Alan Farrell
Question:6. Deputy Alan Farrell asked the Minister for Health if he will provide an update on proposals to reduce the €1.6 billion costs related to obesity to the Exchequer; and if he will make a statement on the matter. [56885/12]
Other Questions
Obesity Levels
The prevalence of overweight and obesity has risen steadily in recent times, with 61% of Irish adults now overweight or obese. The World Health Organization refers to the alarming speed with which obesity has increased in recent decades as a global epidemic.
The recently published report, The cost of overweight and obesity on the island of Ireland, funded by safefood and conducted by University College Cork, provides reliable figures for the annual economic cost of weight related ill health in Ireland. Initial findings estimate the annual cost of overweight and obesity in the Republic of Ireland to be €1.13 billion. The direct health care costs are €398 million or 35% of total costs. This figure includes hospital, GP and drug costs. In addition, two thirds of the economic costs were indirect costs in reduced or lost productivity and absenteeism, which amounted to €728 million. These figures show that the extent of the problem is greater than previously estimated, as indicated in the extrapolated figure of €400 million in the 2005 national task force on obesity report.
The UCC study shows that almost 10% or 37,341 years of life lost are due to overweight and obesity. The burden of disease from overweight and obesity combined account for an estimated 2.7% of total health expenditure. This safefood funded study is particularly timely given that obesity is the major health problem in Ireland, of itself, and is contributing to other chronic diseases such as coronary heart disease and type 2 diabetes. Irish studies have shown that two out of every three adults are overweight or obese; one in four primary school children and one in five teenagers are overweight or obese. Of particular concern are the results of the recent Growing Up in Ireland survey which found that in children as young as three years of age, one in four are overweight or obese.
As Minister for Health I have made overweight and obesity a public health priority and have established a special action group on obesity, SAGO, which I meet with regularly to progress the obesity prevention agenda. It is recognised that no single initiative alone will reverse this growing trend, but a combination of measures should make a difference. For this reason, the special action group is concentrating on a range of measures including actions such as calorie posting in restaurants, which I have asked the SAGO to prioritise as one of the key initiatives that will have a positive impact in addressing the problem of our rising levels of overweight and obesity and as a means of educating the general public on the calorie content of food portions.
Additional information not given on the floor of the House
This involved a public consultation process with over 3,130 responses. Top line statistics from that process indicate that 96% of consumers want calorie menu labelling in all or some food outlets with 73% of food businesses indicating that they want calorie menu labelling in all or some food outlets also. This indicates that there is strong support for this initiative among the general public and also, in fact, within much of the food industry itself. Calorie posting has already commenced in a number of establishments and it is envisaged that in the coming months, when the necessary implementation mechanism has been devised, it will be further implemented.
My Department has worked with the Broadcasting Authority of Ireland with regard to the marketing of food and drink to children towards a new children’s code to restrict marketing of high fat, high salt and high sugar foods and drinks up to 7 p.m. My Department, under the auspices of SAGO, has revised the healthy eating guidelines, including the food pyramid, and I launched these on 13 June 2012.
Treatment algorithms inform primary care staff of the steps to be taken with regard to managing obesity. An adult algorithm has been agreed with health care professionals and is now available. It is understood that the treatment algorithm for children is at final stages of agreement. The special action group on obesity has been discussing opportunistic screening and monitoring with the HSE with a view to earlier detection of overweight and obesity in children. This will improve the identification of overweight children at an earlier age and prevent these children from progressing into the obese category. Research is underway in association with the Department of Children and Youth Affairs to establish the use and types of foods and drinks stocked in vending machines in post-primary schools. Both I and SAGO have met with the Food and Drink Industry Ireland, FDII, and its members to discuss my action priorities and they have indicated to me that this is an area they are interested in supporting.
