Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein) | Oireachtas source

Go raibh maith agat. I wish to apologise to the spokespeople from the National Ambulance Service Representative Association, NASRA, because I missed the earlier part of their oral presentation. However, I had a chance to go through the documentation in advance of this meeting. At the outset I want to pay tribute to all who work in our ambulance and emergency services. I would also like to make it very clear that when we express concern over response times, we are doing so while being mindful of the overall causes of those concerns and the incidences of which we speak. It is in no way to reflect in a questioning or negative way on the excellent dedicated ambulance crews, some of whom I have had personal experience with in the very recent past and I cannot speak highly enough of them.

Paramedics have yet to receive the proper recognition that their work deserves. Inadequate resources allocated to the service by successive governments places paramedics under enormous pressure on both a personal and professional level. I acknowledge that it is not all about resources and that ways of working must also be addressed. Indeed, they have been addressed and improvements have been made, which have been acknowledged by front-line staff. However, there is a limit. One cannot always say that it is not always about resources. It comes to a point when it is mostly about the resourcing of the service. It is clear to me that there is a crisis in terms of the current inadequate allocation to the NAS. I agree with NASRA when it says that targets are not being met because of a shortage of personnel, infrastructure and funding. No amount of rearranging things on the plate will change the fact that we have an inadequate provision. A comparison of the situation north and south of the Border shows that there are 57 ambulance bases in the six-county area of our island but only 87 for the entire 26-county area. Regarding the area in which I live, namely, the north east, including the counties of Cavan, Monaghan, Louth and Meath, we are expected to be able to survive on an ambulance cover available at any one time of the order of 12. I know that people will say that there are 30 ambulances. I read a most ridiculous article recently where a Member of these Houses said there were 180 ambulances driving around the aforementioned four counties. I wonder where they are being kept. I can say for sure that at any one time we have an available fleet of 12 ambulances covering this huge area. That simply is not adequate and I can attest to that fact on the basis of personal experience.

Does NASRA believe that the HIQA key performance indicator response times are realistic, given the level of resources currently available to the ambulance service, including personnel and equipment? The impact, from a personal and professional point of view, on ambulance personnel must be of concern to members of this committee. What is the impact on ambulance personnel of working to those response times, knowing that they are going to miss the targets, that they are just not achievable, sometimes with very tragic consequences? That must have a human toll and an impact on individual staff.

What are the implications for the emergency services on the ground of cutbacks introduced in recent years, including the cuts in rostered hours, for example, as highlighted in the NASRA document? How has the role and responsibility of the front-line paramedic changed? Is that role acknowledged by health service management? I certainly want to acknowledge it, as do my colleagues here. Indeed, I am sure this committee would be unanimous in offering, if not heaping, praise on those who work as first responders in some of the most difficult situations.