The ongoing problems with the National Ambulance Service are not being addressed. I raised the serious gaps in the ambulance service, particularly in County Laois, with the Taoiseach last year, and it is through no fault of the staff. The number of staff in the county has not increased in the past two decades, despite the explosion in its population. Five vehicles are based in the county, with just two available most of the time. That is five nights of the week. On Monday and Tuesday nights, just one vehicle is available. This vehicle is often a long distance away, so if a serious incident arises, no ambulance is available to attend patients. This is happening on a regular basis in the county. I can list off several cases recently where that has happened.

Crews in Laois can be sent to Dublin, Wexford, Wicklow, Westmeath and Waterford. Often when they are almost at the patient's location, they are stood down and told to turn around and come back because another ambulance has just reached it. Recently, a crew from Portlaoise was two or three minutes from a scene in Wicklow but it was turned back. Dynamic deployment is not working. Crews are chasing around the country, travelling long distances without picking up patients. One crew came on to a shift recently in Portlaoise and was despatched on six occasions. On four of those occasions, the crew was stood down, including when it was almost where the patient was. It was told to turn around and come back to Portlaoise empty. On one of those occasions, it was away for almost four hours while emergencies were waiting in Laois.

Calls are being stacked. Between the time a call comes in, it could be two hours before an ambulance is actually deployed due to shortages. In a recent case involving an elderly woman in Clara, the call came in at 6.27 p.m. but the ambulance did not get there until 9.51 p.m - almost three and a half hours later. Meanwhile, there was a person in Portlaoise with a serious injury but the three ambulances were gone and there was nobody to pick up that person.

There is no rapid response vehicle in the county, despite the fact there are 56 in the State. Civil defence and the fire service are picking up the slack. Rathdowney fire service in one corner of the county dealt with four cardiac patients within a three-month period. Crews are going without regular breaks, meals, etc. The service is understaffed and under-resourced.

Will the Government provide a rapid response vehicle in County Laois? Will it ensure that at least two ambulances and crews are on at all times? Can it engage with the National Ambulance Service? The Government and the Minister for Health need to do this and get a more logical deployment model.

I thank the Deputy for raising an important issue, particularly for his constituents in County Laois. We have a National Ambulance Service. I am sure the Deputy will appreciate I cannot run the National Ambulance Service from here but I will engage with the issues he raised and I will talk to the Minister for Health about them. The National Ambulance Service will always defend the model it has, and it has consistently defended it over time. Notwithstanding that, we have heard illustrations, observations or commentary from different parts of the House about how that service has not been optimal in terms delays attending particular accidents, events or locations. I heard about one yesterday from Deputy McAuliffe, involving an elderly woman in Dublin waiting four hours.

We will engage with the National Ambulance Service but the investment has continued apace. I take the point made by Deputy Bacik earlier that it is not just about investment. I accept that. It is about how the investment is deployed and allocated and what the productivity outcome is from moneys we allocate. Since about 2022, the HSE has invested about an additional €75 million in the National Ambulance Service, with staff numbers increasing by 761 in the same period. Over 85% of National Ambulance Service staff work in direct patient-facing roles. That does help improve ambulance response performance, with additional emergency ambulances, immediate care services and developing alternative care pathways, including community paramedic services.

As the Deputy knows, a new helicopter emergency medical service has been established in the west and the north west. That does not affect Laois. There is further investment this year as a result of the budget, with €34 million for renewal and expansion of the fleet. This is €34 million for emergency ambulances and other response vehicles. The investment is continuing. We are looking at about €291 million being spent on the National Ambulance Service in 2026, with about 2,503 employees. That is up again on the same period last year. Further investment is planned this year, with 21 extra crewed ambulances at peak demand, four intermediate care vehicles and the continued development of clinical hubs and alternative care pathways.

I will speak to the Minister about the emergency response vehicle for Laois and will ask her to reflect on and engage with the National Ambulance Service in terms of the model it uses.

When we compare what we have to what Scotland, which has similar population and geography, has, it has 5,000 staff while we have just over 2,500. Scotland has 1,500 vehicles while we have 620, so I think the Taoiseach accepts there is ground to be made up.

The spring economic statement that came out yesterday shows there are substantial resources there. I am not asking the Taoiseach to throw that money around like confetti. I do not want him to do that but I want the Government to make the ambulance service a key priority in the forthcoming budget. It is essential. We have heard enough over the years about the golden hour. If an ambulance does not get to a person for two or three hours, time is lost.

I am asking the Taoiseach and the Minister for Health to ensure County Laois is provided with a rapid response vehicle because we are at the crossroads of Ireland with the N7, N8, N80 and N78 all going through the centre of the county. I am asking the Taoiseach to ensure there is positive engagement with the National Ambulance Service to sort out rapid deployment and to ensure two or three ambulances are on at all times in County Laois.

Regarding the spring-October statement, the general Government balance is in surplus but all of that money is being used. There is an Exchequer deficit of €1.1 billion. The rest goes into the funds, which we have provided for. Nobody is commenting on that. That €10 million is not hanging around somewhere to be used. The bulk of it has been allocated to the funds and it is being invested in the economy, housing, infrastructure, wind energy and so on.

If we look at the ambulance service over a ten, 15 or 20-year period, a revolution in emergency care has happened, for example, the Pre-Hospital Emergency Care Council and emergency medical technicians. The professionalisation of the entire area has been quite remarkable and has led to very significant outcomes in terms of responses to patients and first responders. It has been dramatic compared to what we had historically but I accept the Deputy's point that there are legitimate issues that need to be examined by the HSE and the National Ambulance and I will ask the Minister to do that.