Is the Taoiseach aware that a report published today by public health researchers in Trinity College has analysed the travel distance and travel time of people accessing health care and that the data have been gathered from throughout the country? The report shows that people living in parts of County Donegal, all of County Leitrim, the western part of County Cavan and throughout County Monaghan are at a major disadvantage as far as accident and emergency service access is concerned. The report calls for a formal and structured arrangement for the integration of accident and emergency services along the Border, not only to serve the needs of those in the counties I mentioned but also their counterparts living directly opposite on the northern side of the Border. Through such a structured arrangement, people would have quicker access to emergency services, especially accident and emergency services.

Will the Taoiseach urge the Tánaiste and Minister for Health and Children, Deputy Harney, to act on this report and to step up formal co-operation on health services generally on a North-South basis? In the course of Taoiseach's Question Time he acknowledged the importance of North-South co-operation. In light of this report I also ask the Taoiseach to urge the Tánaiste and Minister for Health and Children to restore accident and emergency cover on a 24-7 basis at Monaghan General Hospital as an integral part of this address in the interests of all the people of County Monaghan.

I recently had personal experience of a quite serious road traffic accident just north of the Border from County Monaghan in County Fermanagh. The experience was very disturbing. No emergency service arrived at the scene of the accident for almost two hours despite repeated calls. The Garda would not come 200 yards across the bridge to attend the accident and it was almost two hours before the PSNI attended the scene. No ambulance came in response to the calls to the emergency services, although one happened on the scene after an hour and 40 minutes by chance as it travelled on an errand between Monaghan and Cavan hospitals. Two of the people involved in the accident, including the driver who was aged more than 70 years and was suffering from chest injuries, were left at the scene of the accident for a considerable time. They were subsequently brought to hospital and detained overnight.

There are many instances of this type of experience along the Border. I urge the Taoiseach and the Tánaiste and Minister for Health and Children to exercise themselves to ensure we have an equitable health service in the Border counties and one that is truly caring and accessible. The report today from the Trinity College researchers confirms the importance of action before there are further unnecessary fatalities.

The report stated that those people who are not close to hospital services, especially those in rural communities, must travel greater distances. That is stating the obvious. I will not go into the situation at Monaghan General Hospital again. There are hospitals in the area and an examination is being carried out into the best clinical and medical ways of dealing with the health needs in the area. Discussions are taking place on that matter. Discussions are also taking place between clinicians and management in Letterkenny General Hospital and Altnagelvin Hospital in Derry to seek to develop services, particularly breast cancer services. An application for a consultant general surgeon with a special interest in these issues is under consideration by the National Hospitals Office. A new dedicated transport service has been established for patients travelling from Sligo to University College Hospital Galway.

Obviously we will do what we can to improve the travel arrangements for people to hospitals, either in Border areas or anywhere else in the country. The investment that has been made in many regional hospitals in facilities will help in that regard, as will the appointment of additional consultants in many of these areas. Obviously, the Tánaiste and Minister for Health and Children and the Health Service Executive will continue to do all they can to improve the situation.

The Taoiseach's answer lacks any substance. It is imperative that he listens to the cry of the people because a great need exists. This is the reality of their experience. Will the Taoiseach insist that the Tánaiste and Minister for Health and Children initiate whatever formalised and structured arrangements are necessary to improve the accident and emergency cover in the Border counties? Will he help ensure greater integration of accident and emergency provision in the Border counties, of which the Monaghan case is one that is integral and cannot be divorced from the overall need and requirement along the Border from the Cooley Peninsula to the Inishowen Peninsula? The Taoiseach's colleagues in Government are very aware that such an integrated approach is essential to save lives.

The Deputy's time is concluded.

My time has concluded but I ask the Taoiseach not to conclude on this issue. It is important that he listens and recognises that people are putting forward a cogent argument that has been supported by sustained inquiry from professional and informed people. This latest report is yet another example of the body of work that argues and sustains the argument for an integrated and co-operative approach to accident and emergency cover in the Border counties. I again state, without apology, the importance of the restoration of 24-seven accident and emergency cover at Monaghan General Hospital. Will the Taoiseach do that?

To specifically answer the Deputy — I may have been too general — all the hospitals, Letterkenny, Sligo, Omagh, Daisy Hill in Newry, Cavan, Drogheda, Dundalk and Monaghan, are trying to work in co-operation. That is why I mentioned the efforts with Altnagelvin and Daisy Hill. We are very anxious to work with them. The Tánaiste is due to have meetings next week or the week after with the medics in the North about further co-operation. We are in favour of that and of trying to improve the services and facilities.

As has been stated, one cannot have everything in every hospital, but one must try to ensure we have a good service across all these areas as well as in other rural areas. We are committed to doing that and it is happening. A large number of the additional accident and emergency consultants have been appointed to these hospitals and we are making efforts to try to continue to do that.

Over the past four or five years much work has been done on a North-South basis. We are trying to increase co-operation where it makes sense to do so to avoid the type of case the Deputy mentioned where neither service responded to an incident.