We know that three out of every four Irish adults and four out of five Irish children do not meet the targets set in the national physical activity guidelines developed by the Department of Health and the HSE in June 2009 and are consequently at risk of developing serious health problems due to inactivity. National guidelines alone are insufficient to increase participation levels and so the HSE has also developed a programme entitled A Physical Activity Plan for Ireland to give clear direction for the promotion of physical activity in Ireland and address the risk of developing health problems associated with sustained inactivity. The national physical activity plan which will contribute to addressing this major health issue is currently being considered by SAGO and my Department.
A new health and well-being framework is being developed and will be launched as part of Ireland's Presidency of the EU. This is an overarching strategic framework for sustained action to improve the health and well-being of the nation. It will set out ambitious goals for improved health and well-being among our population. Priority areas being addressed include tobacco, alcohol, food and physical activity. The four goals of the framework are: to increase the number of Irish people who are healthy at all stages of life; to reduce health inequalities; to protect the public from threats to health and well-being and to create an environment where every sector of society can play its part.
Certain statistics on this issue were presented to the health committee some time ago. Mr. O'Shea, a consultant with expertise in the area of diabetes and obesity, has said we are now sitting on a time bomb. He went further and said it has exploded and the carnage already surrounds us. He said we must act promptly. We must be forceful in our decision-making process. Some of it might be unpopular in terms of policy, because we will have to examine the issue of taxation to discourage consumption of fizzy or high sugar drinks. There are also the issues of exercise, calorie counting and making ourselves aware of health. Other countries such as Australia have tackled this problem head-on. They have become almost obsessed with health but have achieved amazing results in a short period of time.
The Minister said something previously which struck me considerably, that we owe it to the generation following us because ours could be the first generation to be obliged to bury the people born after us. It is incumbent on us not only to extrapolate from the figures but to do something about it. Every possible measure should be taken. The Minister has set up the special task force and the health committee would like to play its part, but society in general must be encouraged and cajoled by policy, some of which might be unpopular as it might require tax hikes. Other aspects of policy will require a change in mindset. However, if we do not do something, we could end up burying our children.
There is much interest in this question. I call Deputy Ó Caoláin and I will call the other three Deputies after the Minister.
Last February, the Minister told the Dáil there would be a voluntary code which would be monitored over a period of time. In the event of non-compliance or if it did not bear fruit, the Minister said he would legislate. Much of the focus in this regard has been on restaurant menus. I believe it should be directed at the foodstuffs we buy in supermarkets and local convenience stores and what we buy from fast food outlets. There is a much greater danger across those three areas and certainly a greater lack of awareness of what we are consuming. What is the up-to-date position with the monitoring of compliance with the voluntary code? Is the Minister satisfied that progress is being made? Will he consider expanding it into the other areas I have suggested? At what point will he make the decision as to whether legislation is required?
The Leas-Cheann Comhairle is correct. There is major interest in this because, as Deputy Kelleher correctly points out and as I have mentioned in the past and we all believe it now to be true, ours could be the first generation to bury the generation following us due to the epidemic of obesity and the consequent epidemic of type 2 diabetes, something which I never saw in a person under the age of 30 years old when I was practising 20 years ago. Now, one sees it in teenagers. It is scary. There is no question that it is related. I have had an interest in this for a long time. Every second person who came to my clinic and had obesity was unaware of it. If one is not aware one has a problem, one cannot address it. Awareness is a huge part of it, and I thank Deputy Kelleher for his support in striving to improve awareness.
The issue is multi-factorial, so it does not just involve the Department of Health. It involves the Department of Justice and Equality, in terms of having safe places to exercise at night, the Department of the Environment, Community and Local Government, so there are well-lit pathways that are safe, and the Department of Education and Skills, in getting children to form a good habit of physical exercise. Senator Eamonn Coghlan has been very active in this area and in advising people about the value of fitness for the sake of fitness and how well it makes one feel. There is much medical information and research which shows that muscular activity creates endorphins, which are morphine-like substances that can make one feel well.
They are great.
