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Dáil Éireann debate -
Wednesday, 15 Jan 2014

Vol. 826 No. 1

Topical Issue Debate

Water Charges Introduction

I thank the Leas-Cheann Comhairle for allowing me to raise this important matter on the first Topical Issue debate on 2014. This is a very important topic, particularly in light of the negative attention Irish Water has attracted in recent days. I hope the Minister of State will be very explicit when replying to what I have to say.

Ireland is to start charging for domestic water usage and, in that context, a new system of charges is to be introduced for all homes that are connected to a public water supply. The new charge will be levied by Irish Water, which is the new national water services authority, with the first bills for domestic water usage to be issued in 2015. I am of the view that when new national charges are levied on taxpayers, a one-size-fits-all approach cannot be adopted because we are all different and each of our personal circumstances must be taken into account, particularly during the current economic downturn. In these circumstances, there is an affordability factor which must be taken into consideration. The Minister for the Environment, Community and Local Government must impress upon Irish Water that this factor must be taken into account before the charges are calculated. There should be an investigation into the concept of affordability because the introduction of these new charges, combined with other charges and taxes, will undoubtedly give rise to problems for some people. I refer, for example, to those who are on very low incomes or who are in receipt of social welfare benefits.

I am of the view that Irish Water could introduce a free personal allowance scheme for every individual who is liable to pay water charges. Under this scheme, a ceiling level of usage would be put in place and people who do not exceed this would not be liable for any payment. Not only would this be fair and equitable, it would also promote smarter usage of water. The latter is a valuable resource that we often take for granted. A scheme such as that to which I refer would also restore a certain level of control to users. As a result, they could control the amount of water they use and they would not incur any cost until they exceeded their personal free allowances.

According to a study compiled on behalf of Irish Water, the average Irish family uses up to two full bathtubs of water - approximately 150 litres - each day. Most of this is simply wasted by being poured down the drain after use. Some 80% of the people surveyed for the study did not realise the amount of water that they use. An average shower uses approximately 50 litres of water, cleaning one's teeth wastes in the region of six litres every minute and one cycle of a washing machine involves the use of up to 65 litres. This all adds up for the average family of two adults and two children, particularly in circumstances where the children are under a certain age. Put simply, Irish Water estimates that the cost of providing and maintaining water for Ireland runs to approximately €1.2 billion per year. In view of that level of consumption and cost, large families must be granted allowances in order to assist them in meeting their obligations.

I request that the Minister for the Environment, Community and Local Government not only take the suggestions I have made on board but also that he take steps to include an amendment to the Act in respect of this matter in order that what I am recommending be enshrined in law. It is not good enough to state that this is something we would like to include; it must be enshrined in legislation in order that it will work. The only way it will work will be if it is written into law. I look forward to the Minister of State's reply.

Ba mhaith liom athbhliain faoi shonas a ghuí ar gach duine sa Teach.

I am replying on behalf of the Minister, Deputy Phil Hogan, who is currently dealing with legislation in the Seanad. I convey his apologies to the House.

The programme for Government contains a commitment to the introduction of water charges based on usage above a free allowance. The Government considers that charging based on usage is the fairest way to charge for water and it has decided that water meters should be installed in households connected to public water supplies. The introduction of water charges for all users will create a sustainable funding model for the delivery of water services.

The Government has decided to assign responsibility for the economic regulation of the water sector, including the setting of water charges, to the Commission for Energy Regulation. The primary role of the regulator will be to protect the interests of customers and to ensure a consistent and appropriate level of service is provided to them.

I am confident the Commission for Energy Regulation, with its reputation for independence and rigorous oversight of utilities, will protect the interests of domestic and non-domestic customers. An appropriate approach to charging customers will be put in place by the regulator and a public consultation will take place later this year as part of the regulatory process. Households will be informed of the level of charges well in advance of their introduction. No decision has been taken yet on the free allowance. This will be a matter for consideration by the Government and will be reflected in the charging structure put in place by the regulator.

An interdepartmental working group has been established to advise the Government on the appropriate method for addressing water poverty and water affordability issues which, as Deputy Ann Phelan pointed out, may arise with the introduction of domestic water charges. The group will examine the issues arising with regard to the free allowance, affordability issues and specific medical conditions which require high water usage. Supported by the ESRI, the group is seeking to identify the key groups which may be significantly impacted upon by the introduction of water charges.

