The debacle caused by the National Ambulance Service over the past weekend has to be seriously investigated. The NAS caused fury in counties Cork and Kerry when it announced further reduction of services covering these areas. This effectively was leaving no ambulance cover for the Skibbereen area on Mondays, no service in Castletownbere on Tuesdays, no day service in Clonakilty and Bantry on Thursdays and no service in Bantry every second Tuesday night. Losses of day services were also announced for Mallow on Mondays, Millstreet on Tuesdays, Macroom and Fermoy on Wednesdays and Kanturk on Thursdays, and all were announced with no consultation with staff or the public by the NAS. This was nothing short of a stunning blow to these communities, which, I might add, they did not take lying down. They came out fighting and this decision was reversed yesterday after some swift action by us all. However, it leaves many questions unanswered.

Our ambulance service workers are working incredibly hard as they continue to save lives under enormous pressure, 24-7, but morale among ambulance staff is at an all-time low. Five staff with 20 years of experience and two graded advanced paramedics have left the service in the Cork county area in the past couple of weeks. The current roll-out of the ambulance service now and in the past few years has been reduced daily to an ambulance-chasing service, getting to people's homes three or four hours after a call, when the patient is gone. Families cannot bear to see a loved one lying in agony so they take the patient in their cars or whatever transport they can find. Not a week goes by but I hear some sad and shocking stories of loved ones left waiting hours and hours for an ambulance. Only last Friday, a GAA player near Cork city lay on a pitch with a suspected spinal injury for up to two hours waiting for an ambulance.

A report published less than two weeks ago showed clearly that Cork was the worst affected area in the State for high-priority ambulance calls that took more than one hour to get to a patient. However, instead of the NAS, the Department of Health or the Minister for Health intervening to put this shocking situation right, they almost ground the service to a halt. I will give a rough idea of how the Castletownbere ambulance works, and this is just one case. It already covers Castletownbere peninsula, which is huge, and it also looks after parts of Kerry, such as Kenmare. It covers as far as Newmarket and all the way down to Goleen and Kilcrohane in west Cork. The ambulance might get a call to Newmarket but when it gets an urgent call to Goleen, the fastest it can make it is in two hours and six minutes. This ambulance, which is meant to be in Castletownbere looking after people there, when in Newmarket might get a call to Ardgroom and the quickest it can make it is in one hour and 44 minutes. That is if it does not have a patient on board; if it does, it is another hour or more to each area.

Heads have to roll at the National Ambulance Service. How can someone at the top who has mismanaged the ambulance service for years cause further havoc and walk away as if nothing has happened? The current ambulance service, which has people waiting two, three or four hours, is an appalling service. I ask the Taoiseach, on behalf of every person in our communities, to demand that the Minister for Health introduce a new model ambulance service for the public that can respond to emergencies in less than one hour, no matter where they live. In this country, your life should not be determined by where you live.

I thank Deputy Collins for raising the matter. The Minister for Health became aware of this on Monday morning and, as the Deputy has requested, he had intervened by Monday afternoon to resolve the matter. Once it was brought to the Minister’s attention, he took swift action. I commend him for that because this never should have happened and it was never the intention that it would happen.

As a Government, we have significantly increased investment in the National Ambulance Service and, in fact, we have increased it by 37% since 2019 or, in other words, by €63 million. The budget for the National Ambulance Service for 2024 is €231 million. When it comes to staffing levels, there are 419 additional staff working in the National Ambulance Service than there were at the end of 2019. Tens of millions of euro of additional funding and hundreds of additional people working in the National Ambulance Service is the record of this Government in terms of investment in our ambulance service.

I would like to receive information on the cases Deputy Collins referenced. It is important that he highlighted them and I thank him for doing so. I am sure we will ask the National Ambulance Service to consider them in the context of how it meets the needs of patients. The National Ambulance Service continues to experience significant growth in demand. I think 398,000 calls were received from the public last year, which is an increase of around 14% on 2019. Despite year-on-year increases in demand, the National Ambulance Service has improved service response times further this year for what it calls purple - cardiac life-threatening - and red - life-threatening - call responses. In fact, this year, it has exceeded its own key performance indicators, KPIs, published in the HSE national service plan. It gave a commitment in terms of response times and it has exceeded that commitment. It will continue to drive service improvement.

To be very clear, the Minister for Health and the Government are keen to ensure there is no reduction of emergency response ambulance services in Cork and Kerry. I regret that there was legitimate concern around that earlier this week before the Minister intervened.

Before people power forced you to retreat.

Please, Deputy.

Welcome back, Deputy Barry. The Minister is instead examining ways to ensure that funding is provided so that front-line services can be maintained. We will continue to work with Deputies in Cork and Kerry on this matter.

I thank the Taoiseach for his reply. He said this should never have happened. This is happening on a weekly basis in Cork county and, from what I hear, it is happening on a weekly basis nationally. The Taoiseach needs to step in immediately. Members of the public in Cork county and city, and nationally, deserve nothing less than a seven-day ambulance service that they can access in no more than an hour, when required. There is a crisis in the ambulance service nationally. After last weekend's chaotic decision, it very much looks like headless chickens are in charge of the service. There is no confidence in the senior management structure of the NAS. As I said, staff morale is at an all-time low, lower than has been seen in the 20 years the staff have been working in it. General managers are dancing to directors' tunes and completely ignoring staff and patients alike. There needs to be a complete wipeout of the current NAS senior managers, who are so caught up with power that they disregard mention of patients or patient care. Anyone who came out with cuts last weekend after such a grim report had been published two weeks previously must be removed from his or her position immediately. It has been widely said in Cork county that if it had not been an election year, this decision would not have been reversed. As the clock is ticking on people's lives, will the Taoiseach immediately intervene in this crisis and help build a new ambulance service that staff and members of the public can have confidence in?

With respect to the Deputy, I appreciate he is raising an important issue but he gave a view in relation to confidence and said nobody had confidence, etc. Just to be clear, I have confidence in the head of the National Ambulance Service, Robert Morton, in the management of the National Ambulance Service and in the people working in the National Ambulance Service.

That is why we raised this question.

I thank Deputy Healy-Rae for his intervention. I base that on the fact that when people give commitments as to what their targets are going to be for the year and then exceed those commitments, that is a good sign. Deputy Collins talked about the cases, and he is right to highlight them. I do not in any way dismiss them but when it comes to the published KPIs for the National Ambulance Service targets for purple and red calls, that is, life-threatening and cardiac life-threatening calls, the National Ambulance Service has exceeded those targets. To the end of July, 76% of calls in the purple area were being responded to within 19 minutes. I can understand that when something goes wrong the Deputy will want to highlight the case, as he should. We should continue to improve the services but this is an area in which we have genuinely improved service times. A lot of innovation is going on in the National Ambulance Service, with new services, the use of advanced paramedics and new training models. We will continue to invest and support the service and we look forward to doing more in the next HSE service plan.

Is that why-----

I thank the Taoiseach. Last and by no means least, I call Deputy Michael Fitzmaurice on behalf of the Independent Group.