Martin Browne (Tipperary, Sinn Fein)
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I thank the Minister of State for discussing this matter with me today. I am talking about the funding needs of the great service that is provided by the Irish Community Air Ambulance. As the Minister of State will be acutely aware, the service provided by the Irish Community Air Ambulance has saved many lives and prevented injuries sustained by people from becoming life changing. Whenever one speaks to people who have been involved in accidents or who have been seriously ill and were assisted by the air ambulance service, they cannot speak highly enough of it. Similar sentiments have also been expressed by workers in the emergency services. In particular, I was approached by the stationmaster of the Cashel fire service, who appealed to me to raise the matter with the Minister.

First, I acknowledge the value of the air ambulance service. I will take as an example an incident in Cashel not too long ago when a person needed urgent intervention. We hear much about the golden hour when it comes to the response given to a person with a traumatic injury. It is a period of time immediately after a traumatic injury during which there is the highest likelihood that prompt medical and surgical treatment will prevent death or life-changing complications. During the incident of which I am speaking, the individual concerned was airlifted to University Hospital Limerick, UHL, which took just 17 minutes from Cashel. If one were to go instead by road, it would take 50 to 60 minutes. I have also spoken to representatives of the Irish Community Air Ambulance service about this and they gave an example of how it can take more than two hours to travel from Waterville to Cork University Hospital, CUH, by road. From my own town in Cashel, it will take more than an hour to get to Cork. The air ambulance cuts that timeframe down to 26 or 27 minutes, so I see where the golden hour comes in.

The service has encountered challenges in recent years, however. Covid-19 had a severe impact on its ability to fundraise, and this is before the issue of added fuel costs comes into it, which I will address shortly. The Irish Community Air Ambulance service approached the Minister about getting some short-term funding in light of the Covid restrictions on fundraising. I understand there was a delay in the Minister acknowledging and responding to a request for a meeting. The delay experience is a matter on which I would like some clarity. I do not expect the Minister of State to give it to me this evening.

It is not the only issue I want to address today, however. The service sought short-term funding for two years at €700,000 per year, which would reduce once fundraising could take place again. It had a plan drawn up. It was well informed about what it needed and how it could progress. After eventually having the meeting with the Minister, the service was more or less told to compete for a tender for the helicopter emergency medical service, HEMS, in the west if it wanted to survive. This is no way to treat such a valuable service. It also raised the question about what happens if it is not successful and is outbid by a commercially minded competitor. What happens to the ground-based doctors' service when they know it would likely not be able to survive? While I do not want to say too much about the tender process, what commitment will the Minister of State give to ensuring the future of the highly valuable service provided by the Irish Community Air Ambulance?

To reinforce my point, as I referred to earlier, I want to touch on and raise the issue of fuel costs. The Irish Community Air Ambulance service was called out more than 500 times last year, which was considerably up on the previous year. Now it has the soaring cost of fuel, which it told me has increased from 70 cent per litre to €1.47, resulting in annual costs soaring from €80,000 per annum to between €140,000 and €150,000 per year. Yet it appears that it is being forced to engage in a tender process because, for some reason, there appears to be an approach within the Department that effectively tells it to sink or swim.

We cannot allow this kind of attitude to be adopted by Government. The service needs to be funded whatever the outcome. Lives should not be put at risk for the sake of such small sums as we are talking about here, at €150,000 for more than two years. The importance of the Irish Community Air Ambulance service cannot be overemphasised, nor can the challenging situation in which it finds itself. I understand some funding has been given through the Department but sustainability is what we are talking about here. We are also talking about the Government not throwing such a valuable service to the lions of commercial activity and letting it sink or swim in the process. I need to hear the Government is committed to the continuation of the Irish Community Air Ambulance service and similarly that the Minister of State is committed to playing her role in saving the lives and well-being of the thousands of people who owe everything to this service.

Anne Rabbitte (Galway East, Fianna Fail)
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I am taking this Topical Issue matter on behalf of the Minister, Deputy Donnelly, in response to the need for additional funding to sustain the Irish Community Air Ambulance service. I welcome the opportunity to address the House on behalf of the Minister in this regard.

The National Ambulance Service, encompassing the emergency aeromedical service, operates the helicopter emergency medical service, HEMS, in Ireland. The service operates in conjunction with the Irish Air Corps from Custume Barracks, Athlone, and the charitably funded HEMS operated by the Irish Community Air Ambulance, ICAA. The Irish Coast Guard provides additional support on an as-available basis under a service level agreement with the HSE.

