Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Senators for a very interesting and informed debate over the past few hours. Before I go into my substantive response, one or two individual cases were raised. Senators will appreciate that I do not have any patients' charts on my desk and it would not be right for me to comment on individual cases but perhaps those cases were raised more to illustrate a point than to seek a specific response. A few questions were raised about particular local issues or local hospitals and I am not going to answer them here today. We have 40 hospitals in the country and that is only the hospitals, never mind another few hundred social care institutions and other primary care institutions. I do not have a day to day working knowledge on which wards are being opened and closed in particular hospitals or matters like that. No Minister ever has, ever will and or ever should have that, but my officials will take note of those questions and get replies from the hospital, local management or the group, or the HSE, as appropriate.

The vast majority of the questions and issues raised by Senators were national matters and I will respond to them as best I can. A few Senators raised the issue of ambulances. I want to point that our ambulance services in Ireland are improving. It is not that long ago when all an ambulance and a driver did was to take one to hospital. Now ambulances are largely staffed by paramedics and advanced paramedics who can offer one care on the scene. We record the response times for Echo and Delta calls and turnaround times and they are published every month in the HSE's performance assurance report, PAR, and they are improving. Senator Ó Murchú made a good point, namely, that when it comes to health care we tend to only hear about the bad things, it will never be a front page story that our ambulance turnaround times and response times are improving.

The budget for ambulance services in 2015 has been increased by €5.4 million. We now have intermediate care vehicles, which means we are not using ambulances for simple transport. It was inappropriate to use an emergency vehicle for simple transport between hospitals. We have 100 community first-responder teams, now responding on the scene, particularly - but not only - in rural areas. I will be with them tomorrow launching the national network of community first-responders. We want many more of them because what we need in a remote area is somebody living locally who can respond very quickly. It is not practical to have an ambulance in every parish answering one call a week. That is not realistic.

We also now have rapid response vehicles. These are paramedics who travel by car who can get to patients and begin treating them before the ambulance arrives. I have been out with that crew in recent months, as some of the Senators will know. Under this Government we now have an air ambulance for the first time and that is particularly important in the midlands, the Border areas and west in getting people to specialist centres such as the neurosurgery centre in Beaumont or cardiothoracic surgery in the Mater, which is where they need to go and not to the local hospital. That goes for Connolly hospital as well, which would not be able to deal with level one trauma such as a major head injury.

We are integrating all the call centres. Within the next few months all of the calls will run through a single centre in Tallaght instead of there being seven or eight around the country, which was the case previously.

There has been much talk about the eight minute and 20 minute targets. They are UK targets which are not met in Scotland, they do not apply to a large parts of Wales and are often not met in large parts of England. HIQA now acknowledges that we need to have a different set of targets for Ireland. I live in Castleknock. My nearest hospital is Connolly hospital. If the bus lane is blocked it would be quite difficult for an ambulance driver to get me to Connolly hospital in eight minutes, and that is in an urban area. My grandmother and cousins live in Dungarvan in west Waterford and there is no way one could get from Dungarvan to the hospital in Cork or Waterford in eight minutes. That is impossible, even by helicopter, never mind by ambulance. There are targets in that if one applies the eight minute target and if the ambulance gets to the patient in seven minutes and the patient dies, that is counted as a success. If the ambulance gets to the patient in nine and a half minutes and he or she is defibrillated at the scene and treated in the ambulance and survives, that is counted as a failure. It is a funny way of doing a target in my view.