It was a decision that led to not only the closure of an emergency department at an acute hospital but the resignation of a key government deputy who would later become a controversial member of the cabinet.

Denis Naughten lost the Fine Gael whip in 2011 after voting against the government and the decision to close the emergency department in Roscommon County Hospital, but his constituency colleague Frank Feighan "roughed it out" - telling angry protesters the hospital would be safer in future with a different path to development.

The arrival of the shiny new Department of Defence air ambulance to be based at the Custume military barracks in Athlone was the political  "life-line" that Feighan needed.

The presence of the air ambulance was Frank Feighan's personal safety card

With a permanent air ambulance unit in the region and with local patients now speedily moved to Galway University Hospital after road crashes and medical emergencies, Feighan proudly proclaimed that dozens of lives have been saved because of the stand he took.

He was still frequently jeered and heckled in public and sometimes feared for his personal safety but the air ambulance presence was his own personal safety card and he never missed an opportunity to show it off.

He stood closest to the chopper's doors and reminded everyone it would not have happened if the hospital ED had stayed open.


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Fast forward to November 2019 and the scene is the vast open square of the same army barracks in the town of Athlone.

In the dark and wet winter's daytime the purpose-built hanger built here for the chopper will be empty for at least four days a month from this point onwards - the chopper service itself effectively pulled out of service after major concerns over training, safety and manpower.

.....for any pilot from Cork coming up here it is clearly going to take more time and careful scrutiny of the locations to get the job done safely.

The problem is, in fairness, a worldwide, issue. Retaining highly-qualified and experienced pilots and staff in State employment is now a never-ending headache for those charged with flying army and State air services.

Whether it's the Athlone-based AC112 air ambulance or the Baldonnel-based Lear government jet or any other defence force regime aircraft in any corner of the western world, there's a huge demand for experienced captains and pilots and the battle to match wages and conditions is a losing one for many governments.

The Department of Defence should have up to ten crews to choose from when it comes to providing experienced and highly-quality personnel to fly these air ambulance services in Ireland.

Each aircraft should be safely equipped with a captain and a co-pilot who work with an experienced HSE paramedic when it comes to swooping from the skies over Roscommon or Longford, or any county in the top half of the country for that matter, and saving the life of somebody unfortunate enough to have been involved in a road collision or perhaps suffered a heart attack.

The reality is, however, that today the Defence Forces can only rely on three crews to do the job and even that includes the use of some of the top managing officers in the unit who are tasked with not only ensuring safety and training standards are maintained but must nowadays get into the chopper themselves in Baldonnel and fly to Athlone once a month to operate the emergency service themselves.

While there are a number of new cadets going through the training process at the moment, the service cannot operate without the experienced captains in the middle ranks and that's why this week's reshuffle of the services has been forced to happen and is causing such concern for people who rely on the air ambulance in the region.

The Athlone chopper will be grounded for four days per month from now until February to allow key personnel get back to urgent duties in training and management and in the meantime the public will depend on the coast guard helicopters and the Cork-based charity led rapid response service to literally come to the rescue.

The southern team will even have a new base for their four days tour of duty right beside Roscommon hospital which Frank Feighan and Denis Naughten have of course both welcomed.

Nobody doubts the ability of the highly-trained and professional personnel in these services to respond to the task they are being given, but there are a number of question marks and key concerns about what is going on here.

Lack of local knowledge 'concerning'

In the first instance experienced flying personnel say that landing the coast guard aircrafts in the same terrain that the Army's AC112 services have been using will be a non-runner in many areas.

The larger coast guard aircraft needs a much more spacious and significant site to land safely in and the days of the air ambulance "landing in the front garden of the victim's home when an emergency hits are over" as one experienced staff member told me this week.

....who covers their liability in Cork and Kerry when they are now up along the border responding to an emergency

The journey from the incident or accident to the chopper will inevitably be longer for the patient and the delay, while still relatively short, is going to be an immediately irritating and distressing factor for those waiting for a life-saving service.

The lack of immediate local knowledge of the specific terrain of the region is another concerning factor.

The Athlone-based crews have built up thousands of flying hours in the top half of the country and already have their own specific knowledge of key locations in practically every town or community where they can land safely and deliver the service.

"You can't build up that sort of intelligence overnight," one HSE paramedic said to me this week.

"The aero-medical team knew exactly where they were going and precisely how close they could get to the scene of any incident. They were in automatic drive once the call came in - and for any pilot from Cork coming up here it is clearly going to take more time and careful scrutiny of the locations to get the job done safely."

While these matters may be overcome in some respect as time goes on, the overriding and most serious issue of concern about the new arrangements is the major reduction on the operational capacity of the service to be provided by the coast guard and the Cork team in the jobs they are already tasked with - along our coast and in the south of Ireland.

"The southern heli was always available to be called upon" the paramedic points out, "but who covers their liability in Cork and Kerry when they are now up along the border responding to an emergency and what happens if a fishing boat is on fire off the west coast while the coast guard is desperately trying to get a car accident victim to hospital in Dublin?"

Those who know how these air ambulance services operate place huge emphasis on the professionalism of the personnel flying them but any further "stretching" of the duties is seen as deeply concerning and a recipe for problems - when major emergencies actually happen as they inevitably well.

New cadets will of course come on stream in due course and ease the problems as they become experienced but this solution is considerably down the road.

In the meantime people like Frank Feighan in Roscommon will watch carefully to see there is no erosion of the life-saving service that the "green bird", as it has become known in the skies over the midlands and the west, was providing to every parish and every community in the region on a daily basis and was so warmly welcomed too by dozens of people who would have lost relatives and family members were it not available to fly to the scene of their injury or illness.