Mr. Peter Ray:

In regard to the target period of seven and a half minutes, in the UK service, which is a comparable quality service across the globe, this target has been examined in a different light in regard to patient outcomes. The target period of seven minutes 59 seconds emanated in 1979 but that was a different day and age. As that target was in operation in the UK it was transposed here. It was a convenient mechanism to apply here, but for today's ambulance service, there is no scientific basis for it because what is called a critical intervention period for a patient in hospital is well outside the eight minutes period. Patient outcomes is what is being examined currently in all developing services.

On the question raised regarding a second vehicle that might arrive at the scene of an incident, that is a patient-carrying vehicle that would arrive within the target period of 17 minutes 59 seconds minutes rather than a second vehicle.

A first responder might get to the scene within the target response time of 7 minutes 59 seconds because they live in the community; it could be a next door neighbour or whatever. The second vehicle could be an RRV instead of a patient-carrying vehicle. The target for a patient-carrying vehicle is 17 minutes 59 seconds.

Regarding the vehicles, a question was raised about the figures supplied. All the vehicles would not be on duty at the one time. In other services the figures supplied would be vehicles that are on duty at the time. The numbers supplied by the Health Service Executive, HSE, to us are on the actual fleet. Some of them might be parked but the numbers that might be on duty would be considerably reduced from those figures. Also, there is a cohort - the officer response vehicles - that would be a resource to call upon out of hours; they are not actually on duty.

Queuing of ambulances is a worldwide problem. It is not unique to the Irish set-up. A number of jurisdictions have examined different ways of trying to tackle it. I am sure if there was to be a capacity review it would examine what might be deployed in other jurisdictions to try to resolve that problem but it is not unique to the situation in Ireland. It happens in the Australian, American and United Kingdom ambulance services. I hope we would not end up with the Australian experience because they use ramping, which involves putting people into a 40 foot container. In the Australian services it is like a second room but it is kitted out with staff etc. They call it ramping because of the ramp up into it.

Regarding the degree programme, the Irish Ambulance Representative Council, under the auspices of SIPTU, has always welcomed the continued professional development of the service for the staff in terms of education. The BSc programme will be coming down the tracks. There are a number of hurdles that University College Dublin and other educational establishments must overcome but, essentially, people entering the service now will have a BSc degree in line with all other health care professionals, that is, nursing and all the other paramedical personnel. It is a very important development education-wise. It brings us into a new plain, and we welcome it in that regard.

Mention was made of the pressures on staff, critical interests, the stress management programme, etc. That area needs investment because staff are constantly under pressure from local management to try to meet these targets. I will hand over now to Mr. Bell.