I thank the Deputy for raising this important issue in relation to having a rapid response vehicle on a 24-7 basis in County Roscommon. I acknowledge that the Deputy has been continuously raising this issue and advocating in relation to advanced paramedics. By way of background, as the Deputy well knows, the National Ambulance Service serves County Roscommon out of three bases located in Roscommon, Boyle and Loughglinn, which all operate on a 24-7 basis. All three bases are staffed by a highly skilled workforce of pre-hospital emergency care practitioners, including paramedics, advanced paramedics and emergency medical technicians. In addition, the National Ambulance Service operates a modern fleet of emergency ambulances, intermediate care vehicles and rapid response vehicles from these bases. Turning to the specific issue, I am aware that this topic has been raised by the Deputy, as I said, on a number of occasions. The National Ambulance Service operates two rosters at its Roscommon ambulance bases, one for the operation of a rapid response vehicle and the other for emergency ambulances. The RRV roster has four paramedic posts and there have been two vacancies on this roster. The National Ambulance Service made repeated attempts to fill these vacancies in 2025 through its national transfer process. I am informed these attempts have been unsuccessful and the National Ambulance Service will continue efforts in 2026 to fill these vacancies. This is not about trying to save a few euro or trying to save money. The NAS is actively trying to recruit into this role and will continue to do so. I am also informed by the National Ambulance Service that the rapid response vehicle in Roscommon is currently rostered on a 24-hour basis, six days per week and on a 12-hour basis on Thursday nights. I understand that the daytime shift on Thursday is covered by available emergency resources in the region and the rapid response vehicle from surrounding areas. Roscommon also benefits from the emergency aeromedical service operated by the National Ambulance Service in conjunction with the Irish Air Corps, as well as additional aeromedical support provided by the Irish Coast Guard in the region on an as available basis for its bases in Sligo and Shannon. I can also update that the HSE is progressing plans to establish a new National Ambulance Service helicopter air ambulance service this year, which will predominantly serve the west and north west. This service will be particularly beneficial in providing additional emergency coverage to patients in County Roscommon. As well as front-line urgent and emergency care, the National Ambulance Service is a vital partner in the development and expansion of a range of clinically appropriate alternative care pathways to improve patient flow and reduce pressure on emergency departments. However, I take on board the point the Deputy made in sharing the story about a young man who had an asthma attack. I thank her for sharing that and his family for allowing her to do so. It points to the fact that if that service had not been available, the outcome may not have been what we would have wanted it to be. I am taking this question on behalf of the Minister, Deputy Jennifer Carroll MacNeill, and I will certainly feed back to the Minister the Deputy's concerns, especially the point she made about paramedics filling in for advanced paramedics. For the record, I asked for a breakdown on NAS clinical staffing in County Roscommon. The total number of paramedics, including six advanced paramedics, is 21. There are two paramedic supervisors and six emergency medical technicians. That amounts to 29 staff currently in place. I will speak to the Minister about the 12-hour period and the issue of paramedics filling in for advanced paramedics.

Sentiment score: 0.15

I thank the Deputy for articulating the current situation in County Roscommon. The Deputy referred to people being put at risk. When anybody makes a 999 call looking for an ambulance, the call is triaged in relation to how serious the situation is, for example, whether it is a cardiac case, stroke, a broken limb, a fall or whatever else. The first response from the National Ambulance Service is always to triage and respond to the most critical incident first. It is important that anybody tuning in to this debate hears that. The Deputy said lives are being put at risk because the service is not available for 12 hours during the week. It is important to say, however, that all calls are triaged appropriately. Almost 30,000 patients were treated in the first six months of last year alone through a National Ambulance Service alternative care pathway, which is also important, with 40% of these patients not requiring subsequent conveyance. The Deputy is speaking about the emergencies that arise and the challenge that arises for patients and their families. I reiterate two points. In relation to the action card, which the Deputy said has been issued in two other counties but not in Roscommon, I will bring that point back. I reiterate also that I have been advised that the National Ambulance Service will continue efforts in 2026 to address the vacancies identified in Roscommon. I thank the Deputy again for raising this extremely important matter.

