Brian Lenihan Jnr (Dublin West, Fianna Fail)

I thank Senator Kitt for raising this matter which is close to his heart and about which he has expressed much concern.

The report of the strategic review of ambulance services 2001 is the basis for the development of pre-hospital emergency medical services in the future. It identifies aspects of the current emergency ambulance service which need to be addressed to bring the service into line with best international practice to ensure effective and quality-driven practices.

The report recommends that the service be developed at a number of levels. The principal proposed developments are the elimination of on-call as a means of providing emergency cover; improved fleet reliability; and the roll-out of the emergency medical technician-advanced, EMT-A, programme. There is convincing evidence of a direct relationship between speed of response and good outcomes in life threatening emergencies such as cardiac arrest and major trauma.

The elimination of on-call is designed to facilitate further improvement in response times. The Minister was pleased to be in a position to provide funding in excess of €3 million in the current year to facilitate the continuing phasing out of on-call in a number of regions. The Minister hopes to extend this programme.

In the area of the ambulance fleet and equipment, the Department provided additional capital funding of €2.5 million in recent months to assist the boards and authority in Dublin with their fleet and equipment replacement programmes, which are essential prerequisites for enhanced speedy and appropriate care.

Last year, the Minister announced policy approval to the development of the emergency medical technician-advanced, EMT-A, programme. Considerable work has been done by the Pre-Hospital Emergency Care Council in conjunction with my Department in preparing the legislation necessary to give effect to this programme. The introduction of EMT-A training is the single most important development taking place in our emergency ambulance service.

I turn to the specific issue raised by the Senator which is the need for funding to be provided to the Western Health Board for the establishment of an ambulance base at Tuam, County Galway. The Western Health Board emergency and patient transport ambulance service provides a service to a population of more than 353,000 people. The emergency ambulance service is provided from ten stations spread throughout the catchment area of the board. The past four to five years have seen a significant expansion of the service. Ten additional crews have been put in place. The number of 24 hour bases has increased from three to five while the overall hours of operation across all bases have increased significantly.

These improvements in service delivery have been facilitated by the use of development funds provided to the board for that purpose. The board is continuing with its development programme for the service and, I understand, is developing proposals for the establishment of a number of additional stations in its functional area including the establishment of a station at Tuam. These capital proposals will be considered by my Department in conjunction with the Western Health Board and in the context of capital priorities to be progressed in line with overall funding resources available in 2004 and beyond.

I assure the House that the Government is fully committed to the development of an emergency ambulance service. Much has been achieved in the development of the service and I recognise that much remains to be done. It is essential to maintain the progress which has been made and to continue the process of service development so that effective pre-hospital emergency care is accessible to those who need it most when and where it is required.