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Seanad Éireann debate -
Wednesday, 24 Nov 2004

Vol. 178 No. 17

Ambulance Service.

I thank the Cathaoirleach for allowing me to raise this matter and the Minister of State, Deputy Brian Lenihan, for coming to the House. I have raised the need for an ambulance base and a primary care unit in Tuam on a number of occasions with the Department of Health and Children and the former Minister for Health and Children, Deputy Martin. On 31 May last, the former Minister told me in a letter that he understood that the Western Health Board was:

. . .developing proposals for the establishment of a number of additional [ambulance] stations in its functional area including the establishment of a station at Tuam. These capital proposals will be considered by my Department in conjunction with the Western Health Board and in the context of capital priorities to be progressed in line with overall funding resources available in 2004 and beyond.

The provision of ambulance bases at Tuam, Achill and north Roscommon have been the Western Health Board's main priorities for some time. The full package which was put together by the health board in October 2002 included an ambulance base, a primary care unit, a community hospital to replace the Bon Secours Hospital and child care, respite care and day care units.

It is right that the board considered the ambulance service as a priority, but no such service is available in Tuam at present. There are two ambulances in Galway, there is one ambulance in Loughrea and one ambulance is on call from Portiuncula Hospital in Ballinasloe. The lack of an ambulance based in Tuam is an important issue in north Galway, south Mayo and west Roscommon. There is a fine health campus in the town, on a seven acre site that the health board bought from the Bon Secours order. I give credit to the former Minister for Health and Children, Deputy Martin, who allocated funds for the health campus. Two years on, however, I would like to see some development on the campus.

I thank the Minister of State, Deputy Brian Lenihan, for coming to speak on this matter. He knows the relevant area of north Galway and west Roscommon well because his late father represented it in the Dáil. I assure him that this issue is of major concern. The people of the Tuam area want some part of the health campus to be developed. I hope the Minister of State can give me some information about developments in that regard.

I am glad Senator Kitt has raised this matter on the Adjournment. I am aware of his constant interest in the improvement of ambulance and medical services in Tuam and the surrounding area.

The Western Health Board's emergency and patient transport ambulance service provides a service to over 353,000 people. The emergency ambulance service is provided from ten stations throughout the board's catchment area. There has been a significant expansion of the service in the past four or five years. Ten additional crews have been put in place, the number of 24-hour bases has increased from three to five and the service's hours of operation have increased significantly across all bases. The board purchased six new high specification ambulances this year to ensure first class facilities for pre-hospital emergency care patients. Two new rapid response vehicles have been introduced as back-up to the new fleet. The board has improved facilities at ambulance stations in Ballina, Boyle, Clifden and Roscommon.

Improvements in service delivery have been facilitated by the use of development funds provided for that purpose to the board, which is continuing its development programme for the service. I understand that the board is developing proposals for the establishment of a number of additional ambulance stations in its functional area, including one at Tuam. The capital proposals will be considered by the Department of Health and Children and the Western Health Board in the context of capital priorities to be progressed in line with overall available funding resources.

I assure the House that the Government is fully committed to the development of the emergency ambulance service. A great deal has been achieved in that regard, but I recognise that much remains to be done. We need to maintain the progress that has been made and to continue the process of service development, so that effective pre-hospital emergency care is accessible to those who need it most, when and where it is required.

The primary care strategy document, Primary Care: A New Direction, outlines the Government's vision for the development of integrated multidisciplinary primary care teams and networks which will enable clients to access a broad range of services in their local communities. The strategy provides for the early establishment of initial primary care teams on the basis of the model described in it. The future widespread implementation of the model will draw on experience gained through the development and operation of the teams.

The Department of Health and Children sought proposals from the health boards in 2002 for the establishment of primary care teams, with a view to funding a number of projects. The Western Health Board made two such proposals. Following discussions between the Department and the board, approval was granted for the development of a primary care team at Erris in County Mayo. The board had proposed that a primary care team and network would cover the Tuam urban and rural areas. It had envisaged that the Tuam team would be based in a purpose-built facility at the proposed Tuam health campus on the site of the former Bon Secours Hospital. It was not possible to approve such a development, however, having regard to the scale and costs associated with the proposed Tuam primary care team.

The primary care strategy states that the development of primary care teams must involve the reorientation of existing staff and resources. The Department has asked the health boards to examine how existing primary and community care resources can best be reorganised to give effect to the application of the teamworking concept on a wider basis and to map out the locations to be served by primary care teams. When the Health Service Executive is operational, it will be responsible for building on the health board initiatives to mainstream the development of primary care teams as the core unit of service delivery. The strategy acknowledges that the provision of modern, well-equipped and accessible premises is central to the effective functioning of primary care teams. One of the Government's key objectives is to facilitate and encourage the development, where appropriate, of facilities in which the broad range of primary care services can be delivered. While the State may contribute towards such developments, it is intended to explore a range of different approaches to the financing and provision of such facilities because of the scale of what will be required.

The Western Health Board has indicated that the development of a new primary care centre in Tuam would constitute a regional priority. The board was unable to proceed with the development this year, however, in light of the resources available for capital development. The position will be reviewed again in 2005 under the capital investment framework, in the context of priorities for development under the care programme and overall capital funding availability.

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