The group comprises officials from the Department of the Environment, Community and Local Government, the Department of the Taoiseach and the Departments of Social Protection, Finance and Public Expenditure and Reform. The group is to prepare a report for consideration by the Government to enable decisions on the proposed approach to be taken in advance of proposed public consultation by the Commission for Energy Regulation during 2014 on the design of domestic water tariffs.

I thank the Minister of State for the comprehensive reply. As public representatives we must be included in the consultation process and lay people must also be included so their voices are heard. Most in this House will be able to afford the water charges better than many people. However, I am very conscious that households must be listened to, in particular those households with elderly people and young children.

Irish Water should take responsibility for setting up an education programme to encourage people not to waste water in the way that I have outlined and which has been the practice in this country for many years. Only now we are beginning to appreciate that water is a vital resource and to appreciate its importance for our health and wellbeing.

We should encourage water harvesting and the retention of water for secondary uses. Opportunities were missed during the Celtic tiger years when the planning guidelines should have included the provision that every house should have its own water harvesting mechanism. This missed opportunity is another lesson we have learned from the past. I have taken note of the Minister of State's reply and I hope to be able to contribute to the consultation process.

I thank Deputy Ann Phelan for her comments which are very important. She is absolutely correct that a consultation process which includes listening to people and making them aware of the issues is the only way forward. This is our job for the next year. The Commission for Energy Regulation will undertake the consultation process but Members will be fully engaged in it. I can assure the Deputy that we will debate the proposed regimes in the House and people will be able to contribute to the process.

I fully support the Deputy's comments about a campaign to educate and inform the public on how water usage can be reduced and water used more efficiently in households. I have raised the issue of a campaign with Irish Water on many occasions. The benchmark for such a campaign is the Government's Race Against Waste campaign which transformed the way people dealt with their domestic waste. That campaign was extremely important in informing and educating people and it helped to change attitudes. I am assured that the scale and the import of the communication campaign will be at that level and that every household will be supported in this regard. The Deputy is correct that simple actions make the difference.

I refer to the point about the inclusion in the planning guidelines of water harvesting facilities being installed in new houses. I believe it can be difficult to retrofit some existing houses. I will discuss this matter with the Deputy at the committee. I agree that people must be given the information so they understand what is being proposed.

Industrial Disputes

I wish to raise the matter of decisions taken overnight with regard to the Liebherr plant in Killarney, the result of the ballot and the ongoing publicity. We must ensure that wise heads and wise counsel are brought to bear in this long-running dispute. The Liebherr plant was established in Killarney in the late 1950s and it has been one of the best employers in the south west. Many people in Kerry and in my part of County Cork have benefited to a great degree.

SIPTU represents approximately half the workforce and a ballot has been held. I suggest that a hands-on approach is required from the Minister for Jobs, Enterprise and Innovation. Wise counsel and wise heads need to be brought together. The Government needs to intervene immediately in this ongoing industrial dispute in order to effect a resolution. Such a resolution is essential for the employees, for the region and for Liebherr Container Cranes in Killarney which is continuing to operate. The company has been an excellent employer since the late 1950s.

I ask the Minister and the Government to intervene immediately in this ongoing industrial dispute and to resolve it. This dispute is serving neither the south west, the town of Killarney nor the workers and the employer.

I thank the Deputy for raising this matter and I share his concerns about the potential risk to jobs in Killarney as a result of this situation. Liebherr is a major international company which was established in 1958 and which employs 670 people in Killarney and a total of 39,000 worldwide.

In addition, it has two hotels employing 200 people. It is estimated that 500 additional local jobs are dependent on the company through supplies services and so on. It is no doubt a very important contributor not only to the Kerry economy but nationally. It has a turnover of €250 million and has been increasing employment in recent years. It is in a key sector exporting cranes globally. Its payroll is €40 million and €30 million is paid to local contractors. It has been investing in the plant - €30 million in the past three years - and has further investment planned in the future. It has put money into the defined benefit pension scheme and has shown very real commitment to the economy.

It is remarkable at a time of heavy losses in manufacturing which have, unfortunately, been a feature of our manufacturing sector, that Liebherr continues to grow. While that trend has, thankfully, reversed in manufacturing through our manufacturing strategy, we are seeking to build the manufacturing sector again. None the less, Liebherr is a shining example of what can be achieved. It is a high-quality, cutting edge manufacturing plant.

