Dáil Éireann Debate, Wednesday - 20 March 2013
6. Deputy Denis Naughten asked the Minister for Health the progress that has been made in the Health Service Executive west region since the introduction of standardised ambulance response times; the steps being taken to improve ambulance response times in the region; the way that is to be evaluated following the non-implementation of Health Information Quality Authority standards; and if he will make a statement on the matter. [13683/13]
Amharc ar fhreagraEmergency response times vary significantly between regions, depending on, among other things, geography and the rural-urban mix. Despite the geographical diversity of the national ambulance service west region, improvements in emergency response times were achieved in 2012. I am informed by the national ambulance service that there has been an improvement in response times in the west from 2011 to 2012.
The national ambulance service has been addressing response times through a number of measures, including the intermediate care service, ICS, for non-emergency ambulance transport such as inter-hospital transfers, thus freeing emergency vehicles for emergency calls. Almost 40 ICS staff were appointed last year, with further resources to be deployed in 2013. Other measures include the trial emergency aeromedical service, EAS, which reduces transit times, particularly in the West, and allows emergency vehicles to remain within their regions, and the national control centre reconfiguration, with one national control system on two sites, in Tallaght and Ballyshannon, for improved dispatch and response times, with regional rather than local deployment and better use of first-responder schemes. These measures, together with more effective use of existing resources, for example with improved training and better deployment through more efficient rostering, will drive the improvement of response times in every region, including the west of Ireland. This will lead to better services and better outcomes when our citizens need these services.
I am disappointed that the Minister did not give more specific information on the provision of services in the west. As he is aware, response times in the west are some of the worst in the country. Difficulties include the wide geographical spread and the lack of adequate resources. The Minister's counterpart in Northern Ireland, the Minister for Health, Social Services and Public Safety, Mr. Edwin Poots, MLA, said that 90% of people in Northern Ireland who suffer a heart attack outside hospital die. Does the Minister believe that the figures are similar here? I ask him to respond to the comments of the coroner for south Mayo, Mr. John O'Dwyer, who said that it was physically impossible and totally unachievable for patients in Mayo to be in the catheterisation lab in Galway within 90 minutes. The same would apply to heart attack sufferers in County Roscommon, especially since the closure of the accident and emergency department there.
What steps are being taken to improve the ambulance service in the region and to deal with the lack of a catheterisation lab north of the line from Galway to Dublin?
With respect, I am not aware of the coroner's comments and I fail to see why a patient in Mayo would not be in a catheterisation lab in Galway within 90 minutes, particularly if he or she was being transported by air ambulance. I do not have the transit times from Mayo to Galway before me but we all know that outcomes are considerably improved for those who have an ST segment elevation myocardial infarction or STEMI if they are brought to a catheterisation centre, where a stent can be inserted.
Many improvements are being put in place, some of which I have enumerated. We will continue to review and upgrade the service to meet the needs of the people on an ongoing basis.
It is a pity the Minister did not answer the question I put to him. What mechanisms are now in place to monitor ambulance response times, in light of the fact that the Minister has now stated that he is not going to comply with the HIQA criteria? I am surprised that the Minister is not aware of the coroner's comments, not only because of the extensive media coverage given to them but because I tabled a parliamentary question on that specific issue. I am disappointed that something as prominent as this has not been brought to the Minister's attention.
On the west specifically, what is the situation regarding the use of existing resources? What are the plans, for example, for the ambulance base in Tuam that is lying idle because of a lack or resources and staff to man it? Where is the long-promised and long-planned ambulance base for the communities in west Roscommon?
I must reject out of hand what the Deputy has just said with regard to HIQA and non-compliance. Perhaps the Deputy will set out in writing an explanation of how he forms that opinion.
Will the Minister respond to the letter?
I have made it very clear that we now have the technology to monitor response times and that is being used. If the Deputy requires a more comprehensive answer, I will respond to him in writing.
What about the ambulance base?
In a previous reply to a parliamentary question on current national targets for ambulance response times, the Minister indicated that the targets were being abandoned and replaced with new criteria. Could we have an update on what is happening in that regard and the process being used? Does the Minister accept that with the loss of critical services at some of our smaller hospital sites, it was advised to dependent communities that services lost would be compensated by greatly improved state-of-the-art paramedic services? The reality is far from that, however, and there are many gaps in the service. Will the Minister comment on that?
Hear, hear.
The Deputy is alluding to the position in Mayo and there was an incident, which has been reviewed, with the issues addressed. I know there have been six ST elevation myocardial infarction transfers from Mayo General Hospital to Galway, with the procedure successfully carried out under protocol. I reassure people that there is a service that can be trusted and depended upon.
With regard to the more general comments from Deputy Ó Caoláin, there is ongoing review and monitoring. I am in contact with Mr. Edwin Poots on a regular basis with regard to cross-Border ambulance co-operation and air ambulance co-operation in particular.
Question No. 7 is in the name of Deputy Áine Collins.
A number of questions are being taken together.
There is a grouping of questions.
On a point of order, I object to the grouping. I have seen cynical exercises in this House. We have a case of-----
I am sorry-----
-----25 questions-----
The Deputy could listen to the answer. It is because this is good news. This always happens when there is good news.
Deputies-----
It is the Deputy's first time in here at this time. It is a cynical exercise the like of which I have not seen in years.
Deputies, please-----
The Deputy is a disgrace.
With the 25 questions tabled, we cannot ask questions-----
The Chair is on its feet.
There are 42 questions on waiting lists. I have seen it all.
The Deputy should resume his seat or leave the House.
It is an absolute disgrace.
The Deputy is a disgrace. Let the Minister answer.
Come on.
The Deputy should resume his seat.
Let the Minister answer.
I object.
I am sorry, Deputy-----
I object to this House being abused to the extent that there are 25-----
Deputy Kelleher-----
-----questions on MRSA being tabled-----
What about the rest of us who tabled questions?
I do not begrudge any Deputy tabling a question-----
The Deputy should resume his seat.
-----but these were tabled by the press office of the Department. It is a disgrace.
For the last time, Deputy-----
The Leas-Cheann Comhairle and everybody in the Chamber knows it is a disgrace.
The Deputy should resume his seat. We are proceeding with the questions.
Deputies are lined up. It is an absolute farce.
Please resume your seat.
I will not.
A Leas-Cheann Comhairle-----
If the Deputy does not resume his seat-----
On a point of order-----
-----I will suspend the House for five minutes.
-----there are 42 questions on waiting lists alone. It is a sham.