This issue requires a cross-departmental approach. This is the first Government to appoint somebody at the level of principal officer across health, education and children to promote this issue and awareness. All help and support is gratefully accepted and we will facilitate the Deputy with any suggestions he might have on how we can progress this.
On Deputy Ó Caoláin's question, we are monitoring the situation. There is an appetite among many of the businesses to become engaged in this. Part of the problem earlier was that they, even the Dáil restaurant, were a little concerned about whether they would be in trouble if there were not exactly 65 calories in the sandwich. That is not what we are trying to achieve. We want people to be aware of the general level of calories in a product. I am aware of an instance of somebody going to a coffee bar, reaching out for a bun but putting it back when they saw that it contained 400 calories. That is what we want. It is not about a nanny state, but we want people to be informed. They have a right to know. What they do with the knowledge thereafter is entirely a matter for themselves.
One cannot turn on the radio without hearing about how much money we would save if we could do something about the promissory notes. It would not save us as much as some people claim. It is only approximately €1.3 billion, but we hear about it all the time. However, alcohol abuse is costing us €3.7 billion, the Minister says obesity costs us €1.13 billion while not doing enough exercise was estimated to cost us €1.8 billion. Yet, every day of the week we are talking about the promissory notes. The promissory note is very important but it pales into insignificance in comparison with these figures. Is there a figure that takes all three into account? If €3.7 billion is the cost of problems with alcohol abuse, part of that sum would be included in the obesity figure. In a way, they are subsets of each other. Is there information on the exact figure?
The big problem is that for the first time in the history of the human race, with the exception of the landed gentry and royalty in the past, it is easily possible to get enough calories. In my house it was often said that one would not leave many tins of dog food open for the dogs because the dogs are so stupid they would keep eating it until they died. It appears that human beings in certain areas of the world who have unlimited access to food are a little like those dogs and do not know how to stop. It is a big challenge. One issue that is never taken into account is the fact that few of us prepare our food. While perhaps one should not eat a bag of chips because they contain many calories, and ideally one would not, if one at least goes out to buy the spuds, carry them into the house, peel them, make the chips and wash the dishes afterwards-----
One would be too tired to eat the chips.
-----one is using up some of those calories. The problem nowadays is that there is unlimited access to food and one need not put any energy into getting it.
One cannot go to the bog to cut the turf either, which would burn more calories.
Previously, I have raised the issue of compiling the number of people we know will invariably die as a result of obesity related illnesses in the future, be it cancer, diabetes or heart disease, and comparing that with the manner in which the State has addressed the issue of deaths on our roads through the Road Safety Authority under the stewardship of an independent person such as Mr. Gay Byrne.
Will the Minister consider, as part of the interdisciplinary, inter-departmental approach, appointing an obesity czar? The person could be a figurehead in holding the Government to account but, more importantly, also bringing members of the public, especially younger people, with him or her. Members are not viewed in the best light on many issues, particularly those that affect society. It is a good idea to put a person in situ, who is respectable to legislators, children and people involved in the matter. The White House and the Obama Administration has done something similar in the United States and there have been tangible results.
Deputy Luke 'Ming' Flanagan should eat his spuds in their jackets rather than putting them in the deep fat fryer. With regard to the Minister's bun, I have a coffee shop and would rather people did not touch them if they are not going to eat them. Obesity is costing over €1 billion but the last round of sports grants to sports bodies was oversubscribed by ten times. Some €26 million was available at the time. Perhaps the Minister can have a word with the Minister for Transport, Tourism and Sport to say that it would be a great investment if the State was to spend more on sport in order to fight obesity. None of the members of the Wexford Youths under-18 and under-19 teams are obese.
We have ranged far and wide in this question. I must ask the Minister to be brief.
That is because the issue ranges far and wide. I will examine the idea proposed by Deputy Patrick O'Donovan. Having a focussed individual such as that has merit. I have made this point about public health to county council health forums. We have a responsibility in the House on the issue. Politically, it is more sexy to open a new wing of a hospital or an MRI scanner than to promote a public health initiative. We have been very poor in supporting these things as politicians. We pay lip-service rather than paying for them. Every euro spent on prevention can save between €12 and €20 on treatment. That is well proven.
