Trevor Ó Clochartaigh (Sinn Fein)
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Táim ag ardú ceiste ar maidin a bhaineann leis an tseirbhís otharcharr i gConamara thuaidh. I raise the issue of the ambulance service in north Connemara, in particular in the Leenane, Maam, Kylemore, Renvyle and Clifden areas. An ambulance crisis steering group was set up in the area due to the concerns that exist and a number of meetings have been held with elected representatives. The group has given two examples to underline the seriousness of the situation. One case related to a young mother who was waiting for more than two hours for an ambulance while haemorrhaging badly a few days after giving birth. A second case related to a serious cardiac patient who presented himself to the doctor at 2.30 p.m. with chest pains. The doctor called an ambulance and it arrived at 4.50 p.m., and the man eventually arrived at the hospital at 6.45 p.m. The response from the National Ambulance Service at a meeting was that the resources are not available to put a workable solution in place.

We feel that is totally unacceptable. The group believes the National Ambulance Service, NAS, the Department of Health and the Government have a duty of care towards people and patients in rural areas such as north-west Connemara as much as to people living in other rural areas. We all fully understand that living in rural areas creates delays but we take issue with the often two to three-hour delays in waiting for ambulances to arrive to tend to patients. Their major concern is the waiting time between the call for an ambulance to attend and the arrival of the ambulance at the scene. Although the group has made numerous requests under the Freedom of Information Act for ambulance response times in the area, it appears the National Ambulance Service is reluctant to give the information. That is something I might follow up with the Minister.

A follow-up meeting was held with the National Ambulance Service at which various issues were raised and options were explored. It was put to the National Ambulance Service that the current service is totally inadequate with it regularly being the case that people are waiting more than two hours for an ambulance to arrive. That is the norm rather than the exception. In addition, people who are very ill then face a 50-mile or 60-mile journey. We appreciate that air ambulances are available but NAS helicopters cannot fly in darkness and while the Coastguard helicopters are available, they have only limited use. Both types of helicopter need areas in which they can land safely and an ambulance to transfer a patient to the helicopter, which gives rise to issues concerning that particular option. I noted the case of a man who was waiting for a very long time.

The ambulance crisis steering group has put forward a number of suggestions. There is a Red Cross ambulance in the area and it has been suggested that a rapid response unit could be developed with two fully qualified and salaried paramedics being put in place to cover the area, but that would require the support of the Red Cross whose ambulance was purchased through fund-raising activities by the local community. Such an approach would have to work in conjunction with the National Ambulance Service. To date, the National Ambulance Service has not been open to such an option on the basis that the Red Cross ambulance is not up to the same standard as an NAS ambulance. People on the ground however say they would prefer a Red Cross ambulance than no ambulance or an ambulance that would take two hours to get to them. This is a very serious issue.It is a remote area of north Connemara. We appreciate resources are tight, but the length of time people must wait for the ambulance service to get to them is completely unacceptable. They need a better response. We need to hear the Government response to this and how it intends to tackle this issue.

Dara Murphy (Cork North Central, Fine Gael)
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I thank Senator Ó Clochartaigh for raising this issue. On behalf of the Minister for Health, Deputy Varadkar, I am pleased to outline to the House current developments in pre-hospital services, nationally and in Connemara. Before doing so, I apologise on behalf of the Minister for his absence. On behalf of the Government, he is attending a funeral linked to the tragic events in California.

The national ambulance service, NAS, is working to ensure high quality and timely emergency pre-hospital care, using all available resources as effectively and efficiently as possible. As with any pre-hospital service, development and modernisation is a continuous process as technology and clinical standards change. A significant and ongoing reform programme has been under way in recent years and it is important to acknowledge the progress being made. The single national control system, with control centres in Dublin and Ballyshannon, is now almost fully operational and is improving control and dispatch performance.

The NAS continues to develop the intermediate care service, ICS, which transports non-emergency patients between facilities, allowing emergency vehicles to focus on emergency calls. The ICS now carries three quarters of non-emergency work. We are also moving to more efficient on-duty rostering and developing a national rostering system. The model of service delivery is changing. The NAS is moving away from the care model where ambulance services are provided only locally from a fixed ambulance base in that area. It is moving to strategic deployment, with resources used across a region, so that if demand increases in one area, other resources can provide cover as required.

Enhancements to the ambulance service in the west include the introduction earlier this year of 24/7 services in Tuam in Galway and Mulranny in Mayo. Accordingly, in addition to the existing 24/7 coverage for Leenane from Clifden ambulance station, under strategic deployment the new capacity in Tuam and Mulranny stations will provide greater coverage across north Galway and west Mayo in general, including Leenane. Also in 2015, an additional €5.4 million has been provided to improve technology and clinical audit and to address service gaps, particularly in the west. Some 50 additional paramedics are being allocated in the west this year under this process.

The emergency aeromedical support, EAS, service is further assisting service provision in the west. The EAS allows swift transfer of seriously ill or injured patients from remoter areas to the most appropriate hospital. Over 1,000 EAS missions have been completed since June 2012. Galway, Mayo and Roscommon have the highest demand for the EAS. However, as HIQA noted recently, no feasible increase in resources will address all of the access issues in remoter areas. For this reason, the NAS is working with communities to develop community first responder groups, local initiatives which provide basic life support in life-threatening situations until an emergency response can arrive. I understand that CFR groups in Connemara currently cover Spiddal, Ahascragh, Moylough, Lettermore, Maam, Leenane and Turloughmore.

There has been ongoing investment in ambulances services and in their capacity and coverage, including in the west, in the face of some of the most stringent budgetary restrictions ever seen. I assure the House, on behalf of the Minister, that the national ambulance service is as focused as possible on addressing and improving services in the west in 2015.

Trevor Ó Clochartaigh (Sinn Fein)
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I welcome the allocation of additional paramedics to the west but apart from that there does not seem to be much of a change in the situation and it will not assuage the worries of the people in north Connemara. Would it be possible for the Department to make the information on ambulance response times in this area available to me so that I can pass it on to this group in order that we can undertake an analysis of how serious the situation is in the Leenane, Maam, Kylemore, Renvyle and Clifden areas?

Dara Murphy (Cork North Central, Fine Gael)
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I will pass on the Senator's request to the Minister and the Department and check whether it is possible to make the information available.