Kathleen Lynch (Cork North Central, Labour) | Oireachtas source

I thank those who made contributions to the debate up to now. I must admit that I did not hear all of the contributions but I will very much take on board what was said during those for which I was present. I wish to express my thanks to the people who crew ambulances throughout the country. I recently had an opportunity to be very thankful for those individuals. As Deputy McConalogue correctly stated, treatment begins when a highly trained paramedic or first responder attends at the scene of an accident. That is why what these people do is so important.

The Minister, Deputy Reilly, outlined the significant reform programme currently under way within our ambulance services. Everyone acknowledges that this programme has been put in place. We are making progress and additional resources have been provided to the national ambulance service, NAS, to facilitate further developments. Additional funding of €3.6 million and 43 extra staff were provided in 2014. The NAS is working to ensure the provision of high-quality and timely emergency pre-hospital care services, using all available resources as effectively and as efficiently as possible. However, as with any pre-hospital service, the process of development and modernisation is ongoing, particularly as technology and clinical standards change.

A number of Deputies referred to the use of officer response vehicles. While usage of these vehicles is currently under examination by the NAS, I should clarify that officers use official vehicles in line with NAS policy on the authorised use of official vehicles. Use of a vehicle out of hours may be approved by a senior manager where it is necessary for an officer to be on call. Deputy McConalogue explained the difference between rostering and being on call very well. Use of a vehicle out of hours could include parking it overnight at an officer's home in order to facilitate on-call availability. Officers using vehicles out of hours are qualified to respond to life-threatening calls. These vehicles can be tracked by control centres and are available for dispatch. It is important to note that the vehicles in question are a valuable additional resource, particularly as officers provide an emergency service in their communities outside normal working hours. Officers are not paid an on-call allowance and respond to these calls on a pro-bonobasis. In the first quarter of this year, officer vehicles responded to over 630 incidents. More than 250 of these occurred outside working hours and the officers involved received no payment for their attendance in respect of them.

A number of Deputies also raised issues relating to ambulance coverage in specific areas. They may wish to note that an independent review of NAS capacity nationwide is currently under way. This review will provide greater clarity while also determining the level and use of resourcing required in terms of staff, vehicles, skills and distribution for the provision of a safe and effective service now and into the future. It is accepted that we need to further improve the service. The single national control system, which is due for completion in 2015, will improve our control and dispatch performance. We are also continuing to develop the intermediate care service, which is specifically focused on non-emergency clinical transport, such as inter-hospital transfers and low acuity work. This frees up emergency resources - which traditionally provided such services - to focus on more urgent calls. In order to drive improvement, performance response time targets for 2014 in respect of high acuity emergency calls have been increased in the service plan.

Further areas for improvement will be identified by the three separate reviews of pre-hospital care which are currently under way. I have already mentioned the capacity review. In addition, HIQA is examining governance arrangements to ensure the timely assessment, diagnosis, initial management and transport of acutely ill patients to appropriate care. A joint review of Dublin ambulance services, commissioned by Dublin City Council and the HSE, will determine the best model of ambulance services for the city. The reports relating to these reviews will inform the development of a modern, clinically-driven system - properly resourced - which will deliver appropriate and timely services for the benefit of patients. I assure the House that the NAS will continue to modernise and reconfigure services in order to deliver the best possible level of pre-hospital emergency care.

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