The company has been successful in attracting new orders but it has emphasised over time that it faces global competition. Against this backdrop, it has pointed out that wage levels face a competitive threat with much lower wages in Asia. It also needs to be borne in mind that this company has many plants in other locations and, as has been publicly stated, the company has transferred production of certain parts of its work previously undertaken in Killarney to a plant in Germany. This is clearly a worrying development.

Unfortunately, this plant has had a poor industrial relations record in recent times, unlike the industrial relations landscape generally, and it has impacted. The present dispute relates to a pay increase of 2.5% agreed under the Towards 2016 pay agreement. The company paid phases one and two of the agreement, but with the economic downturn which started in 2008, it felt that given the economic circumstances, it was not in a position to pay the final phase of the agreement.

The dispute around this pay increase has been ongoing for some time and has involved the full range of State industrial relations machinery and independent facilitators. The Labour Court recommendation of late December recommended a 2.5% pay increase to be given to the staff backdated to May 2012 and subject to the union engaging with management on issues regarding ongoing change, work practices, etc. Liebherr management ultimately accepted this recommendation.

Last evening, as the Deputy indicated, SIPTU members, who account for 270 workers out of the total workforce of more than 650, voted to reject the Labour Court recommendation. There is no question that this latest development represents a serious challenge for all involved, with potentially serious outcomes for the company, the workforce and the surrounding area. I urge all parties to take time to reflect and assess the implications of the ballot result and to engage in dialogue, through the appropriate channels, to seek to achieve a long-term and permanent resolution to the problem. The importance of such engagement cannot be overstated.

The Labour Relations Commission will remain in contact with both parties. We have a world class, high-technology operation in Killarney which exports its products to all corners of the globe. We need to maintain and, one hopes, expand and embed its operations in this country. We need to maintain such manufacturing operations in this country as they illustrate our industrial capacity. They pave the way for the future investment in these sectors and the development of indigenous spin-off business. Our economic recovery depends on vibrant success stories like Liebherr and I strongly urge all parties involved to consider the full implications of the difficulties which have developed recently.

I thank the Minister for the reply. I think he stated the obvious. Has the Department or the Minister made any contact with the company or SIPTU today to ensure wise heads prevail and that there is a resolution to this issue? This is a fundamental issue to the people of the south west and for Ireland Inc. Has the Labour Relations Commission been in contact? The Government needs to ensure every aspect of the State's industrial relations machinery is employed to resolve this issue because there is far too much at stake for the region.

The Minister outlined the benefits which accrue to the Irish economy, so this is a very serious issue. If the shoe was on the other foot and if it was a case of this company thinking about coming to Ireland, the red carpet would be rolled out. We need to ensure we keep this company, we keep the employees working there and we keep the huge spin-off to the south west, the Killarney economy and to my region across the county boundary. Has the Government or the Department made any contact with the two parties today to try to resolve this issue once and for all?

As I indicated in my reply, this is an industrial dispute and, of course, my Department, through the IDA, is in daily contact with the company. The services of the Labour Court and the Labour Relations Commission are available to the parties at all times, which are also provided through my Department. We have a well-established voluntary system of industrial relations. It is important to maintain the independence of that operation.

We have learned over many years that ministerial intervention in disputes could serve to politicise them. We need to allow those with professional experience in the Labour Relations Commission and the Labour Court to work with the parties to find a solution. That is the approach I urge both sides to take. There needs to be a time for reflection following this decision and, as the Deputy urged, for careful consideration of the potential implications as people consider how we can move to resolve this dispute. As I indicated, the services of the agencies under my Department are fully available to the parties to assist in any way they can to resolve the dispute. The stakes are undoubtedly very grave and I urge people to take up those offers.

Primary Care Centre Provision

I thank the Office of the Ceann Comhairle for selecting this very important issue which relates to the health centre in Gort in south Galway. I was invited to visit this health centre some weeks before Christmas by a number of patients using the facility. Before I visited the centre, they had told me about the facilities which they felt were completely inadequate.

As I said, I took the opportunity to visit the health centre some weeks before Christmas and found the building in quite a deplorable state. It is a building more from 1914 than a building suitable for 2014. The rooms in it are much too small and are completely inadequate. It simply cannot provide the level of care it aims to provide to the people for whom it aims to provide such care. The staff are located in a small corner of the building and they do not even have a proper filing system. Given the Government is trying to direct more people towards the primary care system, this is certainly not an advertisement for it.

