Jimmy Harte (Labour)
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I welcome the Minister of State, Deputy Kathleen Lynch. Last week in Letterkenny, an injured jogger had to wait 48 minutes for an ambulance to come from the hospital, which is about 1.5 km from where his injury occurred. It turned out that the ambulance came from Carndonagh, 35 miles away. Luckily, the jogger was not seriously injured but he could have been. He had to lie on the road with passers-by comforting him.

Six months ago, I had reason to get an ambulance. It arrived within five minutes and I was in hospital approximately ten minutes after the incident occurred. I am aware, therefore, of the comfort associated with having an ambulance arrive quickly and the professionalism of the ambulance and hospital staff. I would not like to believe I would have had to wait 48 minutes for an ambulance. I wonder whether I would have coped as easily as the jogger. Perhaps other people could have.

It is scary that in a town the size of Letterkenny, which is well serviced with a general hospital, primary care centre and general practitioners, an ambulance could take 48 minutes to arrive. It is not acceptable. I am not criticising the ambulance drivers or staff but pointing to a breakdown somewhere. This matter was aired extensively on local radio, thus giving a negative impression of the health service. If the incident was isolated, we could live with it. However, we are very concerned that if such an incident happens again, the injured party may not receive proper attention on time. If it had been a cardiac incident, 48 minutes would have been too long to wait. I still have not discovered why there was a delay. Perhaps the Minister of State will outline the circumstances and give comfort, if not a guarantee, to the people such that there will be no recurrence. Such an incident should not occur in this day and age, particularly when there is a hospital but a ten-minute walk away.

Luckily, passers-by assisted the jogger in question. In Letterkenny town, many people walk and jog in the evenings. The incident was an unfortunate one in which two cars collided and ended up on the footpath, injuring the unfortunate jogger. Perhaps the Minister of State will offer some comfort to those concerned about ambulance delays.

Kathleen Lynch (Cork North Central, Labour)
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I am responding to this matter on behalf of my colleague, the Minister for Health, Deputy James Reilly. I expect that everyone agrees the Minister has spent considerable time today responding to questions. I thank the Senator for raising this matter and for the opportunity to clarify the position. It is important that it be clarified.

The HSE's national ambulance service, NAS, provides pre-hospital emergency care and emergency and some non-emergency patient transport. Before the NAS was established, each health board had its own ambulance service, with little co-ordination across board boundaries or national leadership on pre-hospital care. Supported by the Department of Health, the Pre-Hospital Emergency Care Council and HIQA, the NAS is providing national management of ambulance services. In particular, the following developments are continuing: ongoing reduction to two ambulance control centres; increased deployment of advanced paramedics, who provide more complex on-site care; modernisation of communications and control infrastructure; and the development of new performance indicators.

Where necessary, emergency cover is supported by advanced paramedics in rapid-response vehicles and by resources dynamically deployed from adjacent stations. A new intermediate care service is addressing routine inter-hospital transfers and releasing ambulances for emergency work, and the national aeromedical co-ordination centre organises aeromedical support, including inter-hospital transfers, transplant transport to the United Kingdom and the emergency aeromedical service, EMS, based in Athlone. The effects of these changes are improved efficiency and increased resource availability across the service.

In deploying emergency resources, the national ambulance service, NAS, operates under the Pre-Hospital Emergency Care Council, PHECC, EMS priority dispatch standard. The PHECC standard identifies the appropriate resource for emergency calls and promotes practice in line with Health Information and Quality Authority, HIQA, national standards for safer, better health care. These set out the principles for timely and clinically appropriate responses.

Ambulance crews are available to respond to emergencies, emergency transfers and lower acuity calls. Ambulance control centres are responsible for strategically deploying emergency ambulances to maintain emergency cover, and for dispatching the nearest appropriate emergency resource to a call. Emergency ambulances from all stations across Donegal are used in a dynamic manner to maintain emergency cover and to respond to calls as required. Ambulance stations across the county and adjacent counties support one another, and the nearest available ambulance responds to an emergency call regardless of where it is based.

Key to the Senator's issue, the NAS has informed the Department that, at 7.31 p.m. on the day in question, Ballyshannon control centre received a call relating to an incident in Letterkenny. The on-duty ambulance crews in Letterkenny were responding to other calls. In line with established procedures, an emergency ambulance was tasked from Carndonagh. This ambulance arrived at 7.55 p.m., 24 minutes after the call was received. Meanwhile, an off-duty HSE paramedic was at the scene from 7.50 p.m., some 19 minutes after the call, and had informed Ballyshannon centre of her presence. The ambulance left the scene with the patient at 8.10 p.m. and arrived at the hospital at 8.13 p.m. I am satisfied the nearest available and appropriate emergency resource was deployed and that established procedures were followed.

The NAS has undergone significant change to ensure quality, safety and value for money. As with other clinical areas, this process is ongoing as clinical needs and standards develop. These developments are in the best interests of patients and are a key part of the Government's work to ensure high quality emergency care. We all aim to have emergency calls responded to as quickly as possible. I do not mean to take away from this particular incident, but it is clear the most appropriate response was provided in the quickest possible time.

Jimmy Harte (Labour)
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I thank the Minister of State. The call was received at 7.31 p.m., and I assume that it took three minutes from the call being logged to the ambulance being told to mobilise, as well as two or three minutes in travel time. However, the ambulance arrived at 7.55 p.m. Assuming the ambulance left at 7.35 p.m., it took approximately 20 minutes to get there. Perhaps I am incorrect, but the distance between Carndonagh and Letterkenny is 40 miles or so. I do not know how the ambulance could have travelled 40 miles in 20 minutes. What speed can an ambulance achieve? Perhaps the Minister of State might clarify. Seeing as how it would have taken 40 minutes at roughly 100 km/h, the ambulance would need to have been travelling at 120 mph to cover it in 20 minutes. Even if the times are correct, they are unacceptable in a cardiac arrest situation. A person would die. The person who arrived would not be a qualified cardiac medic whereas a cardiac unit was only 1.5 miles away.

Kathleen Lynch (Cork North Central, Labour)
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It is unclear from the response provided to me whether the ambulance was actually in Carndonagh. It could have been somewhere else, but I will try to clarify for the Senator. Having spoken to some people in the Department, it is clear that, had the emergency call involved a person suffering a cardiac event, the response would have been different

Jimmy Harte (Labour)
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I hope so.

Kathleen Lynch (Cork North Central, Labour)
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It would have been. This is the idea behind having centralised, most appropriate responses. Centres take the details of the emergencies. I am sure this emergency was not pleasant for the person in question.