I agree with Deputy Luke 'Ming' Flanagan that there is a great amount of money to be saved in prevention. There is a major educational job to be undertaken and there are many vested interests. I would like to see vending machines in schools selling only fruit, apples and water rather than the chocolate and crisps they currently sell. We must make the right thing to do the easy thing to do. If one is hungry and all one can avail of is a vending machine that sells this sort of stuff, that is what one will do. The issue will occupy minds for a considerable time to come. I am open to initiatives people have and I ask them to submit them to the special action group on obesity. I look forward to the contributions of Deputies.
The Minister of State, Deputy Alex White, is particularly interested in alcohol and is progressing a policy on it. I would like to see not only the unit of alcohol on the side of the container but also the calories.
Symphysiotomy Report
Mick Wallace
Question:7. Deputy Mick Wallace asked the Minister for Health when he expects to receive the Walsh Report in relation to the practice of symphysiotomy here; the reasons for the delay in its publication; and if he will make a statement on the matter. [57054/12]
Brian Stanley
Question:12. Deputy Brian Stanley asked the Minister for Health the reasons for the delay in the completion of the final Walsh report into the practice of symphysiotomy and related procedures at a number of hospitals; when he expects the report to be presented; his plans for its publication; and if he will make a statement on the matter. [57026/12]
I propose to take Questions Nos. 7 and 12 together. Professor Oonagh Walsh, an independent researcher, was commissioned by the chief medical officer in my Department to draft a report on the practice of symphysiotomy in Ireland. The report was conducted in two stages. The first stage is an independent academic research report, which is based on an analysis of published medical reports and research. The draft report contains information about how frequently symphysiotomy was carried out in Ireland and compares rates with other countries. The researcher experienced unforeseen difficulties in accessing information sources and, as a result, submitted the first stage of the report behind schedule in late January 2012. The researcher informed my Department that this was due primarily to the challenges with accessing historical data from a time when records on the procedure were not routinely kept.
The second stage in the research process involved a consultation process on the draft report involving patient groups, health professionals and, in particular, the women who have undergone symphysiotomy. The researcher is currently finalising the report based on the consultation and it is also planned to have a peer review process. It is hoped the report will be published early in 2013.
Is the Minister aware of a number of inaccuracies and misleading findings in the draft report? For example, there is a suggestion that symphysiotomy was used only in emergencies, which is untrue. There is also a suggestion that symphysiotomy was safer than Caesarian section in the 1940s and 1950s, which is also wrong, and that doctors are not and were not legally required to obtain the patient's consent to medical treatment. Like other statements in the report, it is nonsense. Does the Minister know the vast majority of survivors of symphysiotomy refuse to co-operate with the so-called consultation process run by the Department of Health on the Walsh report? Like the Finucane family in response to the de Silva report, they see it as a whitewash. Will the Minister not do the decent thing by jettisoning the discredited report on yet another sorry chapter of institutional abuse in Ireland and set up a commission of inquiry so that survivors in their 70s and 80s can finally access the truth and justice?
The Deputy has made some statements. The idea that content is not necessary for procedure is nonsense. Whether we are comparing the practices of today and the practices of 50 and 60 years ago is an issue and a difficulty. Through the report, we seek to find justice and closure for the people who suffered at the hands of doctors who performed these utterly unnecessary procedures. The idea of symphysiotomy performed on the way out, when the child has already been delivered, is outrageous. I would like to allow the report to be finalised and consultation to take place so that we can come back with a solution that can bring closure on the issue for the women who have suffered as a consequence.