The Gort health centre needs considerable upgrading. I understand Gort was on the list for primary care centres. Where was it on that list and why was it not selected? I do not know about all the centres throughout the country but this one should have been selected because it is in desperate need of upgrading.

There is a room available in the centre which was used by the Department of Social Protection. It has since left the centre to go to new offices in Loughrea in County Galway. If that facility was handed over by the Department of Social Protection to the HSE, it could kit out that room as a sort of stop-gap measure at least to facilitate the staff and give them a proper office to work in. It might even allow for an extra room where the staff could treat the patients who use the service.

I would like answers to some of these questions. It is unacceptable that there is not a new primary care centre at this stage because the health centre is in a deplorable state. The facilities there need to be upgraded as soon as possible. It is simply not adequate for the people of Gort and south Galway who use it.

I thank the Deputy for raising this issue. The programme for Government sets out the Government's commitment to ensuring a better and more efficient health system - a single-tier health service that will deliver equal access to health care based on need and not on income.

In a developed primary care system, up to 95% of people's day-to-day health and social care needs can be met in the primary care setting. The key objective of the primary care strategy is to develop services in the community which will give people direct access to integrated multidisciplinary teams of general practitioners, nurses, physiotherapists, occupational therapists and workers in other health care disciplines. This is central to this Government's objective to deliver a high-quality, integrated and cost-effective health system.

A modern and well-equipped primary care infrastructure is central to the effective functioning of primary care teams. These teams enable multidisciplinary services to be delivered on a single site, provide a single point of access for users and encourage closer co-ordination between health providers. The development of infrastructure through a combination of public and private investment will facilitate the delivery of multidisciplinary primary health care. It represents a tangible refocusing of the health service to deliver care in the most appropriate and lowest cost setting. The intention to date has been that where appropriate, infrastructure will be provided by the private sector through negotiated lease agreements, and where service needs dictate, accommodation will be provided in primary care centres for mental health service delivery.

The HSE embarked on a prioritisation exercise for primary care centres in 2012. This dynamic exercise is constantly evolving to take account of changing circumstances, including the feasibility of implementation. It is the Government's intention to develop as many primary care centres as possible using one of the following methods: direct build by the HSE, leasing arrangements with the private sector or public private partnership. Considerable progress has been made in the delivery of primary care centres. Some 34 centres have opened since March 2011. Gort was one of the 35 potential locations for primary care centres to be developed by means of public private partnership projects, as announced in the July 2012 infrastructure stimulus package. Due to a lack of GP interest, however, this location is not progressing at this time. The HSE is exploring alternative options for this location. I am sure the matter can be revisited if the Deputy finds that the level of interest has increased.

I thank the Minister of State for coming to the House to respond to what I said. I understand she is not responsible for this particular area. It seems that this is a question of GP interest. If more interest can be found, can the people of Gort take it that the possibility of bringing a primary care centre to the town could be revisited very quickly? If that happens, what timeline would we be looking at? How could we go about doing that from now on? I know the people who use the service are very eager to see the facilities upgraded as much as possible. All of the services mentioned by the Minister of State should be provided in primary care centres, but that cannot be done in Gort at the moment because the facilities do not allow that to happen. The people of Gort and south Galway want a proper primary care centre to be developed in the town. Can the Minister of State set out the timeline that would apply to increasing the level of interest? How should we go about doing that? How long would it take to get a decision on the matter? Perhaps the Minister of State might bring the other issue I mentioned back to the Minister for Social Protection. I refer to the question of whether the room that is currently available in the health centre could be freed up. At least that would provide additional office space in advance of the delivery of a primary care centre for Gort.

While I might have some chance of having some influence in the Department of Health, I am not certain that I can extend my influence to the Department of Social Protection. Nevertheless, I will make sure the Deputy's contribution will reach the desk of the Minister for Social Protection. My experience of how primary care is developed is that the HSE writes to all the GPs in an area to ask if they are interested in participating in a collaborative primary care project. It is only when there is a sufficient level of buy-in that anything can be progressed. If enough people were to express interest in this process, I am sure the HSE would be happy to re-engage in trying to put a properly functioning primary care centre in place. It is essential for such primary care infrastructure to be available in areas where there is a significant distance between the population and the nearest general or local hospital. These services need to be provided as close as possible to where people live. We will ask the GPs whether there is renewed interest. If there is, I am sure the necessary negotiations can happen as quickly as possible.

