Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Minister of State. The issues I wish to raise are intertwined. I have raised previously the need for a proper ambulance in Carlow with the Minister. While I appreciate having the opportunity to speak to the Minister of State again, the last time I was here I was told Carlow was second on a priority list for a new ambulance base. My understanding is that is true, but that refers to the south east. I have since found out that there is a national list and I am finding it very difficult to find out where Carlow is on that. The HSE estates unit is committed to land at Kelvin Grove for a new build, which is important. I want to find out about the capital plan and funding for drawings or design. Is there an update on that?.

As the Minister of State is aware, a few months ago I was fortunate to bring the Minister of State, Deputy Jack Chambers, who was visiting Carlow, to the ambulance base to see the need for a new building. I have also had a virtual meeting with the Taoiseach and meetings with national ambulance management with responsibility for the area. Nobody is in any doubt that we need a new ambulance base. However, in the meantime we need a major refurbishment of what is there. I have also extended my support to HSE to find a place to rent. Do we need to consider finding a place to rent at the moment? The premises the ambulance paramedics are currently in are not suitable. I am totally committed to resolving this problem because it is a very serious issue for Carlow.

I will provide a small explanation of why this is so important to me. The ambulance base is in a prefab which is part of a delivery unit that used to belong to St. Dympna's Hospital. There are no training facilities or canopy over the vehicles. The store is beside an adjacent methadone clinic which has created an additional risk for the staff. The staff are professionals and deserve to be treated as such. Would a service in the private sector be kept open under such circumstances? I do not know. There is an extra €10 million in the budget this year. What is the situation regarding capital projects? Kelvin Grove is a HSE site and, therefore, I believe the project should move forward more quickly. I ask for an update on that.

I also want to ask the Minister of State about discussions regarding understaffing in the south and the current recruitment process. What is the update on that? The Minister of State is aware, given her remit regarding the elderly, that recruitment seems to be an issue. Covid showed up the great work our health care staff and ambulance paramedics do in calling to people's houses. They work 24-7. It is important that enough staff members are in place. I want to know the updated position on that because it is important that every area is staffed.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy for the question. She has raised this issue many times. I welcome the opportunity to address the House, on behalf of the Minister for Health, Deputy Stephen Donnelly, regarding ambulance resources and services in the south-east. Since 2016, the National Ambulance Service, NAS, including in the south-east region, has undergone significant reform and modernisation involving the prioritisation of investment in new service developments, including increased manpower and fleet and improved technology. Since the end of 2016, NAS staffing resources nationally have increased from 1,744 in December 2016 to 2,049 at the end of January this year, an increase of 305 whole-time equivalents, WTEs, representing over 17% growth in staff over that timeframe. I do not have a specific breakdown for the south-east area.

It is the case that ambulance services across the country are experiencing a very high demand for 999 services for patients and last year saw a record of over 366,000 emergency ambulance calls. Delays in patient transfers at hospitals, caused by extremely busy and pressurised emergency departments, are currently presenting a particular challenge for the NAS in meeting emergency response time targets. In response to these challenges, this year an unprecedented €200 million has been allocated, including €8 million for new service developments. This funding will be invested in capacity building, as well as increasing staffing within the hear and treat service in the National Emergency Operations Centre, NEOC, which advises lower acuity patients of appropriate alternatives to hospital transfer. Overall, the funding for new service developments will allow for the recruitment of 128 additional WTEs.

In addition, Government investment in the NAS has meant that 80 paramedics graduated at the end of 2021 from the NAS college BSc paramedic studies programme. A further 200 student paramedics are currently enrolled in the college on various stages of the programme. The Minister, Deputy Stephen Donnelly, is pleased to note that the NAS 2022 recruitment programme for paramedics, student paramedics and intermediate care operatives was launched at the end of last month.

Turning to infrastructure in the south-east and the particular questions the Deputy raised regarding her constituency, the NAS last year completed a detailed prioritisation assessment for all ambulance stations in the southern region. As a result of this assessment, a new ambulance base in Carlow has been confirmed as being the second highest priority for the NAS in the south east. That will answer one of the Deputy's questions. It is not for the whole of Ireland, but rather the south east. The NAS is working with HSE estates in planning a future replacement for the current facility. A greenfield site has been identified and is under consideration. Capital funding for the project will follow in accordance with overall prioritisation planning and I can confirm that the Carlow ambulance base is progressing through the various stages outlined in the public spending code.

Finally, I can advise that a new five-year NAS strategic plan is currently being finalised by the HSE. This plan, elements of which have been funded in budget 2022, will facilitate a strategic organisational redesign and continue to focus on key priorities. Regarding the Deputy's other question, the 2022 capital plan is under final review and has not yet been published. Therefore, it is not appropriate at this time to outline or comment on any of its specific details.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I thank the Minister of State for her comprehensive answer. I welcome the increase in the number of ambulance paramedics. I can speak on behalf of the crew in Carlow in terms of the excellent work that is being done across the country. All have done marvellous work. It is important that Carlow is not forgotten and that there are enough staff in the south-east region, including paramedics. The Minister of State might try to come back to me with an answer on that. It is of concern. Carlow needs a new ambulance base. We have a duty of care to our ambulance paramedics who do an excellent job.

The funding that goes into this type of work through the HSE, the capital plan and the Government is vital because the services are vital for people. I know how hard all those in these services work. I know the Minister of State will keep me updated and provide replies on some of my questions she has been unable to answer tonight.

Mary Butler (Waterford, Fianna Fail)
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I thank the Deputy. Everybody in Carlow can rest assured that the county will not be forgotten as long as she is in the House. As I stated, she has raised this issue on so many occasions and I know how important it is. I can assure the House that the Government remains committed to resourcing the National Ambulance Service across the country, including in the south east.

As I have outlined in the limited time available to me, the NAS is currently undergoing a multi-annual reform programme which is prioritising investment in new service developments, including increased manpower and fleet, and improved technology. This has involved significant investment on the part of the Government. For instance, the €200 million being allocated to the NAS this year represents an increase of no less than €30 million on the allocation for 2019. This funding is facilitating an increase in paramedic staff numbers to target capacity deficits and is also being invested in the progression of the development of alternative patient care pathways. These include "hear and treat" and "see and treat" services that are designed to manage low-acuity calls in an integrated manner and often mean that an emergency department attendance can be avoided for these patients.

It is important to acknowledge the work that has been done. We have had 80 new paramedics trained this year and there are more being trained up. We often hear about a lack of different definitions, especially in the context of the Department of Health, whether it is psychologists or psychiatrists or whatever else, but the way to address the issue is to start at third level. I know it takes a few years for the students to come through as trained paramedics but it will be really welcome when they do. I will pass on the Deputy's questions to the Minister.