Brian Lenihan Jnr (Dublin West, Fianna Fail)

I am glad Senator Kitt has raised this matter on the Adjournment. I am aware of his constant interest in the improvement of ambulance and medical services in Tuam and the surrounding area.

The Western Health Board's emergency and patient transport ambulance service provides a service to over 353,000 people. The emergency ambulance service is provided from ten stations throughout the board's catchment area. There has been a significant expansion of the service in the past four or five years. Ten additional crews have been put in place, the number of 24-hour bases has increased from three to five and the service's hours of operation have increased significantly across all bases. The board purchased six new high specification ambulances this year to ensure first class facilities for pre-hospital emergency care patients. Two new rapid response vehicles have been introduced as back-up to the new fleet. The board has improved facilities at ambulance stations in Ballina, Boyle, Clifden and Roscommon.

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

I assure the House that the Government is fully committed to the development of the emergency ambulance service. A great deal has been achieved in that regard, but I recognise that much remains to be done. We need to maintain the progress that 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.

The primary care strategy document, Primary Care: A New Direction, outlines the Government's vision for the development of integrated multidisciplinary primary care teams and networks which will enable clients to access a broad range of services in their local communities. The strategy provides for the early establishment of initial primary care teams on the basis of the model described in it. The future widespread implementation of the model will draw on experience gained through the development and operation of the teams.

The Department of Health and Children sought proposals from the health boards in 2002 for the establishment of primary care teams, with a view to funding a number of projects. The Western Health Board made two such proposals. Following discussions between the Department and the board, approval was granted for the development of a primary care team at Erris in County Mayo. The board had proposed that a primary care team and network would cover the Tuam urban and rural areas. It had envisaged that the Tuam team would be based in a purpose-built facility at the proposed Tuam health campus on the site of the former Bon Secours Hospital. It was not possible to approve such a development, however, having regard to the scale and costs associated with the proposed Tuam primary care team.

The primary care strategy states that the development of primary care teams must involve the reorientation of existing staff and resources. The Department has asked the health boards to examine how existing primary and community care resources can best be reorganised to give effect to the application of the teamworking concept on a wider basis and to map out the locations to be served by primary care teams. When the Health Service Executive is operational, it will be responsible for building on the health board initiatives to mainstream the development of primary care teams as the core unit of service delivery. The strategy acknowledges that the provision of modern, well-equipped and accessible premises is central to the effective functioning of primary care teams. One of the Government's key objectives is to facilitate and encourage the development, where appropriate, of facilities in which the broad range of primary care services can be delivered. While the State may contribute towards such developments, it is intended to explore a range of different approaches to the financing and provision of such facilities because of the scale of what will be required.

The Western Health Board has indicated that the development of a new primary care centre in Tuam would constitute a regional priority. The board was unable to proceed with the development this year, however, in light of the resources available for capital development. The position will be reviewed again in 2005 under the capital investment framework, in the context of priorities for development under the care programme and overall capital funding availability.