Just for the record, there are serious claims of wrongdoing by NAMA. I have written to the Taoiseach and the Minister for Finance about this matter. I have yet to receive a satisfactory reply.

I want to raise another issue here this morning. I have sent notice of this matter to the Taoiseach because it is very serious. On 26 August last, the two back wheels of an ambulance coming from Letterkenny fell off outside Sligo. The vehicle was carrying a chronically ill patient on a life-support unit, a nurse, two anaesthetists and two paramedics. The skill of the driver prevented this accident from becoming a much more serious incident with lives lost. The patient in question subsequently died, although it is not believed that the accident played any part in this. Go ndéanfaidh Dia trócaire orthu. Understandably, there was a delay of at least 30 minutes while a new ambulance was sent for. The ambulance which lost its wheels, which is a Mercedes Sprinter 515 model, is eight years old and has 411,000 km on the clock. That means it has been travelling 50,000 km a year.

The nub of my question and of the concern that is being expressed about this matter relates to an inspection report that has been carried out by an independent consulting engineer and assessor. According to the report, there is a serious design flaw with this model of ambulance. The engineer and assessor has suggested that the vehicle design has a major negative characteristic in the wheel stud nut design. His opinion is that this weakness in design could result in a wheel stud failure if a sudden stress were transmitted to the vehicle via the wheel. He has said, on the basis of his experience, that the wheel studs on the Mercedes Sprinter 515 are too small.

Do we know how much of our ambulance fleet is made up of this model? The implications of this for patients, paramedics and other road users are obvious. The independent report has been with the HSE for three weeks. Has this matter been brought to the Taoiseach's attention? What steps has the Government taken to ensure that this matter is urgently and thoroughly investigated?

I thank Deputy Adams for giving notice about a very specific matter here. In a general sense, obviously, the Government is very anxious to ensure that people get medical treatment as swiftly and as safely as possible from the health service. Since 2011 there has been a major change programme under way to reconfigure the way pre-hospital emergency care services are delivered throughout the country. Clearly, great progress has been made, but there is still a good deal of further work to be done. For instance, in 2015, €144 million was allocated to the National Ambulance Service, which serves 4.6 million people, responds to 300,000 ambulance calls per year and employs more than 1,600 staff across 100 locations. The service has a fleet of 500 different vehicles, including emergency ambulances, rapid response vehicles, intermediate care vehicles, motorbikes and the Dublin Fire Brigade ambulances. Clearly the programme is continuing to evolve and change.

Deputy Adams raises a very specific case. I asked for a report on this, and I have a preliminary report here. The National Ambulance Service can confirm that an ambulance broke down near Ballindine, County Mayo, on the Mayo-Galway border, at ten minutes past two on 26 August 2015. Two of the vehicle's rear wheels were dislodged from the vehicle while a patient was being transferred from Letterkenny General Hospital to University Hospital Galway. There was a patient on board the ambulance at the time, as Deputy Adams mentioned, as well as two paramedics, a doctor and a nurse. An ambulance was immediately dispatched to the incident, arriving at the scene at 2.15 p.m. - that is, five minutes after the incident happened - and the driver took the appropriate action. The patient, medical personnel and one of the paramedics travelled in the second ambulance to University Hospital Galway, UHG, and the patient arrived safely at 3.05 p.m., or five minutes past three. The ambulance from which the wheels had dislodged was recovered from the scene for further investigation and examination. I would point out that there was no deviation at all from the care and attention being given to the patient in question, and it is important to say that.

I can confirm for Deputy Adams that the ambulance service is carrying out a comprehensive investigation to determine what exactly happened and why this breakdown occurred. That investigation will include interviews with all of the staff members who operated the vehicle concerned during the transfer of the patient to Galway. Obviously the driver took appropriate and careful action which resulted in no adverse effects and no deviation from the care being provided to the patient. The investigation will also include a detailed examination of the vehicle by an independent engineer to determine the nature of the breakdown and an examination of the vehicle's service and maintenance history to see how that stacks up.

The vehicle, as Deputy Adams mentioned, has an 07 registration and had driven 411,786 km in total. It was stationed at Letterkenny. The engine was replaced on 17 August 2010 at 165,000 km and again on 16 February 2015 at 390,000 km. The preliminary findings, for Deputy Adams's information, suggest that the wheel nuts loosened, which resulted in the wheels becoming dislodged. This is a cause of extreme concern to the NAS. An urgent examination of the vehicle is being undertaken and any necessary corrective action will be taken.

