Billy Kelleher (Cork North Central, Fianna Fail) | Oireachtas source

I welcome the contributions from everyone with regard to this motion. The purpose of the motion was not to scaremonger or frighten people. It was simply to highlight the inadequacies of a service that is critical to many people. We have been accused of Punch and Judy politics. I do not mind being accused of being Punch or, for that matter, Judy, but I would be failing in my duty if I did not raise this issue because it is an issue of key concern.

There has been couched language from the Government Deputies in their support for the Government motion. At the same time, they raised legitimate concerns in mild language. Perhaps I am more direct but the bottom line is that there are major problems with our ambulance service. It is not meeting the required targets as laid down by the Health Information and Quality Authority. It is under-resourced and understaffed. By any stretch of the imagination to deny that this is the case leads me to believe that we have a greater problem with regard to the provision of emergency care in the country than I had thought.

We have had members and representatives of the HSE National Ambulance Service before the Oireachtas Joint Committee on Health and Children. They were at pains to say that things are okay. However, we have discussed the matter with front-line personnel, including advanced paramedics, paramedics and the people driving the ambulances. They have informed us that there are major deficiencies in the service. Issues have been outlined by Deputies on this side of the House in respect of some parts of rural Ireland which highlight that we are now playing dice with people's lives. There are inadequate resources and personnel in large tracts of the country when it comes to emergency cover on a 24 hour basis, and the "Prime Time" programme exposed this. I and others have tabled parliamentary questions time and again to try to find out the true extent of the deficiencies in the ambulance service. We now know that this is the case.

Our difficulty is with the denial by the HSE and senior management of the National Ambulance Service, NAS, and at ministerial and departmental levels. We must acknowledge that, by any international standard, the Irish service is under-resourced and understaffed. Compared with Northern Ireland or Scotland, the service we are providing is amazing. This is down to the dedication, determination and commitment above and beyond the call of duty of the service's personnel. The difficulty is not caused by the personnel working in the service, but by the lack thereof. We must tackle that shortage to ensure we have a service in which people can be confident.

We have discussed the reconfiguration of hospital services throughout the country, universal health insurance and the creation of hospital trusts and hospital groups in the context of what the Government calls the White Paper on Universal Health Insurance. A key problem is that, as the Government downgrades emergency departments in hospitals, ambulances must drive longer distances to provide cover. This stretches personnel's ability to reach emergency scenes in a timely fashion, as highlighted in the "Prime Time" programme. Given the response times for delta and echo calls, the service is not meeting the requirements set by the Health Information and Quality Authority, HIQA.

A review is being carried out, but we want a full comparison between the ambulance services of Ireland, Northern Ireland and Scotland. In this way, we could definitively know how under-resourced we are. The former director of the NAS stated that we would need approximately 400 personnel in addition to the current level of 1,600 staff. That is a lot. By publishing HIQA's guidelines but lowering the threshold, we are dropping standards so that they can be met. This is not proper policy. It is disingenuous to claim that the standards are being met. Of course they are if they keep being lowered. They were meant to be 80% as regards first responders, but they are now 70%. HIQA's recommended guidelines are being manipulated.

If one spoke with front-line personnel, they would say that they were at breaking point. More importantly, we know what happens when, from time to time, an ambulance is not available to be dispatched to the scene of an emergency. People's lives are being put at risk.

The Government will reject this motion, but I urge it to keep in mind the opinions expressed by Deputies from all sides of the House and to consider resourcing the NAS.

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