedics. Where needed, a patient may be taken by helicopter to a specialist centre right away, thereby cutting out the kinds of delay that occurred in the past. This is much better for patient survival and mortality rates.