Éamon Ó Cuív: Island evacuations rise, calls for ambulance funding

Thank you for your time, I'm going to show you a special guest, I'm going to show you a special guest. I'm going to show you a special guest. Evacuations from islands happen many times and they've always happened. And we've improved the ferry services, lifeboats there and some of the islands. And we also have the helicopter rescue service, which is hugely important in the islands. But what we also know is that the number of evacuations has grown very rapidly as mass tourism has come to the islands. And particularly with the growth of bike cars. And the islanders will tell you that a lot of people hire a bike on an island that haven't cycled for a long time. And unfortunately a fair number of them come off. And need to be taken off the island by boat or by helicopter or in some cases by plane to the mainland for treatment. Now the problem is nobody or very few will have an accident near the airstrip or near the pier. So they have to be brought from the place where they have an accident or in the case of somebody getting sick in a house, which happens as well. They have to be brought to the airstrip or to the pier. And with the exception of, I think, a Orang Moor in Donegal, an Inish Moor or Orang, as it's more correctly called, in the Arden Islands, there are no ambulances or vehicles for carrying patients on the other islands. Now it's interesting that the National Ambulance Service in 2023 sought funding to the multi-annual integrated urgent and emergency care delivery of CELTA, of CH01, CH West, PH and NAS, the NAS standing for National Ambulance Service process. Which was the only route they sought to getting funding, but no funding was received through this route. And the money is not only needed for the physical ambulances, but there's a huge amount of work that goes into governance and safety. The training that the islanders had got so that they would be able to handle patients according to the highest standards. But this requires investment, requires investment in the National Ambulance Service training college, operational staff who would work with the island volunteers and so on. So there's a huge amount of training to be done. Now it is a fact that in recent times, a new vehicle was put in Inish Moor or Orang, and another one in Orang Moor in Donegal. And this came out of National Ambulance Service resources. But the simple fact of the matter is that they don't have the resources, unless more resources are made available, to provide an equivalent service and the other inhabited offshore islands that need it. Now one thing I believe here that might resolve the problem somewhat would be, if there was match funding got from the Department of Rural and Community Development that also covers the islands. Because what I found was, when you provided match funding, all sorts of other funding became available. But one way or the other, this is needed. And it's only after something goes wrong, that people will say, why was this issue not attended to long ago? Go round mongah to Airdas, ocht seachtas iag. Thank you. Thank you. Go round mongah to Dr O'Keefe. On behalf of Minister Donnelly, I would like to thank Deputy O'Keefe for raising the very important issue of Ambulance Service provision on our islands for both residents and visitors. I'm here on behalf of Minister Donnelly. Unfortunately you couldn't be here with us tonight. As part of its planning for medical emergencies, the National Label Service, NES, has made significant investment in training and equipment for volunteers on our inhabited islands. Through the NASC Community Engagement Unit, training and support is provided to emergency first responders, EFR, on the islands, who provide an essential service to their communities. I am informed that five of the six islands located in the southwest now have community first responder, CFR groups, which include members who have been trained to both CFR and EFR levels. Furthermore, automated external defibrillator, AED, cabinets have been provided to all inhabited islands with year-round populations through both local funding and through funding by the NAS out-of-hospital cardiac arrest, OHCA strategy. Emergency medical support is provided to the islands by the Emergency Aeromedical Services, the AES, in the west, northwest, and by the publicly funded Helicopter Emergency Medical, HEMS, in the southwest. The Irish Coast Guard, IRCG, Search and Rescue Service also provide essential support to the offshore islands. They have made a number of volunteers active on Inishore, Arn, Inishmoor and Torra. These volunteers are available to support emergency responses, including the arrival and departure of the IRCG helicopters. On land ambulance services to the islands, I am informed that the National Ambulance Service, Government's existing resources, has supplied ambulances this year to both Inishmoor and Arn Vor. Concerning the other islands, the HSE as well as the NAS, continue to explore ways to hand services to our island communities. I understand, Deputy, that the one issue about supplying the ambulances is about making sure you have people on the islands who are trained to deal with the emergencies as well. According to the service provided by the NAS, more generally, I would take this opportunity to acknowledge the commitment of the NAS in delivering access to patient care across the country. Last year saw record levels of activity with nearly 400,000 emergency calls received. And activity to date this year is up around 11 percent on the same period in 2023. Despite this unprecedented increase in patient demand, National Ambulance response time performance this year has shown improvement over the same period in 2023. Government investment in NAS has also improved with NAS budget of over 247 million, representing an overall