Maura Hopkins (Fine Gael)
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I thank the Minister of State for his attendance in respect of an issue I have raised several times in the Chamber regarding the ambulance service in County Roscommon and, in particular, its response times. There have been a number of reports on the issue, such as a HIQA report in 2014 and the Lightfoot report in 2016. Both are very stark in their findings and provide us with evidence that action is required to ensure we have increased resources in the form of increased ambulances and personnel to deliver better response times for those in our region. People there are currently at an increased risk because they are living in an identified blackspot area and are exposed to an increased risk of delayed intervention. All Members know that being able to access a medical centre that can intervene at the earliest possible time will have a positive impact on recovery. All Members know of the FAST campaign highlighting the need for quick action for stroke victims and that being able to get to a centre that can intervene as quickly as possible has a major impact in terms of intervention and recovery. A hugely positive impact for sufferers of thrombolysis across the country is getting people to centres where they need to as quickly as possible.

Residents of west Roscommon and east Mayo have to wait the longest time in the country for an ambulance to arrive. Although there is an ambulance base at Loughglynn, County Roscommon, it is currently being operated by a crew from Roscommon town. I have raised this numerous times and it is not acceptable. We need a functioning Loughgynn ambulance base serviced by a Loughglynn ambulance crew. It is not acceptable that a borrowed ambulance from Roscommon town is catering for the needs of our region. We do not want special treatment but we do want fair treatment and we deserve better. It is not acceptable that no extra resources have been given for this area.From the outside, it appears we are building hubs and a health service for an urban centre. Medical treatments and interventions have become more specialised and centralised, which undoubtedly has resulted in positive outcomes according to the evidence and research. As part of that movement, we must ensure that we are able to get those of our people who live in rural areas to those centres quickly. It is currently very difficult in certain rural areas and I point in particular to west Roscommon and east Mayo. We have also seen the hugely positive impact of the air ambulance service and its ability to improve response times, in particular for critically ill patients. As such, it is essential to ensure that service is operational at night.

I have two questions. First, when will we see increased resources for the identified black spot of west Roscommon? Second, when will we see the air ambulance service operating at night? What is happening? The programme for partnership Government indicates that additional resources will be provided for the national ambulance service. When will they be provided in identified black spot areas? A feasibility study was to be carried out in respect of operating the air ambulance service at night. What is happening within the HSE to progress that and when will it be operational at night?

Jim Daly (Cork South West, Fine Gael)
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The programme for partnership Government committed to a feasibility study on the expansion of the emergency aeromedical service, EAS. In addition, the programme committed to delivering safer pre-hospital care by considering the recommendations of three reviews of ambulance services, namely, the HIQA governance review, the national ambulance capacity review and the review of Dublin ambulance services. The programme further committed to providing additional annual investment in ambulance personnel and vehicles.

The capacity review, which was published last year, examined overall ambulance resource levels and distribution against demand and activity. Implementation of the recommendations of the capacity review will require a multi-annual programme of phased investment in ambulance manpower, vehicles and technology. To that end, €7.2 million in additional funding was provided in 2016 for the national ambulance service, NAS, including €2 million in development funding. In 2017, an additional sum of €3.6 million was made available, which included €1 million to fund new developments. I confirm that additional funding will be made available for the continued development of the NAS in 2018. This will be set out in the national service plan for 2018, which the Senator will be aware is being prepared as we speak.

With regard to pre-hospital emergency care in Roscommon, the NAS operates from Roscommon town, Boyle and Loughglynn. The Senator may wish to note that in order to further develop services in Roscommon, the NAS acquired the former Garda station at Loughglynn. Following refurbishment, it opened in 2016 as a dispatch point. This facilitates better utilisation of resources and provides greater geographical ambulance cover for the north Roscommon area. The NAS dynamically deploys resources to respond to incidents as they arise. This is achieved in the Roscommon area by dispatching resources from adjacent ambulance stations in neighbouring counties. Thus, resources from ambulance stations in Carrick-on-Shannon, Tuam, Longford and Athlone can be deployed to incidents in Roscommon as required.

Members will be aware that the EAS was established to provide a more timely response to persons in rural areas. The service is operated by the national ambulance service in association with the Air Corps. The service is available seven days a week in daylight hours and is specifically targeted at the west of Ireland. The highest demand for the EAS comes from counties Galway, Mayo and Roscommon. My Department and the national ambulance service are exploring the feasibility of extending the very successful EAS through the establishment of a community-based helicopter emergency medical service in the south. Discussions in this regard are ongoing. The capacity review identified particular difficulties serving rural areas such as County Roscommon. Outside the greater Dublin area, the population is widely dispersed with a relatively large population living in rural areas. On foot of this population distribution, Ireland has a far higher percentage of activity in rural areas than other ambulance services. The review indicated that the only practical way to improve first-response times in rural areas is through voluntary community first responder, CFR, schemes. The NAS continues to work with local CFR groups across the country to develop and enhance services.

Denis O'Donovan (Fianna Fail)
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We are up against the clock. I ask Senator Hopkins to be very brief.

Maura Hopkins (Fine Gael)
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I will make three very short points. In 2017, €1 million in additional resources have been made available. Surely, those resources should be directed towards identified, evidence-based black spots. The Minister of State referred to the Loughglynn ambulance base. To be honest, the response is not at all satisfactory. The Minister of State said this facilitates better utilisation of resources. This is otherwise known as a "borrowed ambulance", which moves between Roscommon town and Loughglynn. It is not acceptable. We need additional resources. While the Garda station was acquired for refurbishment, a refurbished Garda station does not deliver an ambulance service. We need ambulances and personnel.

The Minister of State said discussions on the air ambulance service were ongoing. I am looking for specifics. Has the feasibility study started? When will it finish? We need to see the air ambulance service, which has been hugely positive and beneficial in getting critically ill patients to the centres they need to be in, operating at night. Can the three specific questions be answered, perhaps outside of this Commencement debate?

Denis O'Donovan (Fianna Fail)
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I am not sure if the Minister of State can add anything. He has given a comprehensive answer. The Senator might take the matter up directly with the Minister of State in her own time. In fairness, both Commencement matters thus far were supposed to be in for the last week but were not taken as a Minister was not available. As such, the two slots lapsed. We must find a way to improve our logistics. I thank the Senator. It is a very important issue for her and I am sure the Minister of State will talk to her about it. Senator Pádraig Mac Lochlainn has four minutes for his matter.