Seanad debates

Tuesday, 27 June 2017

Commencement Matters

Air Ambulance Service

2:30 pm

Photo of Paul CoghlanPaul Coghlan (Fine Gael)
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I welcome the Minister of State, Deputy Finian McGrath, to the House.

Photo of Frank FeighanFrank Feighan (Fine Gael)
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I raise the need for the Minister for Health to explore all options to extend the emergency aeromedical service based at Custume Barracks, in Athlone, to a night-time service. I am delighted to have an opportunity to speak about this vital service, which I helped secure in 2012 with the help of the then Minister for Health, now Senator James Reilly, and the then Minister for Justice and Equality and Defence, former Deputy Alan Shatter. I thank the Minister of State also for being here today to discuss this important issue.

Since coming into operation five years ago, the emergency aeromedical service or, as it is commonly known, the air ambulance service, has played a key role in providing critical air support options in response to major emergencies, not least in the catchment area of Roscommon hospital. There is evidence that the Air Corps helicopters have carried out thousands of life-saving missions across the region I live in since it was established. The service located in Custume Barracks in Athlone has undoubtedly saved many lives, and none more so than in Roscommon. Countless lives, from Ballaghaderreen to Ballyleague and Athlone to Arigna, have been saved. This is about a lifesaving approach centred on bringing the hospital to the patient in an emergency. I take this opportunity to pay tribute to the Air Corps pilots, the advanced paramedics and the ground ambulance personnel who do fantastic work in stressful conditions saving the lives of many people.

It is also important to highlight that a large percentage of air ambulance work involves dealing with serious heart attacks where time is of the essence. The gold standard treatment for ST-elevation myocardial infarctions, STEMIs, is access to a 24 hour specialist unit such as Galway within 90 minutes of diagnosis. Usually, helicopter flight times to these specialist centres take little more than 20 minutes to complete. That rapid response service has become an important element of the region's emergency response infrastructure.It goes without saying that the service has proved to be transformative for many critically ill patients and ensures that those living in rural areas have timely access to specialised treatment available in the larger hospitals. We all know the speedier the treatment in the case of heart attacks and strokes, the better the outcomes for patients.

Not so long ago, it was very encouraging to hear the air ambulance being praised highly by a Roscommon general practitioner and a Longford general practitioner on one of my local radio stations. Both doctors recounted incidents where the air ambulance allowed for speedy access to treatment, making a major difference to the lives of critically ill patients. The Roscommon general practitioner, Dr. Greg Kelly, who was a candidate for Fianna Fáil in the 2002 general election, said in the local radio interview that the helicopter service is now more important to the people of County Roscommon than an accident and emergency department as critically ill patients get the expert treatment they need by getting very quick access to a centre with the specialist skills.

In light of the considerable success of the service, what options are available to extend the air service to include a night-time service? As the Minister of State knows, the current protocols do not allow this to happen. During the summer, it is not really an issue given the substantial amount of daylight hours, which allow the emergency air ambulance to fly for much longer, but I ask the Minister of State to explore the possibility of extending this very valuable and necessary service to include a night-time service.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank Senator Frank Feighan for raising this important issue and providing me with an opportunity to inform him of the Department's ongoing work to enhance the aeromedical services. The emergency aeromedical service, EAS, provides rapid access to appropriate treatment for patients specifically where land ambulance transit times would not be clinically appropriate. The service is particularly beneficial for time-dependent cardiovascular patients, who constitute about one third of all EAS patients.

EAS services are provided primarily by the Air Corps, with reserve capacity provided by the Irish Coast Guard. The service operates seven days per week in daylight hours, and it is specifically targeted at the west. The highest demand for the EAS comes from Galway, Mayo and the Senator's county, Roscommon. The service has successfully completed almost 2,000 emergency missions to date.

A pilot emergency and aeromedical service was agreed between the Ministers responsible for health and defence in January 2012. From the outset, it was agreed that the Air Corps would provide aerial support for the service and operate in daylight hours only. A subsequent review of the pilot service examined the level of service provided during daylight hours and it was found that the level was appropriate to meet the demand. In July 2015, the Government established the EAS on a permanent basis.

A Programme for a Partnership Government is committed to a feasibility study on the expansion of the EAS and its possible extension to night-time. My colleague, Minister of State, Deputy Kevin Boxer Moran, has made this a priority issue in the programme for Government. He is pushing this issue very hard.

The Department of Health and the Department of Defence are continuing to examine the programme for Government commitment to this feasibility study. The Department of Health and the national ambulance service are currently exploring the feasibility of a community-based helicopter emergency medical service in the south. While such considerations are ongoing, it is important to point out that night-time flying carries additional risks. All the risks associated with landing and departures are magnified at night. Such risks include low visibility and crew fatigue. There are also restrictions on helicopters landing at night-time in Ireland, and landings can take place only on a lit helipad or at an airport. These restrictions would significantly reduce the number of emergency incidents that the service could respond to, and it is possible that most night-time calls would, in view of the risks involved, be better served by a land vehicle.

Of course, significant additional capacity in terms of Air Corps personnel and national ambulance service paramedical staff would be required to extend the EAS to a 24-hour service.The Air Corps is faced with challenges in the recruitment and retention of personnel. In that context, and in light of the fact that ambulance activity drops significantly at night, the Department will need to consider if a 24-hour service would be the best use of limited resources.

The Irish Coast Guard operates on a 24-7 basis from its four bases at Dublin, Waterford, Shannon and Sligo. Where necessary and appropriate, it can be tasked by the National Ambulance Service.

I thank Senator Feighan for raising this important issue.

Photo of Frank FeighanFrank Feighan (Fine Gael)
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I thank the Minister of State for his detailed response. I am encouraged that the Irish Coast Guard, located in Sligo and Shannon, can provide an air ambulance service at night.

Five years ago, the provision of this air ambulance service came as a direct result of Roscommon hospital’s accident and emergency department being downgraded. People were quite certain that lives would be lost. I know this service is what the consultants in Roscommon hospital wanted. I am delighted the service was delivered and that it has been a huge success. In the past month, I know of five people personally, from Ballintober, Roscommon town, Boyle and Castlerea, whose lives have been saved because of this air ambulance. People do not fully realise the changes it has brought about. Effectively, the accident and emergency department has been brought to people on the side of the road. Modern medicine has evolved in such a way that it is now necessary to have an air ambulance in this area. The service has saved dozens of lives in County Roscommon.

We need to look at providing such a service for the island of Ireland, like in the south and around the midlands. If we are talking about cross-Border co-operation and the Good Friday Agreement, there needs to be one in Northern Ireland to cover all of that area also.

Photo of Finian McGrathFinian McGrath (Dublin Bay North, Independent)
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I thank Senator Feighan for his remarks. I take his point on the downgrading of the Roscommon accident and emergency department several years ago and how this service was brought onto the pitch. I will bring his concerns back to the Minister for Health, Deputy Harris, and the Minister of State at the Department of Defence. He has pointed out how the accident and emergency service has been brought to the side of the road for people in difficult situations. I thank the staff of the air ambulance who do magnificent work.

I strongly support his proposal for the Good Friday Agreement. We need to look at an all-island approach and be a little more creative when dealing with these services. In my portfolio for disabilities, I collaborate closely with services in the North of Ireland. There is a glorious opportunity under the Good Friday Agreement to develop health and safety and air ambulance services in the interests of all the citizens on the island.

Photo of Denis O'DonovanDenis O'Donovan (Fianna Fail)
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I am sure the Senator will share his positivity and joy with Senator Leyden.