Dáil debates
Tuesday, 13 November 2018
Saincheisteanna Tráthúla - Topical Issue Debate
Ambulance Service Provision
6:25 am
Tony McLoughlin (Sligo-Leitrim, Fine Gael)
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I have tabled this matter as the people of County Leitrim seek clarity from the Government as to why ambulance waiting times in the county are so high and why south Leitrim generally has been left without any ambulance cover whatever in recent months. They want to know why the new ambulance service which was based in Carrick-on-Shannon in County Leitrim has been moved to Boyle in County Roscommon. They want to know when the new measures which were promised by the HSE about new personnel, ambulances and first responder schemes will be put in place in Leitrim as advised in the 2015 capacity review of the national ambulance service.
As an elected representative for the County Leitrim area of the constituency, I also want to understand the problems and to help to identify what has gone wrong with ambulance waiting times in the county. I want to know what is being done by the HSE management to try to improve response times in the county and when the national ambulance service will be returned to its new base in Carrick-on-Shannon to cover the southern part of the county.
There is much concern on the ground about this as there have been several shocking cases where people have been left waiting for hours for an ambulance. In January this year in Ballinamore, a woman aged 85 years who had fallen and broken her leg had to endure a two and a half hour wait for an ambulance. In June, another elderly lady in Ballinamore had to wait for almost five hours. An ambulance was first called at 2.50 p.m. but did not arrive at her home in south Leitrim until almost 7 p.m. The woman was eventually brought to Cavan hospital which is only a 40 minute drive from her home, and had surgery a few hours later.
These are shocking examples of what is going on across the county under the current service. I have done some research on the issue and have been advised in a written parliamentary question, according to the assistant chief ambulance officer, Mr. Oliver Reilly, that County Leitrim only ever had two ambulance rosters on duty, one during the day and a night shift. One is based in Manorhamilton while another was set to be based in Carrick-on-Shannon but, as I noted earlier, is now based in Boyle in County Roscommon where it will remain for the foreseeable future. It is alarming that only one ambulance is ever on call in the whole county. In effect, one ambulance is often not available as under the current system, ambulances must often attend emergencies in other rural parts of the county.
Does the Minister believe this is sufficient ambulance cover for a widespread rural area in which few community first responder units have yet been established? If not, will he agree to make the HSE acutely aware of local communities' concerns on this issue and will the Department of Health make representations to the HSE as a matter of urgency?
Catherine Byrne (Dublin South Central, Fine Gael)
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I welcome the opportunity to address the House on behalf of Minister Harris regarding the ambulance service in Leitrim. The national ambulance service operates from two locations in Leitrim, namely Carrick-on-Shannon and Manorhamilton. However, services in Leitrim are not exclusively provided by staff based at these Leitrim stations. This is because the national ambulance service is increasingly moving to a policy of dynamic deployment. This ensures that vehicles are strategically located where they are most likely to be required, rather than located at a particular station. In line with this policy, and using the advanced medical priority dispatch system to triage calls, Leitrim is supported by other national ambulance service ambulance bases in Boyle, Sligo, Loughglynn, Cavan, Roscommon and Longford. Several developments have been made by the national ambulance service in order to address the issue of response times and ambulance cover in Leitrim.
I know too that in Border counties the national ambulance service works closely with the Northern Ireland Ambulance Service in order to provide a more responsive service for patients.
The capacity review, published in 2016, identifies particular difficulties serving rural areas such as Leitrim. The capacity review indicated that the only practical way to improve first response times in rural areas is through voluntary community first responder, CFR, schemes. The national ambulance service continues to work with local CFR groups across the region to enhance services.
The national ambulance service has undergone a very significant process of modernisation in recent years and there have been important service innovations and developments. This ambulance reform programme is taking place against the backdrop of the HIQA review of ambulance services, which was published in late 2014, and the national ambulance service capacity review.
The National Emergency Operations Centre has been established, where emergency calls are received and emergency resources are dispatched. The national ambulance service has visibility of all available paramedic resources and vehicles in real time, ensuring that the closest available resource is dispatched to an emergency. In addition, the national ambulance service has developed the intermediate care service to provide lower acuity hospital transfers, which frees up emergency ambulances for the more urgent calls.
A permanent emergency aeromedical support service has also been established to provide a more timely response to persons in rural communities.
During recent years additional investment has been directed towards the national ambulance service. This year, an additional sum of €10.7 million has been made available, which includes €2.75 million to fund new developments. New developments include the development of alternative pathways to care with the Hear and Treat clinical hub that went live in the national emergency operations centre in March of this year. This diverts some lower acuity patients to alternative care pathways and frees up some emergency capacity. It is anticipated that such initiatives will help to improve response times around the country, including in the Leitrim area. I will come back to the Deputy on other issues he raised.
6:35 am
Tony McLoughlin (Sligo-Leitrim, Fine Gael)
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I thank the Minister of State for her reply and I have a few queries on foot of it. A capacity review into the national ambulance service was conducted in 2015 and its findings were released in 2016. It found that in order for the service to meet strict HIQA standards, additional staff needed to be hired. Can the Minister of State identify the Government's efforts in that regard and indicate the progress that has been made to date in providing new staff and ambulances for the service? I note the capacity review outlined the case for working with community first responders in rural areas in County Leitrim. They are generally the local GPs who are under considerable pressure, working in large rural areas on their own and they have very busy surgeries without adequate back-up and support. What efforts are in hand to improve matters?
I ask the Minister of State to come to Leitrim to meet the local doctors to hear at first hand their genuine fears for their patients, namely, the prospect that they face the worst outcome as a result of longer than acceptable response times.
As per the commitment given by the national ambulance service, will she agree to facilitate a meeting with the management of the north west ambulance service to enable its members to outline their efforts to increase resources in the area, place more than just one ambulance in the new base in Carrick-on-Shannon to serve the people of south Leitrim and west Cavan and reduce waiting times to under one hour?
I have been advised this evening that the Boyle ambulance crew has filed a health and safety complaint regarding the deployment of the second ambulance from Carrick-on-Shannon to their base, thus prompting serious concern that only one crew from Carrick-on-Shannon will be moved and that the crew currently based there will be moved to Sligo, leaving no ambulance service for Leitrim in the county. That would be regrettable and it is a matter of great concern to me as Deputy representing the county. While the Minister of State is responding to the requests I have made, it is vital that these facts be brought to the attention of the Minister.
Catherine Byrne (Dublin South Central, Fine Gael)
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The Deputy has raised a number of specific questions to which I do not have a response. I will, therefore, have to go back to the Minister and ask him to respond to the Deputy on a personal basis. I understand the Deputy's frustration and the concerns he raised. He has outlined the difficulties that arise when people who have suffered an injury are not transported by ambulance immediately and often have to wait for up to two and half hours or even longer for an ambulance. I will raise those with the Minister and, if the Deputy wishes, I will also ask the Minister if he will consider meeting him and visiting the area to enable him to fully recognise and understand the problems that have occurred in the past as the Deputy outlined. I have taken a note of all of his questions and I will ask the Minister to respond to him on a personal basis.
Tony McLoughlin (Sligo-Leitrim, Fine Gael)
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I thank the Minister of State for that.