Brian Hayes (Dublin South West, Fine Gael)

I thank the Senator for raising this issue, particularly in the wider context of non-emergency patient transport.

I wish to make it clear on behalf of the Minister for Health that the HSE has no statutory responsibility to provide transport or support for patients to attend its facilities or clinics. Patient transport funding is primarily intended to provide an emergency ambulance service. The cost of non-emergency transport rose significantly over the latter part of the previous decade, as stated by the Senator, and provision was not uniform across the State. Accordingly, this was an area identified for improved budgetary control and management.

Against this background, I wish to set out the principles that underpin the HSE's operational practice for non-emergency patient transport. As a rule, patients should make their own transport arrangements, especially where public transport is available, unless there are clear clinical factors involved. HSE ambulance resources and health care personnel should be used only where there is a clinical need for such service - for example, medical or nursing support during a journey or where a stretcher is required - and the HSE should arrange other transport only when the patient is not in a position to make or fund his or her transport arrangements.

The Donegal-Dublin bus service mentioned by the Senator has been extensively subsidised by the HSE over many years, and the HSE has now reviewed the service to assess its viability. In recent years, there has been an increase in public transport services on the Donegal-Dublin route, with shorter journey times. This has resulted in fewer patients using the HSE-funded service. The review has shown that, in recent months, on average five people per day have been using the service. Additionally, Letterkenny General Hospital has in recent years sought to reduce the number of people travelling outside the region by improving and increasing services.

Given the need for the HSE to operate within available resources, it is necessary to review all costs to ensure that spending is necessary and effective and that essential core services are maintained. The level of support available at any given time for non-emergency transport is dependent on financial resources, and such resources are very limited. The cost of the subsidised bus service is now approaching €100,000 per year. Based on the number of the people using the service, the alternatives available and the cost-effectiveness, the HSE has made the decision to discontinue funding the service from 27 July 2012.