Header Item Ambulance Service Provision (Continued)
 Header Item Public Health (Tobacco) (Amendment) Bill 2013: Second Stage (Resumed)

Wednesday, 16 January 2013

Dáil Éireann Debate
Vol. 788 No. 1
Unrevised

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(Speaker Continuing)

[Deputy Alex White: Information on Alex White Zoom on Alex White]  Some concerns over perceived levels of cover or lack of cover at certain stations in the north Leinster area have been raised as these changes have progressed. I reassure the Deputy and the population of the areas referred to in this regard that the national ambulance service is not a static service. It deploys its resources in a dynamic manner and works on an area and national basis rather than on a local basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource is mobilised to an incident, including incidents in the greater Dublin area. Where necessary, emergency cover is provided by an advanced paramedic motorcycle response unit, supported by resources deployed from adjacent stations on a rolling basis.

In addition to the operational efficiencies being implemented, two new rapid response vehicles, RRVs, now operate in the south Dublin and Kildare areas, to improve services further across the greater Dublin area. The national ambulance service has also introduced a new intermediate care service in south County Dublin to address routine inter hospital transfers. This releases emergency ambulances for emergency service work. The net effect of these changes is improved efficiency and increased availability of emergency ambulances across the area for incidents where hospitalisation is required.

As mentioned, the national ambulance service is a dynamic service. It responds to calls on a prioritised basis, through the advanced medical priority dispatch system, AMPDS, which is in operation in all NAS control centres. The NAS has established that 10% of all 999 calls are inappropriate for an emergency ambulance and a further 50% are neither life-threatening nor serious. This data is in line with international experience.

With regard to the specific stations mentioned by the Deputy, Maynooth, Baltinglass, Swords, Athy and Arklow, these stations particularly benefit from the dynamic and rolling cover improvements due to their proximity to each other and to the road network available in the area they cover. I appreciate the Deputy referred to Maynooth in particular. The question raised with regard to Maynooth and the manner in which these issues are being addressed must be seen in the context of the dynamic service that exists, which comprehends a broader area of cover than a particular town or centre.

Deputy Emmet Stagg: Information on Emmet Stagg Zoom on Emmet Stagg The system we use for raising topical issues is very useful for Members like myself, but we appear to be falling back into the old trap, where Ministers or Ministers of State come into the House and read a script that was prepared before hearing what we have to say on the issues. The result is that regularly the issues being raised are not addressed at all. This is what has happened today.

I asked some specific questions and while I did not expect the Minister of State to have the answers, I would have been satisfied if he had said he would get the answers for me. I will put my questions again. How can he justify not having an ambulance service in Maynooth when there is, apparently, no savings whatsoever from abandoning it? The system being put in place is no better and is probably more expensive than the system that existed when Maynooth had a full service. I do not accept the notion that Athy and Maynooth are adjacent, as they are an hour and a half apart. A person could have died from a heart attack ten times in the time it would take for the special ambulance to come. However, perhaps the man on the motorbike would arrive to help.

The man on the motorbike would probably cost more than it would cost to send the ambulance which is lying idle in Maynooth, all because somebody decided that five stations in the country should have 12 hours a week with no ambulance service and that a motorbike service would replace them. I do not understand how this could provide any savings. Will the Minister inquire or find out what exact savings are being made, as all of this was based not on more efficient services, but on cost efficiencies? I fought for years to get an ambulance service for Maynooth and we succeeded in getting it. I am not about to allow it be whittled down or reduced so as it will eventually disappear into some larger centre.

Can the Minister of State tell me what happens in Maynooth on a Thursday when the ambulance and crew are not allowed to leave the station? Does the crew sit in it and wait for the 12 hours to be up before they can go out? What has occurred is nonsense. A group in Maynooth and the north Kildare area is organising a protest on this issue and I understand and appreciate that. If we could get some answers, we could explain why this has occurred.

Deputy Alex White: Information on Alex White Zoom on Alex White The Deputy has indicated he would like me to ascertain the level of savings associated with the changes in so far as they apply to Maynooth and I will endeavour to ensure that if the information can be ascertained it will be relayed to him.

I cannot explain the broader issue any further than I have done. However, all of us would be concerned if any of the decisions being made in order to achieve efficiencies brought an associated risk with them or if they introduced any kind of public health risk into the system.

Deputy Emmet Stagg: Information on Emmet Stagg Zoom on Emmet Stagg Of course there is a risk.

Deputy Alex White: Information on Alex White Zoom on Alex White Our primary concern is to ensure the health and well-being of the population, including access to emergency care if needed. If it can be demonstrated there is some risk associated with this change, that must be addressed.

Deputy Emmet Stagg: Information on Emmet Stagg Zoom on Emmet Stagg If there is no risk, there is no need for an ambulance service at all.

Public Health (Tobacco) (Amendment) Bill 2013: Second Stage (Resumed)

Question again proposed: "That the Bill be now read a Second Time."

Deputy Joe O'Reilly: Information on Joe O'Reilly Zoom on Joe O'Reilly Earlier I addressed the issue of cost as a disincentive to people starting to smoke cigarettes. I also addressed the issues of the proposed new graphics on cigarette packages and the smoking ban.

I would like to put forward my strong view that the promotion of sport among young people and the support of sport by the Government financially and within schools and communities will act as a significant disincentive to smoking. In that context, the recent sports capital grants are welcome. My experience as a former teacher, both within my family and elsewhere, is that young people engaged in sport have a personal incentive not to smoke so that they can develop and enjoy their sport. Their desire to get on a team or participate in individual sports such as martial arts ensures they refrain from smoking so as to be involved in sport, physical activity and an alternative lifestyle. I appeal to the Minister of State to bring the message to the Government that moneys invested in the promotion of sport and an alternative lifestyle will help overcome the enormous health bill resulting from cigarette smoking. This concerns the issue of people starting to smoke.

With regard to encouraging people to quit smoking, we need to focus on advertising and promotional work. We must emphasise the quality of life changes that will occur if people quit. There has been too much emphasis on the threat of lung cancer and other medium or long-term threats. However, if we are to succeed in encouraging people to quit smoking, we must advertise the immediate benefits of quitting, such as an improved appetite, improved breathing, cleaner air and an improved quality of life in the here and now. This should be the focus of advertising.

This Bill merits discussion. While it is a short Bill dealing with an amendment that needed to be addressed, we could well spend a full session discussing this serious health issue. The support clinics held by the HSE over the years - I have personal experience of one in Cavan town - for people trying to quit smoking and run by professional staff are excellent and I urge the Minister of State to reconsider the extent to which these clinics are available as there is great potential for them.

This legislation was made necessary by the ruling from the European Court of Justice.


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