Yesterday, I raised with the Taoiseach the scandal of tens of thousands of patients being omitted from official waiting list numbers published by the National Treatment Purchase Fund, as revealed on the "RTE Investigates" programme on Monday evening. I will return on another day to my party's recommendation for dealing with this emergency. I wish today to raise another shocking case that highlights the utter incompetence of the Government in managing our health service. The Taoiseach will recall the case of Meadhbh McGivern and the failure to transport her for a liver transplant in July 2011. An inquiry was put in place into the circumstances which led to that failure and to examine existing inter-agency arrangements for people requiring emergency transportation for transplant surgery. Among the recommendations of the inquiry was the need for co-ordination of land and air logistics for patients requiring emergency aero-medical transportation on a 24-hour basis and the requirement for staff to be trained appropriately in aero-medical logistics. At the time, in response to a question from me, the Taoiseach expressed his deep regret for what happened to Meadhbh. I understand from an interview by her father that, buíochas le Dia, she is now doing well.

Fast forward to 22 December last year when Our Lady's Children's Hospital in Crumlin was told by the national aero-medical command centre set up after Meadhbh's case that the transportation of priority 1 children for heart and liver transplants could not be guaranteed over the Christmas period. The matter was brought to the direct attention of the Minister for Health, Deputy Harris. On 3 January, the hospital was informed that the situation had worsened, that the four-hour timeframe for heart transplants was unlikely to be achievable and that the six-hour timeframe for liver transplants was also in doubt. This affects seven children whose lives are at risk. Their families were not informed of these developments.

On 16 January, the hospital was told that the situation will remain unchanged until the end of May this year at the earliest and the Department of Health stated at the time that it will continue to raise the issues with the Department of Defence.

The Taoiseach is the Minister responsible for the Department of Defence. He also expressed deep regret about how Ms Meadhbh McGivern was treated yet it seems that a key recommendation has not been implemented. These are deeply worrying times for the children and the families concerned. Has the Department of Health raised these issues with the Department of Finance and, if so, will the Taoiseach give us the details of this contact? Has this matter been raised directly with the Taoiseach, in his capacity as Minister for Defence, by the Minister for Health, and what is the Taoiseach proposing to do about it? Will the Taoiseach clarify what contingency plans are in place for the transport of transplant patients?

I read the letters in respect of this. Within the HSE, the national aeromedical co-ordination centre is responsible for the co-ordination of emergency aeromedical patient transfers to hospitals within Ireland and abroad. As part of that inter-hospital transfer service, the Department of Defence has an agreement with the Department of Health and the HSE for the Air Corps to use its fleet of helicopters and fixed-wing aircraft to transport patients - children or adults - and medical teams between hospitals in Ireland and abroad on an available basis. If a call comes through, Air Corps personnel may be involved in sea rescues or other activities. The service is obviously dependent upon the availability of suitable aircraft and the availability of crews to fly them. When the Air Corps is not available, the HSE has arrangements in place with the Irish Coast Guard or private air operators to provide the inter-hospital transfers.

The Air Corps has experienced retirements of highly experienced personnel. There is a current shortage of pilots within the Air Corps, which is a central issue, but the Air Corps continues to provide an inter-hospital transfer service, albeit on a reduced basis because of that. It means that out of hours on weekdays, between 6 p.m. and 8 a.m. the following day, the Air Corps does not have air crews standing by for fixed-wing aircraft.

As to what happens in the meantime, obviously every effort is being made to address this. There are 28 cadets going through three classes at present under the various stages of training to be pilots and other aircraft personnel but that will only yield results in the medium term. The Minister for Health and the Minister of State with statutory responsibility for health are looking at what options are open now.

The Department of Defence has always kept the Department of Health aware of this. The fact of the matter is when a call comes that a transplant opportunity is available for a person, they need to know that they will be able to get to the hospital in London, elsewhere in Britain or wherever it might be within the timescale involved.

The service that the emergency aeromedical service provides is based in Custume Barracks in Athlone and that continues to operate as normal. That delivers life-saving treatment and rapid aeromedical transport for seriously ill patients throughout the country. Since its inception, it has transported 2,500 patients in this regard. Obviously, because of those unexpected retirements in air traffic control, the availability of Baldonnel as an aerodrome has been reduced. There are a number of other technical options that are being considered. The Minister of Health is meeting the Minister of State at the Department of Defence. We want to get this in such a way that there is a guarantee for people that all of the options can be considered to have a patient transferred within the four-hour timescale involved.

We were told weeks ago that the Minister for Health was meeting the Minister of State at the Department of Defence. It still has not happened. I asked the Taoiseach a clear question. Did the Minister for Health raise this issue directly with the Taoiseach?

These children are waiting for transport now. If they got word that there was a transplant, they would not be able to be transported by the Air Corps now.

The Taoiseach talks about unexpected retirements. Approximately ten retirements are expected in the next year and five have already given notice.

However, I will come to the crux of the matter. It came in confidential form to our spokesperson on health, Deputy Louise O'Reilly, and it considers the impact of personnel shortages in the Air Corps. The Taoiseach has responsibility for this. The shortages have a direct effect on contingency arrangements for children on the transport list. The current class of pilot cadets will not have been through basic training until next September at the earliest. Then they must undertake further basic training, which can take between one and two years. None of the current class of pilot cadets will be qualified to undertake this type of ambulance mission in 2017 and perhaps into late 2018. With regard to unexpected retirements, not one recommendation in two Department of Defence working group reports on how to retain experienced pilots has been acted on even though the Taoiseach has held that job for the past six years. This is the Taoiseach's direct responsibility, as is the failure to implement the recommendation in Meadhbh McGivern's case.

These are extremely worrying times for the parents, the children involved and their families. They need clarity on what arrangements are in place. Will the Taoiseach provide clarity? If a family gets word that a transplant is available now, will the Taoiseach outline the contingencies to get the child to where he or she can receive that life-saving operation?

If a call came now, at 12.20 p.m., the answer is "Yes". The Department of Defence has an agreement with the HSE to supply that transport. However, who knows whether there might be unfortunate circumstances where an air-sea rescue might be taking place at a particular time and helicopters might be involved in that.

There are two challenges here. One is a shortage of pilots. Some have retired and some have gone to other employment. We do not have control over that. The second is the air traffic controllers. Given the technology, it is possible to carry out air traffic control from different locations. There are 28 cadets currently in training who will become pilots who are able to fly both fixed-wing aircraft and helicopters. In the meantime, outside the hours I have mentioned, we must use either the Coast Guard, the Custume Barracks emergency aeromedical support or private enterprise. The important matter is that if a call comes for a patient, be they an adult or child, a service will be provided.

This was brought to my attention at the weekend and I have asked for a report from the Department of Defence. I am the Minister for Defence, but I have given statutory responsibility for many areas in the Department to the Minister of State, Deputy Kehoe. He is meeting the Minister for Health and as soon as I have that report-----

When is the meeting?

They are meeting today. As soon as I have that report I will make it public in order that parents of children, in particular, will have the comfort of knowing that if a call comes in respect of their child, it will be answered with available transport within the time period.