Wednesday, 24 November 2004
Dáil Eireann Debate
Mr. Lowry: A new community hospital on the grounds of the old Hospital of the Assumption, Thurles, is currently under construction. I welcome the fact that the building programme is on schedule for completion and that the facility will be fully operational in spring 2006. The new hospital will provide a wide range of services such as respite, rehabilitation and long-term care. The old hospital contained an ambulance station that served a large part of Tipperary. This station was always an integral part of the hospital. Everyone assumed there would be a new ambulance base facility as part of the new overall hospital plan.
On making inquiries to the Mid-Western Health Board I was shocked and dismayed to discover that provision has not been made for an ambulance base. It is an astonishing omission that highlights the lack of forward planning and co-ordination on the part of the Department of Health and Children. A temporary ambulance base has been established in an old laundry building on the hospital campus. This building is dilapidated and totally unsuitable for staff and patients. The building has an asbestos roof, which raises serious health and safety issues. Male and female members of staff have to share one toilet. The present circumstances are totally inadequate and unacceptable. There are legitimate health and safety concerns for the emergency medical technicians and other staff.
The Thurles ambulance station provides pre-hospital emergency services and patient transport for a large section of north Tipperary. It also forms part of the health board’s response to any major emergency. Depending on demand, this station also provides cover to other areas, such as Roscrea and Nenagh. The Thurles station provides 24 hour cover. Two-person crewing on all ambulance vehicles has been implemented. This year so far, the crew from the Thurles ambulance station answered almost 6,500 calls. This temporary shack houses in excess of 15 staff who are entitled to and deserve a safe and healthy working environment to enable them to continue their life-saving work.
According to the construction programme from the Department, demolition of the existing hospital, including the removal of asbestos will commence in early July 2005. As part of this demolition the current temporary accommodation will also be removed. Amazingly the Department of Health and Children has no provision within the scope of the hospital project for interim measures to accommodate the ambulance base.
The Mid-Western Health Board has recently submitted a detailed proposal for funding to the Department of Health and Children to build a new modern ambulance base on the campus, the estimated cost of which is approximately €1.6 million. It would be commonsense and cost effective to sanction the construction of a new base immediately. The builders are currently on site and can undertake the essential building work with a simple variation to their existing contract. The Department of Health and Children must provide the necessary funds for a modern ambulance station as a matter of urgency. The facts speak for themselves. Quick responses save lives. Many of the 6,500 patients carried by the Thurles ambulance would not have survived if an ambulance had to travel from Limerick or Nenagh. The reality is that if the ambulance base is closed or funds are not provided to build a modern base lives will be lost in the Thurles and mid-Tipperary area.
Without an ambulance base a person with a cardiac arrest in Thurles has almost zero chance of survival. A cardiac arrest patient must get immediate emergency medical attention to have a significant survival chance. This is only possible with a local ambulance base.
I ask the Minister of State to inform the House if his Department will take responsibility for the potential loss of life arising from the present bungling with the ambulance station in Thurles. When funding for the community hospital was sanctioned why was a modern ambulance base not included in those plans? What proposals does the Department intend to sanction to secure a permanent ambulance base in Thurles? When will the Mid-Western Health Board be notified that it can proceed with the planned development of a new ambulance station.
There has been a dramatic reduction in the level of health care delivery in north Tipperary. The status of Nenagh General Hospital is under threat from the implementation of the Hanly report. There is neither an accident and emergency or a cardiac care unit in Thurles. The provision of a proper ambulance facility is of vital importance to the delivery of adequate health care to the people of Thurles and mid-Tipperary.
Mr. S. Power: I thank Deputy Lowry for raising the issue. The report of the Strategic Review of the Ambulance Services 2001, forms the basis for the development of pre-hospital emergency medical services into the future. It identifies aspects of the current emergency ambulance service that need to be addressed to bring the service into line with best international practice to ensure effective and quality driven practices.
The report recommended that the service be developed at a number of levels. Principal among the developments being put in place arising from the report are the elimination of on-call arrangements as a means of providing emergency cover, improved fleet reliability; and the roll-out of the emergency medical technician-advanced programme.
The elimination of on-call arrangements is designed to facilitate further improvement in response times. Additional funding of more than €4 million was provided in the current year to facilitate the continuing phasing out of on-call arrangements in a number of regions. This is a programme the Tánaiste hopes to be in a position to extend.
In the area of the ambulance fleet and equipment, the Department provided additional capital funding of more than €8 million in the past 12 months to assist the boards-authority with their fleet and equipment replacement programmes which are essential prerequisites for enhanced speedy and appropriate care. The Mid-Western Health Board ambulance service was allocated approximately €1million of this funding.
In regard to the new Community Hospital of the Assumption in Thurles, a brief to replace existing institutional services for the elderly at the 150 year old Hospital of the Assumption was completed in recent years and construction commenced in April 2004.
The scope of the development is in keeping with the objectives laid down in the report, The Years Ahead, and comprises accommodation and ancillary services for 72 inpatients and a day hospital. The need to replace the ambulance station on the campus was recognised in the brief and space has been protected on the site for provision of a new base. The original base, housed in an old gate lodge, was inadequate and has been demolished. The service is currently housed in temporary accommodation on site.
The Mid-Western Health Board has reviewed its requirements for the new ambulance station and has recently clarified its proposals in this regard to my Department. These proposals take account of an option appraisal exercise and the implications of the current health reform programme. The current proposal recognises service development in terms of the elimination-reduction of on-call arrangements and the introduction of two-person crewing to all ambulances. The development as proposed is designed to provide the accommodation required to support the future development of the service. These proposals are currently being examined by my Department and will be considered in conjunction with the Mid-Western Health Board, in the context of overall capital priorities.
The Government is fully committed to the development of our emergency ambulance service. Much has been achieved in the development of the service and I recognise that much remains to be done. It is essential to maintain the progress 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.
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