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

Will Mr. Dixon shed some light on the HIQA guidelines for the first responder to be at a location within seven minutes 59 seconds? He said the rapid response vehicles are meant to complement the ambulances rather than replace them. Is it the case that the rapid response vehicle is sometimes the only vehicle dispatched to a very serious traumas, such as a heart attack? Does that happen regularly or only when there is a shortage of ambulances? Is it almost an unofficial policy that rapid response vehicles are used not only as the first responders, but also as emergency vehicles?

Mr. Dixon referred to staffing and a lack of resources and made comparisons with Northern Ireland and Scotland. One could argue that we do not have the vehicles or the staff and Mr. Dixon went on to say that management does not seem to appreciate the pressures under which staff work. Is there any form of communication between the front-line paramedics, ambulance drivers and others and management to deal with the shortage of resources in terms of vehicles, the shortage of personnel and the stress and pressure under which people must work to try to deliver emergency care?

In regard to the reconfiguration of hospitals throughout the country, the biggest concern people have when there is a downgrading of an emergency department in their communities is whether there will be an adequate ambulance service put in place. When hospitals emergency departments are downgraded, are there any formal discussions in terms of the delivery or enhancement of an ambulatory service? Is there any mechanism in place to ensure that is the case as opposed to just downgrading the emergency department and hoping there will be no difficulties in a particular area?

I refer to some of the very serious incidents which have been highlighted and the tragedies that have unfolded because of the inability of the emergency services to respond in a timely fashion due to the lack of resources.

Are the witnesses satisfied with the investigations into those complaints by the National Ambulance Service, NAS? In other words, when something happens and it is brought to the attention of the NAS, are the witnesses satisfied that the service investigates the matter correctly, liaising with the families involved and giving an explanation as to why there was not a timely response, as per the HIQA recommendations and guidelines?