Mr. Geoff King:

We introduced tubes. Everyone thinks these scenes are dignified but they are not; they are full of vomit or whatever. The tubes have made it more dignified. The view is that the job is done but there are two more to do. We cannot pronounce death. Now, the paramedics cease resuscitation but they must wait for the doctor or general practitioner car. At night time, they may be at the scene where a person has died in home or on the roadside. They pronounce death but nothing is going to be done and they must wait for a doctor. It could be ten minutes, one hour or the next day. Hours are wasted when those people could be out resuscitating others who could survive. What we need is endorsement. We do not even need legislation because the city coroner is on board, and we are going to meet the coroners, but we need support for the view that it is legitimate to do what they do in the United Kingdom and Australasia. It should be signed off that a paramedic can pronounce death. It is safe. It is crazy that we have to wait for a doctor, who has other work to do, to do it. That is where we need help.

There is another issue relating to the do-not-resuscitate order. Let us think ahead. The HSE has a draft document on do-not-resuscitate orders and the executive must plan to legitimise it. We need to have it legitimised because we are currently in no man's land and people who do not want to be resuscitated are being resuscitated. In those last two instances we were missing response times. The committee members have read the paper. People who could be saved are not getting a shot because we are wasting time on the acceptance that only a certain person should be able to pronounce death and an acceptance that we need do-not-resuscitate orders. We do not need legislation but the legislation could help, perhaps, in a secondary way.

Finally, we need more ambulances.