The Irish Community Air Ambulance is a charity-funded HEMS that has operated since July 2019 under a service level agreement with the HSE. Under the terms of this agreement, the ICAA committed to fund all maintenance, repairs, fuel and other expenses incurred in the provision of the transportation element of the HEMS, while the National Ambulance Service committed to providing the clinical staff and all medical consumables.

In early March of this year, the ICAA advised of serious financial difficulties. To provide funding to ensure the continued operation of the ICAA, it was necessary that the issue of state aid was addressed with the European Commission and that a procurement process to procure the long-term service was commenced as a matter of urgency. To ensure state aid rules were complied with, the Government gave approval to notify the European Commission of an intention to establish a scheme to safeguard the provision of charity-funded HEMS under the European Commission's Covid-19 temporary framework for state aid. This framework provides that temporary limited amounts of aid may be allocated to undertakings experiencing liquidity difficulties due to the Covid-19 pandemic.

The Commission gave approval last week to the establishment of this scheme, and in line with direction from the Department of Health, the National Ambulance Service will now establish and administer the scheme. The National Ambulance Service is engaging with the ICAA regarding the ongoing provision of funding under the scheme. The HSE has also begun a procurement process to ensure the ongoing provision of HEMS in the south west on a sustainable basis. A recent request for tender went live last month and the tendering process is currently progressing. As such, it would be inappropriate for me to comment further at this time.

I reassure the House that the Government is strongly committed to supporting the strengthening and reform of the National Ambulance Service, including in the area of aeromedical services. The allocation of an unprecedented €200 million to the National Ambulance Service in 2022, which includes €8.23 million for new service developments, is clear evidence of this commitment. This funding will help the National Ambulance Service to continue its transformation from an emergency medical service into a highly adaptable and responsive mobile medical service.

Martin Browne (Tipperary, Sinn Fein)
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I appreciate that the Minister of State is taking this matter on behalf of the Minister. The reply written for the Minister stated, "I reassure the House that the Government is strongly committed to supporting the strengthening and reform". We are being told the Minister did not even respond to the service for a couple of months when it asked him first, although he did eventually come back to it.

The importance of the Irish Community Air Ambulance service cannot be overemphasised. Out of 500 calls last year, consider the lives it would have saved. Like I said, it looked for €750,000 per year over a two-year period, which is only €150,000 over two years for 500 calls and the number of lives it saves. It is not just me. The fire brigade and ambulance crews will tell the Minister of State that, daily when they go to serious incidents, they are able to call on the ambulance service and the ambulance lands. Like I said, it can have a patient from Cashel to Cork or Limerick within the space of 17 to 25 minutes. All of them, even the doctors, will tell the Minister of State that golden hour is vital to saving lives and making sure someone is not seriously injured for the rest of his or her life.

Like I said, we have heard it here. To be honest, and I am not blaming the Minister of State, I am kind of sick of listening to Covid-19 being given as an example of why we cannot do anything. One of the biggest costs, which we have said, is the price of fuel. We all understand the service has not been able and that it is community based and fundraises every year. It is only the past two years with Covid-19 that it has been caught. It has looked for that kind of funding for two years to cover the cost of fuel for its helicopters. Surely, with all the money we are talking about for running the country and running services, that kind of small money should be a priority to make sure we try to save lives or give anybody who is involved in a serious accident or incident as good a chance as anybody of getting there within that golden hour.

Anne Rabbitte (Galway East, Fianna Fail)
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I too acknowledge the wonderful work done by community air ambulance services, of which there is no doubt. I fully understand the challenges they have faced trying to fundraise over recent times. That is why the commission last week approved the establishment of the scheme. In line with a direction of the Department of Health, the NAS will establish and administer the scheme. I hope I have outlined the commitment of the Government and its agencies, including the HSE and the National Ambulance Service, to ensuring the continued provision of air ambulance services to respond to trauma and clinical emergencies in the south west. The effort made by all parties to ensure this service has been able to continue in the face of the charity’s financial difficulties is to be commended.

The temporary framework scheme, as approved by the commission, while time-limited, is still very much designed to ensure the vital services secured under the HSE's ongoing procurement process will be completed and that a successful tenderer will be identified. I again emphasise the Government’s commitment to supporting the development of pre-hospital emergency care services, including aeromedical services. This can be seen in the unprecedented levels of funding allocated, which has increased by 17% since 2016. Through continuous strategic reform, the NAS is continuing its evolution from being an emergency medical service to an agile and responsive medical service that will improve care and outcomes for patients, as the Deputy outlined.

I will convey everything he raised to the Minister of Health.