Sentiment score: 0.04

I thank the Deputy very much for his question. I am quite disappointed at how the Deputy has presented the situation in Wexford. I think of all of those who are working in mental health services in Wexford today. They would be disappointed by the Deputy's statement that Wexford has been completely left behind in relation to mental health services. I will approach this issue in three different ways. First, as the Deputy knows, we have six new regional health areas. Community healthcare organisations, CHO, 5 and 6 have been amalgamated and broken down into three substructures. Waterford and Wexford are amalgamated under one integrated healthcare area, IHA, manager, Dr. Sinéad Reynolds, whose background is in mental health. She is a strong advocate for mental health. I will meet Dr. Reynolds in the next two weeks to discuss mental health services across Waterford and Wexford. I take umbrage with how the Deputy portrayed the department of psychiatry led by the clinical director, Dr. Vwoke Akpubi, in University Hospital Waterford. On two occasions, the Deputy said it was an antiquated service. That is not true. Maybe the Deputy meant the building, but the service is not antiquated. St. Senan's closed in 2013 before the Deputy and I became involved politics at national level. When St. Senan's was closed a decision was taken that all referrals would be made to University Hospital Waterford. There are 42 beds in the department of psychiatry at University Hospital Waterford. We also have a service-level agreement with St. Patrick's in Dublin. I know this inside out because I have lived it for the last five years as Minister of State with responsibility for mental health. We have a service-level agreement with St. Patrick's, a private hospital in Dublin, when we have issues with capacity. The Deputy has spoken about the number of presentations of children to emergency departments in Wexford. As he will know, when Wexford General Hospital had a fire a year and a half ago, University Hospital Waterford partnered very closely with it to take any of the overflow that could not be dealt with at that time. In response to the Deputy's comment that the unit is antiquated and not suitable for children, only two children were admitted to an adult department of psychiatry last year across the whole country, down from 100 when I took over in 2020. There were two cases last year, taken in real time when a clinician - a consultant psychiatrist - had to make a life or death decision on whether to admit that child or young person. In both cases, the patients were 17-plus and they were admitted with the approval of their parents. I cannot let that hang in the air. Wexford is being very well served by community mental health teams. There are six adult community mental health teams, one in Maryville, New Ross, two in Carn House in Enniscorthy, one in Tara House, Gorey and two in Summerhill in Wexford town. There are also two CAMHS teams and there are plans to put a third team in place. That said, I do accept what the Deputy has said in relation to the fact that there are no adult psychiatric beds. That is the nub of the issue in Wexford in general. Indeed, this has been raised with me by the Minister for housing, Deputy Browne, on several occasions and by other public representatives in Wexford. I want to give a shout out to Mental Health Ireland which is very strong in Wexford. Over the last five years I have launched many of its initiatives in relation to mental health, well-being, and emotional distress in the Wexford area and I want to applaud it for all the work it does on the ground. To go back to what the Deputy has said in relation to acute beds, I am aware that there are none in Wexford. I am also aware that there are none in Tipperary. We have done a capacity review of mental health beds and we will be having a look at this in the new year.

Sentiment score: 0.02

I am trying to count to five here because, as I reiterated, only two children across the whole country were admitted to adult wards last year. Two 17-year-olds were admitted, with the consent of their parents, for their own safety. There are no children being admitted to the department of psychiatry at University Hospital Waterford. That is the first thing I want to put on the record. Second, when we are finished here I suggest that the Deputy takes a look at the Mental Health Commission's report on foot of its visit to the department of psychiatry at University Hospital Waterford last year and the results therein. I am not going to leave it hanging in the air that there is a service in Waterford that is not fit for purpose because that is not the case. On three occasions, Deputy Ó Súilleabháin has disparaged that service. I know the teams that work there and I know the work they do. As the Deputy knows, under the capital plan there will be a new-build unit in University Hospital Waterford. A new 50-bed department of psychiatry is in the capital plan and has been progressing, albeit slowly, over the last three years. It was meant to be adjacent to the hospital. The consultants there and the executive clinical director wanted it to be part of the hospital and that is exactly what is going to happen. We must acknowledge the work being done by all six general adult teams in Wexford, the psychiatry of later life service in Wexford, and the two CAMHS teams in the county that I have visited. I also want to acknowledge the services that are available, including the liaison services through Wexford General Hospital. We cannot underestimate the services that are being provided. The issue the Deputy raises today relates to acute mental health beds in Wexford. There are none currently planned but we are certainly going to look at the issue, perhaps in the context of a crisis house or a high-level hostel. It is on my radar. I will give the Deputy that but I want to acknowledge the good work that is done in the department of psychiatry in Waterford.

Sentiment score: 0.02