increase of some 30 percent or 60 million since 2020. This increase in investment has raised total NAS staffing at the end of August to 2,263, an overall growth in staff of 273 since 2020, of which approximately 2,100 are frontline facing patient care roles. In 2025, Government has committed to further increases in funding for the NAS and an additional 13 percent or 33 million next year, displaying this Government's continuous commitment to building further capacity in the NAS. Eight million of new development funding in 2025 will allow for a growth of 180 additional positions, including essential frontline paramedics, to build further capacity in the face of increasing patient demand. Finally, I wish to extend my thanks, obviously, and gratitude to the National Ambulance Service and the staff across the country for their commitment and dedication to patient care. Minister, one of the great frustrations of being a member of this House are the padded answers that tell you everything except what you need to know and address everything except what you addressed. What I asked was the urgent need to provide funding to the National Ambulance Service to enable them to provide ambulance services on offshore islands. This issue has been raised by the doctors who service the islands. It has been raised by the doctors, particularly with me, who services Clare Island, Turk and Inisbygil. And it has been raised with me by the doctors on the Arden Islands and the doctors that serve Inisbyafn. Now you haven't really addressed the answer because the reality is that if you take Inisbyafn where thousands of people go in every day during the summer, a lot of them are hired out bicycles and other people fall, trip and all sorts of things happen and when you have large, large numbers of people in a place like that, things are going to go wrong, as well as the islanders getting sick and having their own little mishaps or needing attention. Now here's my question to you, Minister, as Minister of the Department of Health. The person gets sick up a mile or two miles away and it doesn't matter how well trained you are, there's no vehicle to get them anywhere. And people are doing things, because they have to, that aren't according to standards. And it's leaving them in a vulnerable situation. Now there is a full time doctor, for example, an Inisir. So this training, which is great for having paramedics and so on, in that case you've actually got a qualified doctor and nurse on hand. And they do go to these patients. But they keep telling me, we've no physical way of getting them. In a safe way, in a way that we would not, in a way that is the only way we would accept on the mainland, with no way of getting somebody, for example, with broken bones or whatever, as far as either the helicopter service, the plane service, or the boat service as the Cape may be. And unfortunately, in the reply, and thank you, Les Concorda, for giving me the half minute extra, there was one, two, three, four lines of a reply. Everything else was padding. So can you tell me, is it intended to ensure that normal high standards are provided on the islands for the evacuation of people from where they fall, or where they are, in one case or another, as far as, as I said, the peer or the airfield? Thank you, Deputy. I think, in fairness, the response I gave set out quite clearly that there is emergency support in relation to the emergency area medical services in the west and north-west. Well, how did you get to that service? It's the airfield. The person is two lines away. Well, with helicopter, as I understand that the helicopter service is available, the opening statement addressed a specific issue of emergency care in the islands, and I spoke about the significant increases in NAS resourcing in recent years. I also outlined the levels of additional investment in 2025 for an NAS following budget 2025. That's an increase, which I set out of, I think, over 33 million. And I would now like to mention very briefly, the ambitious program of reform in NAS has, in part, upon recent years, to transform from a traditional patient conveyance service to an agile fit for purpose emergency medical service. And that's basically what the emergency services are now doing. We have, to meet the demands of our growing and ageing population, the NAS has developed a number of initiatives, including community paramedics, increased capacity in national emergency operations centre, clinical hub, expansion of CFR schemes nationally, and development of a number of alternative pathways. These pathways, for instance, since October 2020, have treated over 116,000 patients, with 40 per cent of patients not requiring subsequent treatment at hospital emergency departments. The program hub reform has also been a significant rise in government investment, with an increase of 60 million, 60 million in the annual allocation since 2020, and as outlined in budget 2025, there will be further additional funding to allow for expansion of these pathways and other essential initiatives throughout the country. But one of the things you also need on the islands is people who are trained to deal with and respond to the emergency services. And basically, that has happened in some of the islands, but it's obviously, that's a program that's progressing. And that's how they're responding to make sure that there's an adequate number of people who are trained to deal with emergencies. But there's additional funding in each of these areas, and I think you will have to accept that over the last four years, that funding has benefited the islands, and I've outlined where those ambulances have been provided to the islands. I know, but it is progress that has occurred in 2023, and obviously the budget, the budget that's set out for the coming year, there hopefully will be further developments as well.