The Minister indicated some time early in the new year. On receipt of the report, I presume the Minister will publish it so that we have the opportunity to examine its content. Whatever the final Walsh report contains, there is an onus and responsibility on all political voices to listen to the demands of the victims of what I have always seen as a barbarous procedure, a view the Minister has disputed. I refer also to the victims of the related procedure pubiotomy. We must listen to their appeals across a number of different processes of resolution. The choice should be given to the women. It is an ever-reducing number. Since the last time we addressed the issue in the Chamber, I know of a small number of victims who have passed on from this life. That will continue to be the case. This is the last opportunity to engage the Minister before the end of the year and I ask him to commit to providing a choice. There will be those who are happy to accept some form of redress but many others want the opportunity of a court process as they feel only that process will enable them to fully vindicate their right to the truth and justice. In order to facilitate a significant number of them, the suspension of the Statute of Limitations, in particular for that cohort of victims, is required. I ask the Minister to reflect on that and keep an open mind on it even though I do not expect a response this afternoon. Hopefully, in early 2013, he will provide a choice for the ever reducing number of very unfortunate people.
Deputies on all sides of the House are agreed that this issue must be resolved. The Deputy alluded to removing the Statute of Limitations, but the Attorney General's view on that is clear. It would have serious consequences for the Government in a range of areas beyond this issue.
We need to resolve this matter. I hope the report will help in that regard. I agree that it should be published on its completion and when we have had time to digest it. I do not intend to delay. I am aware that many of these ladies are getting on in years and would like closure of the issue. That is what I seek to bring. We will have to find a way to do that, notwithstanding the tight financial constraints on the Government at present.
May I correct a mistake I made when discussing an earlier question. I meant to say "inquest" rather than "inquiry". That is why the Minister may have been surprised by my question.
With regard to symphysiotomy, I agree with Deputy Ó Caoláin that time is running out for many of these people. The authorities in the United Kingdom have announced a new police investigation into the Hillsborough disaster, which happened 23 years ago. The Minister might follow that example with a symphysiotomy inquiry. It would not go astray.
I accept the Minister's point that concern at this matter is shared across the board in the Chamber. I acknowledge the commitment of members of both Government parties in regard to the all-party group. Their contribution and their commitment to resolving this issue is unquestioned.
I ask the Minister to accept, whatever legal advices might be presented, that there is equal and, arguably, longer standing eminent legal advice that gives a very different view. It would be a tragedy if a particular legal interpretation caused any of these women to be denied what is theirs, by right. Surely this is something we can, collectively, aspire to achieve and deliver as early in 2013 as possible. I hope the Minister will give every favourable consideration to that appeal.
An all-party motion on this issue has already been discussed in the House. There is unanimity among Government and Opposition parties that some way of giving redress to these women should be brought forward.
I urge the that the report be published as soon as possible and that a redress mechanism be put in place. The stories of the women are chilling, harrowing and emotive, but time is not on the side of many of them.
I accept that the Government is obliged to take the advice of the Attorney General into account but we must find a mechanism that addresses the suffering of the women concerned and allows them to share their stories with dignity and respect and seek redress.
I assure the Deputies and the ladies concerned that there are difficulties, as I have outlined, but that where there is a will there is a way. I am determined to find that way.
Medicinal Products Expenditure
Peadar Tóibín
Question:8. Deputy Peadar Tóibín asked the Minister for Health the steps he is taking to secure reductions in the current cost of generic equivalents, which are high by international comparisons; and if he will make a statement on the matter. [57029/12]
The prices of drugs vary between countries for a number of reasons, including different prices set by manufacturers, different wholesale and pharmacy mark-ups, different dispensing fees and different rates of VAT. In recent years, a number of changes to the pricing and reimbursement system have been successfully introduced in Ireland. These have resulted in reductions in the prices of thousands of medicines.
The Department and the HSE have successfully finalised discussions with the Association of Pharmaceutical Manufacturers in Ireland, APMI, which represents the generic industry, on a new agreement to deliver further savings in the cost of generic drugs. Under this agreement, from 1 November 2012 the HSE will only reimburse generic products which have been priced at 50% or less of the initial price of an originator medicine. In the event that an originator medicine is priced at less than 50% of its initial price the HSE will require a generic price to be priced below the originator price. This represents a significant structural change in generic drug pricing and should lead to an increase in the generic prescribing rate.
