Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I have raised the need for a proper ambulance base for Carlow several times before. I understand Covid has been difficult for everyone. I have asked the Minister for Health, Deputy Stephen Donnelly, to come down to Carlow and I am also asking the Minister of State, Deputy Feighan, to come to Carlow to meet the staff and see the conditions that they are in. I was fortunate last summer because the Minister of State, Deputy Chambers, was in Carlow and visited the base. I also had a virtual meeting with An Taoiseach recently to highlight just how serious the situation is.

I will give a little bit of the background. My understanding is the HSE is committed to a parcel of land called Kelvin Grove for the National Ambulance Service, NAS, to get a design 2 ambulance base. However, the money is not committed and I seek an update on that. I am committed to resolving what is a very serious issue in Carlow. I have worn a path to the Taoiseach's door and, of course, to the Minister's door, as I will do with the Minister of State as well. It is important that we keep communicating and get an update on this serious issue.

It is important to recognise these paramedics who are doing a great job in Carlow. The base is in a prefabricated structure which is part of a building that was a delivery unit in St. Dympna's Hospital. There are no training facilities there and their store is adjacent to a methadone clinic. The staff are professionals and deserve to be treated as such. I believe that if it were a private facility, it would be shut down today. I understand that there are some legacy issues and this has been going on for a few years. However, we saw that there was an extra €10 million in the budget. Yet, there seems to be a slowness in capital projects. The site should be moved on more quickly because it is HSE land.

When I originally brought this up a few years ago, the talk from the different Departments was that there was going to be an extension onto a building where the prefabricated structure that serves as the paramedic base is located at St. Dympna's. We have a beautiful building there and it is all stone. It is called St. Dympna's Hospital and we always call it that. While there was to be a build-on there, in the past few years we got word that the plan had changed and the paramedics were going to get a new base on the Kelvin Grove site. It right across the road, by the way, so it is very well situated.

I would like a full commitment to know that there will be a new base on the Kelvin Grove site. There have been huge issues of confusion around if it will be a build on the site they are on at present or if it will be at Kelvin Grove. It is important that we get that decided.

I raise another issue. As the base is well situated in the centre of town, there often will be ambulances outside when people pass by. However, if someone rings for an ambulance, they cannot get one because the ambulance paramedics have perhaps been moved to a different part of the country because, as the Minister of State knows, the system as changed. I will bring that up in my next slot.

There are huge issues. The lack of communication with the Department and even to myself, the ambulance paramedics and the people of Carlow is an issue. We need to have a base that is fit for purpose. Our ambulance paramedics deserve a proper ambulance base. It is only right that we now get that funding and a new base.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Deputy Murnane O’Connor for raising the issue of replacing the current ambulance base, which is located at the Carlow health services complex at St. Dympna’s Hospital, Carlow town.

The National Ambulance Service is the statutory pre-hospital emergency and intermediate care provider for the State and it seeks to serve the needs of patients and the public as part of an integrated health system, through the provision of high quality, safe and patient-centred services. Carlow ambulance base is an integral part of the ambulance service and has two emergency ambulances on duty at any one time. The base is supported by NAS resources from surrounding ambulance stations, including Baltinglass, Athy, Kilkenny, Portlaoise and Enniscorthy. Dynamic deployment of available resources operates on an area and national basis, rather than a county or geographical boundary basis, to ensure optimum resource use as the nearest appropriate resource is mobilised to the location of the incident. The priority of dynamic deployment is patient health and welfare in the context of service delivery, which means that resources cannot be confined by county boundaries, barriers or borders.

The National Ambulance Service operates a comprehensive safety management system across all of its premises across the South and continues to work collaboratively with staff and HSE estates and external providers to ensure that any concerns or issues that occur are dealt with as quickly as possible. Given the work entailed and the timeline to move from identification and assessment of a suitable alternative site to the completion of works and building handover, remedial and refurbishment works at the existing station have been carried out to address shortcomings in relation to health and safety requirements. Remedial works to the value of approximately €50,000 were carried out at Carlow ambulance base in 2020. These works addressed requirements to ensure the ambulance base was a safe place of work and included a list of maintenance-type work to doors, walls, floor covering and minor leaks, with full certification of electrical and fire safety systems.

In 2021 the National Ambulance Service completed a detailed prioritisation assessment for all ambulance stations across the country. The NAS is working with the HSE in planning a future replacement for the current facility.

The HSE has identified Kelvin Grove as a possible suitable site and is currently procuring a design team for another project on the Kelvin Grove site. The design team will prepare a development control plan for the site to include two other facilities including the proposed ambulance base. When this site appraisal is completed, the HSE will be in a position to develop a capital submission for a new ambulance base. Capital funding for the project will be determined in accordance with the overall prioritisation planning for all ambulance stations that require replacement, major refurbishment or expansion. I thank Deputy Murnane O'Connor for raising this issue. She has been to the forefront in raising the ambulance service in her region. I look forward to trying to get her a satisfactory reply.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I am disappointed with the Minister of State's reply. In regard to ambulance services, the people of Carlow have had delays in their ambulance services because as the Minister of State is aware, all ambulance calls are now managed through the central ambulance and emergency operations centre, which is supposed to ensure that the most urgent calls get the highest priority response, regardless of the location of the ambulance vehicles or bases. That is a problem as Carlow does not have an emergency response support because our local hospital is in Kilkenny. We do not have a fit-for-purpose building. There are issues within the ambulance services. We need more ambulances, or we need the two that are based there not to actually leave the county. There is absolutely no commitment in the Minister of State's reply other than saying that the HSE is looking at a site in Kelvin Grove and that it is possible that it could happen. This is unacceptable. This is going on for years. We have ambulance paramedics in Carlow in a prefab, in 2022. I am raging. This needs to be sorted as urgently as possible. My understanding is that a list is being done on ambulance bases, seemingly numbered one to ten, on which Carlow is number two on the list. That is not good enough. I ask the Minister of State to go to the Minister, Deputy Stephen Donnelly, as I will. I will be going to the Taoiseach. I want a firm commitment from the National Ambulance Service, the HSE and the Minister that we are going to get the build in Kelvin Grove. There is another building going on Kelvin Grove, that is right. My understanding is that it is at design stage at the moment but we need to get this building. It is unacceptable that in 2022 we have the best of ambulance paramedics in Carlow and they are in a prefab. It is unacceptable. I am disappointed in the Minister of State's reply.

Frank Feighan (Sligo-Leitrim, Fine Gael)
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I thank Deputy Murnane O’Connor again for raising the issue of the provision of the ambulance base located in Carlow town. A significant programme of work is under way to transform the National Ambulance Service from an emergency medical service into a mobile medical service. As I said, this is a model which aims to treat patients at the lowest appropriate level of acuity, resulting in a better experience for the patient and more efficient use of resources. Carlow ambulance base is an integral part of the National Ambulance Service. Carlow has a maximum of two emergency ambulances on duty at any one time in a 24-7 period. These are supported by National Ambulance Service resources from surrounding ambulance stations including Baltinglass, Athy, Kilkenny, Portlaoise and Enniscorthy. The Deputy is correct that the National Ambulance Service is completing a detailed prioritisation assessment for all ambulance stations. The National Ambulance Service is currently working with HSE estates in planning a future replacement for the current facility in Carlow. Engagement is continuing between the National Ambulance Service and HSE estates in progressing the assessment of options and then preparation of a capital submission for a replacement base. Capital funding for the project will follow in accordance with overall prioritisation planning. I will bring the Deputy's concerns to the Minister. I thank her for raising this very important issue as a Topical Issue matter today.