I acknowledge the excellent contribution our National Ambulance Service, NAS, teams make in delivering emergency care right across the country.

Helicopter emergency medical services, HEMS, are consultant led and paramedic-delivered in Ireland. The NAS provides two dedicated HEMS aircraft, including one aircraft operated in conjunction with the Irish Air Corps. Also, the Irish Coast Guard provides aeromedical support to the HSE in addition to the services already mentioned. HEMS provide fast-access, lifesaving pre-hospital emergency care interventions. Currently, HEMS services are crewed by highly trained and qualified advanced paramedics. The HSE is aware that a variety of crewing models are used around the world depending on geography, distance travelled and other factors. The NAS is proceeding with a previously planned feasibility study to look at the suitability of physician crewing on NAS HEMS aircraft.

A number of emergency department consultants, some of whom have returned from the UK and are working in Ireland, are talking to many politicians - I know this because they are all talking to me - and trying to bring about a change to how this is done. We are not committing to any changes at this point because we are committing to a review. Maybe they are right and maybe they are not. Maybe they are partly right in that there is an augmented model we need to use. We are aware of it. I have had conversations with quite a number of members. These consultants are very politically active and are making a strong case. It is a model they have seen work very successfully in the UK and maybe further afield and they believe we should bring it in here. We are taking their expertise and submissions very seriously and are reviewing the model to see if it is one we should move towards.

I agree with what the Minister said in terms of how highly skilled our advanced paramedic teams are and the level of care they provide at the scene of accidents and crashes. However, having examined this consultant-led model, I think it is one we need to look at because there are things consultants can provide that cannot be provided by advanced paramedics such as anaesthesia to protect the brain, blood transfusions and accessing major blood vessels to stop haemorrhaging, so it is something we should explore. It is in the space of road safety as well. As we have spoken about in many debates at committees and in this Chamber, the numbers of road deaths and serious injuries are going in the wrong direction again. It is incumbent on the State to do everything it can to provide the best possible health service and if that means consultant-led services at the scene of a crash or accident, I hope this State would be able to provide that.

It is something we are taking seriously. We are looking at it. Essentially, the question is whether it is consultant-led or consultant-delivered. Is there a consultant in the background or is there a consultant on the helicopter? The argument is that if we have an emergency medicine consultant on the helicopter, there will inevitably be cases where the patient will get a higher level of care. In some cases, that might make all the difference. We must ask a balancing question about what the position would be if that consultant was in the local emergency department. In those circumstances, would other patients get the increased level of care on offer from emergency department nurse to non-consultant hospital doctor to consultant? There are about 150 emergency medicine consultants in the country. The question is where they are best deployed in order to do the most amount of good for patients. We are actively looking at this proposal.