In addition, the Health (Pricing and Supply of Medical Goods) Bill 2012, which is currently before the House and Second Stage of which was completed this week, provides for the introduction of a system of generic substitution and reference pricing for prescribed drugs and medicines. These reforms will promote price competition among suppliers and ensure that lower prices are paid for these medicines, resulting in further savings for taxpayers and patients.
When does the Minister of State expect the arrangement he has outlined to take effect? Some generic substitutions are costing between 96% and 98% of the originator medicine, which is a very marginal saving and defeats the purpose of replacement and of whatever savings can be accrued from it. Can the Minister outline the action being taken to give effect to the commitment he has outlined?
Second Stage of the Health (Pricing and Supply of Medical Goods) Bill was debated on Monday of this week. There is some concern that the same sense of urgency does not seem to apply to it as to other Bills. A raft of legislation is being rushed through in these last days before the Christmas recess. Would this Bill not have required being moved to Committee, Report and Final Stages much more quickly? How soon will we have the opportunity to address the Bill on Committee Stage?
The Deputy's two questions are one. The generic substitution regime is to be governed by the legislation to which the Deputy referred. The legislation itself does not purport to arrange these substitutions. It gives the Irish Medicines Board the power to do so and the regime is set out in the legislation. The legislation is required for that to be achieved, as the Deputy is aware.
Second Stage of the Bill was completed on Monday afternoon and the Dáil has referred it to the Select Committee on Health. It is my earnest wish, and that of the Minister, that the Bill be expedited as soon as possible. There is no wish for any delay in the passage of the legislation. The contrary is the case. I regard it as a priority. There is, however, an enormous volume of legislation in the system at present, including legislation in the area of health. There have been difficulties in expediting different Bills.
I hope I say this without over-extending the point. We were fortunate that we had time available on Monday, because the House was sitting to deal with other matters, and we were able to get the Bill in on Monday afternoon. The quicker this can be done the better, from our point of view. There are four health Bills in the Houses currently. This is very important legislation, for the reasons I outlined in my reply and which Deputy Ó Caoláin supports, as he did on Second Stage. Anything we can do together to get the Bill through the Houses quickly will be in all our interests.
I recommit to offer every support for the fast-tracking of this Bill which I, of course, support. We should use this opportunity to consider ideas to improve the legislation. That is how we should approach legislation, as opposition voices. If we are not opposed to a measure our amendments are intent on improving it, where possible. We should use the intervening period before the resumption of the Houses in the new year, to prepare any possible amendments that might present so as to be able to expedite the passage of the Bill.
I would welcome a situation that mirrored what the Minister of State indicated in his opening response
That is a position we would like to get to. It cannot happen soon enough in my opinion.
We have also offered support in terms of the Health (Pricing and Supply of Medical Goods) Bill and will try to encourage the committee to move as quickly as possible with that. Equally, however, it is legislation that needs to be critically analysed on Committee Stage.
There was some price referencing between Ireland and New Zealand that showed huge disparities in the cost of drugs. Even with the legislation, we are still completely out of kilter with the norms for pricing of ordinary medicines, the everyday drugs that are issued on prescription and this clearly cannot be sustained. The Bill will deal with aspects of that but there are other inherent difficulties in the system that lead to increased costs for medicines for individuals and the State through the reimbursement scheme.
There has been considerable progress in the broader area. On the question of the agreements with the industry, savings have been made, although not as quickly as all of us would have hoped. The agreements have been put in place and will yield considerable benefits to the taxpayer and patients in the year ahead. I thank Deputies Kelleher and Ó Caoláin and the other Deputies who have supported the rationale behind this legislation, which is finally getting a grip on this issue at a level of legislation, putting in place a system where we can make happen what people had been talking about for so long.