Ambulance Service Response Times

Gabhaim buíochas le oifig an Cheann Comhairle as ucht seans a thabhairt dom caint faoi bhás Wayne McQuillan. I want to extend my condolences and sympathies to the family of Wayne McQuillan, who was stabbed in Drogheda in the early hours of New Year's Day. I am conscious that the raising of this issue could cause further trauma and grief for them. That is certainly not my intention. According to the National Ambulance Service, the nearest available ambulance to respond to this incident was in Ardee. The service has suggested that it took 21 minutes for the ambulance to arrive at the scene. This falls outside the target set in the 2014 national service plan. By the time the ambulance arrived, the Garda had decided to move Mr. McQuillan to Our Lady of Lourdes Hospital, where he died, regrettably. The actual time between the receipt of the first call and arrival on the scene of the ambulance after its dispatch was 25 minutes. I understand that an ambulance was available at Our Lady of Lourdes Hospital on the morning of New Year's Day, but it was not dispatched. Is this true?

There was another serious incident on Monday of this week when a woman collapsed on West Street in Drogheda. Earlier that day, the Drogheda ambulance had been despatched to Navan even though a local crew was available in Navan. That was in addition to a second crew in Dunshaughlin and an emergency response vehicle in Navan. Why was the Drogheda crew dispatched there? As a consequence of that decision, the ambulance had to travel back to Drogheda to deal with this incident. This took more than 30 minutes. These difficulties are not the fault of the ambulance staff or the emergency services. First responders are deeply frustrated about being expected to work in these conditions.

I welcome the HIQA investigation into the circumstances surrounding the death of Wayne McQuillan. An investigation of the resourcing, structure and management systems in this area is also needed. We must ensure this investigation is carried out in consultation with front-line staff, including those who provide ambulance services.

Maura Porter from Carndonagh was unfortunately the victim of a road traffic accident on the day before New Year's Eve. An ambulance was called to come to her support after she suffered severe injuries in the accident. It took almost an hour for an ambulance to come to Carndonagh, unfortunately, because it had to be dispatched from Letterkenny. No ambulance based in the local ambulance station in Carndonagh and no local crew members were available at that point in time. Maura Porter's family - her husband, Neil; her son, Brendan; and her daughter, Davina - had to kneel with her while they endured a wait of almost an hour for ambulances to arrive. Local doctors came to the scene, but Maura needed to get to hospital quickly. She died after she got to the hospital, unfortunately. Her family will never know whether it would have made a difference - whether her life could have been saved - if the ambulance service had arrived on time. They are calling for a full investigation of what exactly happened in this incident and for a full review of ambulance services in County Donegal. Such a review is needed in other parts of the country as well.

A full review of the service is needed to ensure ambulances are available when they are needed. It is the wish of the Porter family that no other family will ever have to go through what it experienced on the Monday night in question. I ask for the Minister of State to respond to this request by giving the House an assurance that an investigation will take place and that proper resources will be provided to ensure ambulances are available to respond when calls come in. The staff who do such Trojan work, and were so good when they arrived on the scene on the night of Maura's accident, should be given the support they need to respond to calls in the way that is expected and asked of them.

I am glad that Deputy McConalogue finished on the note he did because any of us who have been in receipt of the services that ambulance crews provide know that they are an exceptional group of people.

I thank Deputies Adams and McConalogue for raising these issues today. At the outset I express my sympathies to the families involved.

Regarding the response of the National Ambulance Service to the incident raised by Deputy Adams, the National Ambulance Service has reviewed the incident and has confirmed that at the time of the call, there was high call activity in the area. However, the National Ambulance Service is satisfied that the call was appropriately prioritised, using the advanced medical priority dispatch system, and that the closest available ambulance was tasked.

Regarding the incident raised by Deputy McConalogue, the National Ambulance Service is satisfied that the call was triaged correctly and that the nearest available resource was dispatched. However, the National Ambulance Service has now established an escalation process with Letterkenny General Hospital to ensure that ambulance control at Ballyshannon is informed early of any capacity or other challenges which might affect ambulance service delivery. This process will ensure that, where necessary, National Ambulance Service resources are diverted to other appropriate destinations to minimise impact on patients, the National Ambulance Service and the hospital.

