Dáil debates

Thursday, 15 February 2018

Topical Issue Debate

Ambulance Service Provision

4:25 pm

Photo of Eugene MurphyEugene Murphy (Roscommon-Galway, Fianna Fail)
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I appreciate the fact the Minister has attended to take this matter, given his particularly busy schedule today. He is also getting ready for tomorrow.

Approximately three weeks ago, a 13 year old girl waited for an ambulance for 50 minutes after she took seriously ill at her home in west Roscommon. She suffered a serious neurological attack. Only for the help of a neighbour, a former nurse, her family is convinced that she would have died. As the emergency occurred, her father rang 999 and was told that the ambulance would not arrive for in or around 50 minutes. It was coming from Sligo, which was the nearest an ambulance could be found. At this stage, the man's daughter was seriously ill. She was struggling to breathe and he asked for an emergency response. Without a doubt, an air ambulance should have been called in at that point, but none arrived. What a traumatic and stressful situation for any family.

When the ambulance arrived, the staff were excellent. In a short space of time, they stabilised the girl and her breathing and made her comfortable.

When the accident and emergency unit in Roscommon closed, we were guaranteed an increased ambulance service for the county. That has not happened. The people of west Roscommon have been left without a service. While I acknowledge that, from time to time, the air ambulance does a good job and gets to places quickly, this was a serious situation and one about which I am sure the Minister would be concerned.

In January 2016, an ambulance base was opened in Loughglynn, close to where the family lives in west Roscommon. However, no permanent ambulance staff are located there. An ambulance comes from Roscommon University Hospital and parks at the building when one is available.

Will the Minister consider putting in place a permanent ambulance team in Loughglynn to serve the vast countryside of west Roscommon? It is desperately needed, which is a message that the Minister has also been given by others. I hope that he will be able to bring solace to the people of that area so that they do not live in fear of being unable to get an ambulance quickly when it is urgently needed.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I thank the Deputy for raising this important and sensitive matter. I also thank him for telling me of the difficulty that a particular constituent of his experienced. It is important that such issues be brought to the floor of the House, as we are referring to real people when we talk about statistics, numbers, resources and decisions. I will ask the HSE and the National Ambulance Service, NAS, about the matter that the Deputy has brought to my attention.

Within Roscommon, the NAS operates from a number of bases. As the House will be aware, though, the NAS dynamically deploys resources to respond to incidents as they arise. This is achieved in the Roscommon area by dispatching resources from adjacent ambulance stations in neighbouring counties. Resources from ambulance stations including Carrick-on-Shannon, Tuam, Longford and Athlone can, and are, deployed to incidents in Roscommon as required in addition to the resources of ambulance bases in Roscommon.

As the Deputy outlined, in order to develop services in Roscommon further, the NAS acquired the former Garda station at Loughglynn, refurbished it and opened it as a dispatch point in 2016. However, I take the Deputy's point. The ambulance service in west Roscommon has been reviewed a number of times in terms of available resources and demand for services. Since 2011, extra staff have been assigned to Roscommon to provide an additional 24-7 emergency ambulance and a 24-7 rapid response vehicle. In addition, an intermediate care vehicle has been deployed to Roscommon to undertake inter-hospital and inter-facility transfers.

As the Deputy alluded, Roscommon is well served by the Emergency Aeromedical Service, EAS, which operates from Custume barracks, Athlone. I am eager to see whether we can do more in the aeromedical space, since that would enable the EAS in Athlone to do even more in the Deputy's part of the country. That service was established to provide a more timely response to persons in rural areas and is available seven days per week in daylight hours. The service is specifically targeted at the west of Ireland, with the highest demand for services coming from counties Galway, Mayo and Roscommon.

The capacity review, which was the first review of the ambulance service that I published when I became Minister, examined overall ambulance resource levels and distribution against demand and activity. Future investment in ambulance services will be guided by that capacity review.

In recent years, year-on-year additional investment has been directed towards the NAS, but I accept that we have more to do. This year, an additional sum of €10.7 million has been made available, which includes €2.8 million to fund new developments in the ambulance service, for example, the development of alternative pathways to care, with the "hear and treat" clinical hub expected to go live soon in the national emergency operations centre. This will divert some lower acuity patients to alternative care pathways and will free up some emergency capacity. In time, it is hoped that such initiatives will help to improve response times around the country, including in the west Roscommon area.

I should also mention that the capacity review identified particular difficulties serving rural areas such as County Roscommon. Outside the greater Dublin area, the population is widely dispersed with a relatively large population living in rural areas. Due to this population distribution, Ireland has a far higher percentage of activity in rural areas than other ambulance services. This is something with which we must grapple. When we compare ourselves with other jurisdictions, our population is dispersed in a different way. That is a good and welcome thing, but it means that there are extra challenges in ensuring that we get ambulances to every part of this country as quickly as we would like. We need to approach these challenges head on.

As well as additional investment in the ambulance service, the review indicated that one of the practical ways of improving first response times was through our community first responder, CFR, schemes. I am pleased that the NAS is working closely with local CFR groups across the country in order to develop and enhance services.

I assure the House that the NAS is focused on improving the ambulance service in west Roscommon and throughout the country. I will bring directly to the NAS the concerns and points highlighted by Deputy Eugene Murphy on the floor of Dáil Éireann. I will ask that the NAS revert directly to the Deputy on those specific issues.

Photo of Eugene MurphyEugene Murphy (Roscommon-Galway, Fianna Fail)
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It was nice to hear the Minister say that he was worried about people rather than numbers. That is important. I acknowledge his statement that an ambulance can sometimes be in an area and get to a location quickly, but this happened after a family came home from church on a Sunday. That should have been a quiet day, but no ambulance was available in Roscommon to get there. Getting an ambulance from Sligo took 50 minutes. There was a shortage of ambulances in the area.

The Minister has acknowledged that there is a difficulty - we have a sprawling countryside. As he is well aware as a Member of the Dáil, however, our responsibility has to be to our people.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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Absolutely.

Photo of Eugene MurphyEugene Murphy (Roscommon-Galway, Fianna Fail)
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We must do our best for our people and serve them. That is why I am pressing this case so hard. I am grateful for the Minister's answer. Hopefully, there will be some progress towards putting the service in place. It would be welcome. If the Minister puts the service in place, I will be the first to stand up publicly and give him credit for doing it.

Photo of Simon HarrisSimon Harris (Wicklow, Fine Gael)
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I agree with the Deputy that we have a responsibility to all of the people of this country regardless of where they live. In fact, in many ways we have a particular responsibility to people who live in rural and regional communities in terms of putting services in place. That is why we have increased the budget for the NAS year on year. We increased it by more than €10 million this year, including an amount of €2.8 million that will enable us to invest in more ambulances and paramedics. The Deputy will agree on the importance of the NAS following an evidence base and targeting resources in the areas most in need. I hear clearly the case that he and all Oireachtas Members from Roscommon make about the need for more resources for its ambulance service. I will pass those comments directly on to the NAS and ask it to contact the Deputy directly on this matter.