Ambulance Service Provision
Pearse Doherty
Question:9. Deputy Pearse Doherty asked the Minister for Health if enhanced ambulance and paramedic services will be made available in County Donegal; and if he will make a statement on the matter. [57017/12]
Emergency ambulances from all stations across Donegal are used in a dynamic manner, to maintain emergency cover and respond to calls as required. Ambulance stations across the county and adjacent counties support each other, and the nearest available resource responds to an emergency call, regardless of where it is based. I would be the first to acknowledge the geographical spread in County Donegal.
The National Ambulance Service has enhanced the delivery of ambulance services in the north west through the recent introduction of a new intermediate care service in Sligo and Letterkenny. The purpose of the ICS is to undertake routine and non-emergency stretcher-based patient transport, such as inter-hospital transfers, in order to free up emergency resources for emergency calls. Once again, we are back to the patient being treated by the right person in the right place at the right time, which carries for ambulance services as well. This service will be fully operational in early 2013 with 19 intermediate care operatives. At the moment it operates in a limited number of areas, which includes Letterkenny. The NAS is also assisted in the west by a pilot emergency aeromedical service which was established in June 2012 and which is based in Custume Barracks, Athlone. This dedicated resource provides emergency transport where transport time is critical and where certain clinical criteria are fulfilled. I have had discussions with Minister Edwin Poots, MLA, in the North on how we can co-operate on air ambulance services as well and in community services on either side of the Border, and hospital services. Radiotherapy services in Altnagelvin are a case in point.
The ambulance service is also progressing training of additional advanced paramedics and a number of staff from the north west, including Donegal, are included in this programme.
In addition to the above, a paramedic upskilling programme is currently being progressed across the country, which will enhance the delivery of care to patients.
My attention has been drawn to a report in the Donegal Democrat of Monday, 26 November. This referred to a situation where a distraught mother had to drive her unconscious child to hospital while a paramedic tended to the child in the back seat of the car. If this was an isolated incident, it might not have been raised in this way, but I am told there are other reported instances where ambulances have been told only one paramedic was available to both drive and tend. With the child needing to be attended to and brought to Letterkenny General Hospital, the paramedic could not drive the ambulance. The situation is serious and I am drawing it to the Minister's attention because there is a fault line. That is not to question the role of individual ambulance drivers and-or paramedics but certainly it is to question the decision making of those who oversee the service or who have issued governance rules to those entrusted with that oversight.
We were told by the article, and inquiries I have made on the back of it, that the paramedic in this instance sought additional support through the channels he would report to and people were available with the necessary skills, other paramedics and ambulances drivers, but permission to engage those available professionally trained personnel was refused. This is a serious matter and was of significant concern to the paramedic concerned and to his fellow professionals in the ambulance service in Donegal. I ask the Minister what steps he will take to assure the people of Donegal that a situation such as that described in the Donegal Democrat article will not reoccur.
This is a serious matter and I intend to have it investigated. It makes no sense to me that an ambulance driver would go out on his or her own and the paramedic would therefore be unavailable. Given the choice between driving or caring for the patient, it does not make any sense. I went around the country and met the staff, including ambulance staff, in the regions about the future plans for the health service. One of the paramedics raised an issue with me that I intend to address. Sometimes these very experienced individuals are sent to a house and when they arrive, having examined the patient, they see no reason to bring him or her to hospital but they have no other option. They cannot bring the patient to the out of hours doctor on call, or advise them to wait until the follow morning to see his GP. I believe, however, that should be the case; these are highly qualified individuals.
That is not quite what the Deputy is talking about but what I am trying to say is we have a wonderful resource here and we should allow paramedics to give of the knowledge they have in a complete fashion and not just corral them into narrow spaces. I undertake to investigate this and come back to the Deputy with a report. To my mind, this was utterly unacceptable.
Written Answers follow Adjournment.