In the interest of respecting the dignity and grief of the families concerned, of which both Deputies are conscious, I will make no further comment on these two incidents.

I draw the attention of the House to the very significant reform programme which is under way to reconfigure pre-hospital care services in Ireland. This reform programme will ensure a clinically driven, nationally co-ordinated system, supported by improved technology. Development funding of €3.6 million and 43 additional staff have been provided in the national service plan 2014.

A key measure in this programme is the national control centre reconfiguration project. The National Ambulance Service has operated in eight ambulance regions, with no interconnection of radio and computer systems. While this seems incredible, it is a fact. This has delayed improvements in emergency response times, particularly at regional boundaries where the nearest ambulance may be in the neighbouring region.

The control centre project is moving to one national centre on two sites, with significant investment in new voice, data and mapping technologies. This will allow the National Ambulance Service to deploy emergency resources more effectively and efficiently, regionally and nationally, rather than within small geographic areas. The national centre will be located in Tallaght and Ballyshannon, with the project expected to be completed next year.

In co-operation with staff, the National Ambulance Service is successfully moving from on-call rostering, where staff are off-site waiting to be summoned, to on-duty rostering, where paramedic crews are in their stations or vehicles during shifts. This leads to faster deployment as the crew is in position to respond immediately to calls, rather than the average on-call deployment of over 20 minutes. The on-duty system is now in place across most of the State.

A key performance issue has been the use of emergency ambulances for routine inter-hospital patient transfers. The National Ambulance Service is developing dedicated non-emergency patient transport, through the intermediate care service, for routine transfers. This frees up emergency resources for emergency tasks, improving response times and performance.

The National Ambulance Service will continue to modernise and reconfigure its services to ensure emergency pre-hospital care is delivered in an appropriate and timely manner.

I thank the Minister of State for her answer. She must be concerned that the amount of time it took the ambulance to get to where Wayne McQuillan had been stabbed falls outside the national service plan 2014 target. I entirely agree with the Minister of State about the sterling work done by paramedics, ambulance crews and front-line services. Like the Minister of State, I have had use of those services. However, since Wayne McQuillan died it has been revealed that the State has one paramedic for almost 4,000 citizens, whereas in the North and in Scotland there is one paramedic for every 1,500. There is something wrong there. Any investigation should also look at the resourcing structure and management systems of the ambulance service, particularly in the north east.

I thank the Minister of State for her response. She stated that Mrs. Maura Porter's case was triaged correctly and the nearest available resource was dispatched. It is clear that in this instance the nearest available resource was much too far away. Carndonagh ambulance station, which serves the Inishowen Peninsula, was less than half a mile from where Mrs. Porter's accident took place. We need to ensure that two ambulances are available so that if one is called away and a second call comes in, it is responded to immediately. We cannot allow such an incident to happen again. The national guidelines indicate that an ambulance has to be at a scene within 19 minutes, which is the target. In this particular incident it took almost an hour. I ask the Minister of State to give an assurance to the family that there will be a full investigation of what the situation was in this instance, that the service levels available are reviewed to ensure this cannot happen again, and that the proper resources are put in place.

The particular ambulance station I referred to is the third busiest in the north west after Sligo and Letterkenny. One ambulance based there is not enough. If the family has one wish it is that this be the last time that such an incident would happen. I ask the Minister of State to ensure there is a full investigation and a full review to ensure the resources are put in place. The public need to have confidence that this cannot happen again. The service level needs to be in place in order that this family can at least have the comfort of knowing that this will not happen to any other family.

I compliment both Deputies on the respectful way this issue has been dealt with. While the assurances any Government might give might be some small comfort, it is not a great comfort for people who lose a loved one. I cannot guarantee Deputy McConalogue that there will be a full investigation. However, whenever there is a critical incident it is fully investigated. In this unfortunate episode, two people lost their lives.

The National Ambulance Service is undergoing major reform. Isolated areas will be greatly helped by the process of hospitals contacting the National Ambulance Service base, one of which will be in Ballyshannon which is not too far away from the area we are discussing. If there is, for instance, a high alert or a high call-out rate, the National Ambulance Service will know that that is in effect. It will be able to make provision to ensure there is a backup service available. That will have a significant impact.

Both incidents, as critical incidents, will be fully investigated. As Deputy McConalogue pointed out at the end, the only thing that families can seriously request is that in the event of some other family going through this, the response will be appropriate.