Brian Stanley: County Laois Ambulance Crisis - Demand Rapid Response

Taoiseach, the issue of the ongoing problems with the National Ambulance Services has not been addressed. I raised with you here back last year the situation regarding the serious gaps in the ambulance services and particularly in County Leash through no fault of the staff. The number of staff hasn't increased in the county in the past two decades despite the explosion in the population. There's five vehicles based in the county with just two available most of the time, that's five nights of the week and on Monday and Tuesday nights just one vehicle and that's often gone away on long calls, long distances away on a nightly basis. So if a serious incident arises no ambulance is available to attend patients and that is happening on a regular basis in the county. I can list off several cases recently where that has happened and the deployment model Leash crews can be sent to Dublin, Wexford, Wicklow, Westmead, Waterford and are often when they're almost at their location, at the location of where the patient is, they're stood down, they're told to turn around and come back because another ambulance has just reached it. Recently a crew was almost on the scene within two or three minutes of the scene in Wicklow, sent from Port Leash and they were turned back at that case again. Dynamic deployment isn't working. Crews are chasing around the country on long distances without picking up patients and let me give you one example. One crew comes onto a shift recently in Port Leash and they were dispatched on six occasions. On four of those occasions they were stood down, including when they were almost at the point of where the patient was, told to turn around and come back to Port Leash empty and they could be away. One of those cases away for over three hours, almost four hours away while there's emergencies waiting in Leash and calls are being stacked Taoiseach. So what's happening is that between the time the call comes in due to shortages, it could be two hours before an ambulance is actually deployed and there's a recent case of an elderly woman in Clare where the call came in at 6.27 but the ambulance wasn't dispatched to nine or sorry it didn't get there till 9.51pm, almost three and a half hours. Meanwhile there's a Port Leash person with a serious injury and the three ambulances are gone and there's no one to pick up that person and there is no rapid response vehicle in the county despite the fact there's 56 in the state. The civil defence and the fire services are picking up the slack. Rath Downey fire services recently down in one corner of the county had four cardiac patients within three month period. Crews are going without staff, crews are going without regular breaks for meals etc and the context is is they're understaffed and under-resourced services. So what I want to ask you is will the government provide a rapid response vehicle in County Leash? Will you ensure there's at least two ambulances and crews on at all times and can you engage with the National Ambulance Services? You and the Minister for Health need to do this and get more logical deployment models. Taoiseach to respond. I thank the Deputy for raising an important issue and particularly for his constituents and county lead, extremely important. We have a National Ambulance Service. I'm sure the Deputy will appreciate I don't make this point but I can run the National Ambulance Services from here but I will engage with the issue that you have raised and I'll talk to the Minister for Health in respect to the issues you've raised. The National Ambulance Service will always defend the model that they have and have consistently defended it over time and notwithstanding that we've had from different parts of the house illustrations or observations and commentary in terms of how that service hasn't been optimal in terms of particular accidents or particular events or particular locations in terms of delays. Just had one yesterday from Deputy Paul McAuliffe in terms of Dublin and the person waiting for hours, an elderly woman. So we will engage with the National Ambulance Service but the investment has continued to pace and I think increasingly we have to examine and I take the point that Deputy Batshig made earlier it's not just about investment, I accept that as well, how the investment is deployed and how it's allocated, what's the productivity outcome from monies that we are allocating. So we've from about 2022 the HSE has invested about an additional 75 million in the National Ambulance Service with staff numbers increasing by 761 in the same period. Over 85 percent of National Ambulance Service staff work in direct patient facing roles and that does help obviously improve ambulance response performance with additional emergency ambulances, immediate care services and developing also alternative care pathways including community paramedic services. As you know a new helicopter emergency medical service has been established in the west and the northwest, that doesn't affect you in terms of leash. Further investment this year as a result of the budget, 34 million for renewal and expansion of the fleets, 34 million of emergency ambulances and other response vehicles. So the investment is continuing, I think you're looking at about 291 million now being spent in the National Ambulance Service in 2026, looking at about 2,503 employees and that's up again from the same period last year. Further investment planned again this year with 21 extra crewed ambulances at peak demand, four intermediate care vehicles, continued development of clinical hubs and alternative care pathways. I will speak to the Minister in respect of the emergency response vehicle that you've spoken about I think in terms of leash and I'd also ask the Minister to reflect on and engage with the National Ambulance Service in terms of the model that they use. Deputy Stanley. Thanks Aoise, could I say this to you that when you compare what we have to Scotland, a similar population and similar geography, they have 5,000 staff, we have just over 2,500, they have 1,500 vehicles, we have 620. So there is ground and I think you're accepting there's ground to be met up there. The spring economic statement came out yesterday, it shows that there is substantial resources there. I'm not going to ask you to throw that money around like confetti, I don't want you to do that, but what I do want the government to do is in the forthcoming budget to give the ambulance services a key priority. It's absolutely essential. We've heard enough over the years about the golden hour and if an ambulance doesn't get to a person for two or three hours, time gets lost. I am asking you to ensure and the Minister for Health to ensure that a rapid response vehicle is put into the county because we are on the crossroads of Ireland with the N7, N8 and the N80 and N78 all going through the centre of the county and I'm asking you to ensure as well that there is positive engagement with the National Ambulance Service to start out a rapid replacement and to ensure that we have two to three ambulances on at all times in County Leith. Thank you Deputy and just to say on this like the spring October statement, general government balances, surplus but all of that money has been used so an exchequer deficit of 1.1 billion, the rest is into the funds which we provided for everyone, no one's commenting on that, the 10 billion isn't hanging around somewhere to be used, it's already the bulk of it allocated all of it into the funds and it's been invested in a lot of stuff in Ireland in terms of economy, housing, infrastructure, wind energy and so on and so on. But on the ambulance, you know I think we've, if you look at over a 10 year period, 15, 20 year periods, there's been a revolution that's happened in emergency care. The pre-hospital emergency care council, the emergency medical technicians, the professionalisation of the entire area has been quite remarkable and it has led to very significant outcomes and in terms of responses to patients, in terms of first responder, it's been dramatic compared to what we had historically. Thank you Taoiseach, time is up. But I accept your point that there are legitimate issues that do need to be examined by the HSE and the NAS. Thank you Taoiseach, Deputy Richard O'Donoghue.