Robbie Gallagher (Fianna Fail)
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Ar dtús, ba mhaith liom fáilte mhór a chur roimh an Aire Stáit go dtí an Teach seo um thráthnóna. This is the first opportunity I have had since the Minister of State's elevation to high office and I would like to take this opportunity to wish her every success. I have no doubt that she will take her hard work ethic to her Department and that she will make a great success of it.

I come here today for the second time inside a week to talk about the lack of ambulance cover in counties Monaghan and Cavan. There seems to be an issue with the rostering of ambulance personnel in both counties, but in particular in County Monaghan. It is an issue that is causing great concern for the people there, as I am sure the Minister of State can appreciate and understand.

I understand that currently there are three or four vacancies, or thereabouts, in the Monaghan stations, which are located in Monaghan town and Castleblayney. Heretofore, those vacant shifts were covered by local personnel who kindly volunteered to make themselves available to do overtime in order that the people of Monaghan and Cavan would have a service. For some unknown reason, management at the National Ambulance Service has now decided that it will desist from that option, It is now employing ambulance personnel from as far away as Swords in County Dublin and Dundalk. That might be fine but I understand that if ambulance personnel from Swords or Dundalk, whichever the case may be, are called out to an incident in their own area, that will get first priority and Monaghan could be left with no cover whatsoever, which is quite scary.

Last week there were 17 12-hour shifts for which no cover was provided locally. This week, I understand, there are 19 shifts which have no cover provided locally. It is a very worrying situation. I understand that the three or four vacancies in question have been vacant for a number of years and that the National Ambulance Service is saying it is finding it difficult to recruit personnel nationally. I have talked to people from different counties and it does not seem to be an issue there.

What efforts has the National Ambulance Service made to reach out to the communities in Monaghan and Cavan to put forward the many rewards there would be for serving in the National Ambulance Service? I would hope the Minister of State might have some answers on this issue this afternoon. As she can imagine, the thought of not having ambulance cover there is very scary. The community - I speak on behalf of many of them this afternoon - wants answers and to have confidence that County Monaghan in particular, and indeed Cavan, will have cover during those periods. I look forward to the response from the Minister of State.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I worked with the Senator in this Chamber for many years. I welcome the opportunity to address the House on behalf of the Minister for Health, Deputy Carroll MacNeill, regarding his request for information on National Ambulance Service, NAS, response times and staffing for Cavan and Monaghan.

The NAS serves Cavan and Monaghan from four ambulance bases, in Cavan, Virginia, Monaghan and Castleblayney, covering the entire area. All four bases are staffed by a highly skilled workforce of pre-hospital emergency care practitioners including paramedics, advanced paramedics and emergency medical technicians. The NAS operates a fleet of modern emergency ambulances, intermediate care vehicles and rapid response vehicles from these bases. In addition, Cavan and Monaghan are covered by the NAS national emergency operation centre clinical hub, 12 active community first responders groups comprising six in Cavan and six in Monaghan, the aeromedical support provided by the NAS emergency aeromedical support services in Athlone, and the Irish Coast Guard search and rescue service in Sligo.

On NAS emergency response times, I am informed that patient demand for the services continues to rise both nationally as well as in the north Leinster area, which covers Cavan and Monaghan. In 2024, 430,000 urgent and emergency calls were received from the public, representing an 8% increase nationally on the previous year. In the north Leinster area, call volumes increased by 14,662 calls during the same period. Despite the significant increase in demand, ambulance response performance improved both nationally and in the north Leinster region when compared to performance for 2023.

The HSE national service plan sets out key performance indicators, KPIs, for cardiac life-threatening calls, designated as "purple", or other potential life-threatening calls, designated as "red", to be responded to by an ambulance in less than 19 minutes. In 2024, the HSE KPIs reported 73.2% against a target of 75% for purple calls, and 46.2% against a target of 45% for red calls, in north Leinster, which covers Cavan and Monaghan. Performance for purple and red calls was 77.7% and 47.7%, respectively, an improvement when compared to 2023.

The Senator also raised the matter of NAS staffing and staff deployment in the Cavan and Monaghan area. NAS staffing numbers in the region have grown recently, with an increase of 11%, or 28 staff, in the past 12 months alone. In line with international best practice, NAS resources nationally, including in the Cavan and Monaghan region, are deployed dynamically and are actively changing. This means that the NAS prioritises resource allocation to the highest acuity of calls that require an immediate emergency response in direct response to patient needs. The NAS’s operation of dynamic deployment does mean that Cavan and Monaghan may, from time to time, be supported by NAS bases and staff from neighbouring counties to ensure adequate coverage and rostering for both emergency ambulance and rapid response vehicles.

As well as front-line urgent and emergency care, the NAS is developing and expanding a range of appropriate alternative care pathways to improve patient flow and reduce pressure on emergency departments. I welcome the deployment of the NAS community paramedic to the Cavan ambulance base, where they will operate outside of their normal emergency response role to provide care in the community for lower acuity patients. I have also been informed that the NAS plans to increase the number of community and specialist paramedics in Cavan and Monaghan over the year, broadening the range of services offered in the area.

I extend my sincere thanks and gratitude to the staff of the National Ambulance Service for their commitment and dedication to patient care, in both the Cavan and Monaghan areas and across the country.

Robbie Gallagher (Fianna Fail)
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I thank the Minister of State. I too acknowledge the commitment, hard work and dedication of the National Ambulance Service throughout the country. In many cases, those personnel are left in a very difficult situation. I want to ensure that the people of Monaghan and Cavan have an adequate ambulance service, but there are concerns about that. I sincerely hope the response given on behalf of the Minister, Deputy Carroll MacNeill, goes some way to assuage the concerns and fears that people genuinely hold. I assure the Minister of State and the Minister, Deputy Carroll MacNeill, that if the situation does not approve, I will be back looking for more answers. I thank the Minister of State for her response and time.

Jennifer Murnane O'Connor (Carlow-Kilkenny, Fianna Fail)
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I know the Senator’s commitment and hard work and that he is very passionate about this. I concentrated in the first part of my opening statement on ambulance response performance and resourcing in the Cavan and Monaghan areas. I will now focus briefly on funding of services nationally. This Government has consistently committed to investing in the NAS in recent years. The total allocation for the NAS this year alone will be €285 million, representing a significant increase on the previous year. The allocation this year includes €8 million for new service deployments, converting to €16 million in 2026, delivering up to 180 additional posts. These posts will support capacity building in our front-line emergency services, the continued expansion of alternative care pathways and help further development of specialist services, such as aeromedical services and critical care retrieval services. Through continued investment in recent years, the NAS has made considerable progress in implementing an ambitious programme of reform, transforming from what was a traditional emergency response service into a quick emergency medical response.

I apologise that I will not get to say everything I want, but I assure the Senator of the continued commitment of the Minister, Deputy MacNeill, her Department and ourselves and that we are working seriously on what we can do and in terms of the investment going into this. I ask the Senator to come back to me if this has not been answered adequately for him.