When I drove my own car, that happened to me once. The wheel became dislodged and the reason was that the change from wheel braces to air-tightening of nuts resulted in somebody not doing the job properly.

There is another wheel coming off now.

I thank Deputy Healy-Rae for that. I am quite sure that the ambulance service will determine the real cause of this, whether it was somebody inadvertently not tightening nuts properly or an incorrect configuration. In any event, it is lucky that the driver took appropriate action and was in charge of his vehicle, that another ambulance arrived within five minutes and that the patient was brought safely to UHG with no change or lack of attention to the patient in question.

I have to say I am very disappointed with the Taoiseach's answer. It is of interest to the nation that the wheel came off his car one time, but that has nothing to do with the question I raised. The independent assessment, which I have it, says very clearly that there is a weakness in the design. The independent assessor has pinpointed that in this particular model of ambulance there is a weakness in the design. My question was, what steps has the Government taken to ensure that this matter is urgently dealt with? I understand that some staff in the Sligo area are refusing to drive this particular model of ambulance. The Taoiseach may also be aware that there was a similar incident in March 2014 in County Louth. The week before, there was another such incident in the mid-west, and earlier that year a Dublin Fire Brigade ambulance lost a wheel. I do not know whether these ambulances were the same model as that which lost its wheels last month on the way from Donegal to Galway, but clearly this is a question that needs to be answered. We in Sinn Féin have continuously made the case that the Taoiseach's Government has presided over the erosion of our public services, and this incident is another example of a lack of proper investment.

Thank you.

This is most crucially felt in rural Ireland. Even the fact that a patient has to be transported from Donegal to Galway illustrates the deficiencies in the Government's health policy.

The questions are quite specific and I am not trying to score political points in terms of the particular report that has been made by the independent assessor.

Thank you, Deputy.

He says clearly that there is a weakness in the design of this particular model. Ambulance users, hospital users and ambulance crews need to be assured that vehicles with this weakness in design are removed from service and replaced. That is number one. Two, we need to know how many ambulances have lost their wheels and whether it was as a result of this weakness in design. This report has been on the desk of the HSE for three weeks now. What has it done since then? It does not need to be a convoluted process. It has been identified as a weakness of design. What has it done to ensure that there is no recurrence of this dreadful incident?

I know it is of no interest to Deputy Adams what happened in my own personal case. All I am saying is-----

No. I said it was of no interest to the nation-----

Thank you. I appreciate that.

I am really interested.

Deputy Adams speaks for the nation.

All I am saying is that when one investigates something, there is a reason why a wheel comes off. Obviously if the nuts are the wrong configuration or they are not put on properly, then that happens. I am informed, and I do not know whether Deputy Adams has the independent engineer's report that he is quoting from-----

I have it, yes. Does the Taoiseach want it?

Yes. I would appreciate having it.

Okay.

It is actually a tribute to Deputy Adams's own sources of information that he has the final report from the engineer while I have a preliminary report.

The HSE has had it for three weeks.

For three weeks the HSE has had it.

I understand that the Mercedes ambulances in the NAS fleet comply fully with maintenance and service records and I understand that the independent report from which the Deputy quoted has been acted upon. It is a matter of serious concern to the NAS if something like this happens, and I commend the driver involved. Deputy Adams mentioned in his initial question that there was a 40-minute delay, but I am informed by the NAS that it was a five minute-----

The Taoiseach was wrongly informed, I can assure him. He was wrongly informed.

So what I have here is not correct? I am informed here-----

Sorry, excuse me-----

There was the length of time involved in moving the patient to the second ambulance-----

Sorry. Excuse me-----

I am quoting from this-----

There is a time limit on this question.

This is an important point in everybody's interest.

We are already four minutes over time with this question.

The ambulance was immediately dispatched to the incident and arrived at the scene at 2.15 p.m. The wheels dislodged at 2.10 p.m. Now, if the Deputy has different information, then we need to determine that as well.

That is a secondary issue, with respect.

I thank Deputy Mac Lochlainn for that information. This is a matter of serious concern. Let me confirm from my information here that the independent report has been acted upon and that all Mercedes ambulances in the fleet comply with the maintenance and service records fully.

That was not the question.

Thank you. Deputy Fitzmaurice.