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

I thank Ms Laverne McGuinness for her presentation and welcome the representatives from the national ambulance service, NAS. In her opening statement, Ms McGuinness referred to a programme of change, stating, “In order to develop a modern and improved ambulance service the NAS commenced a significant change programme in 2012”.

She then went on to outline the ten key strategic objectives of that programme. One of them was to undertake a national ambulance service capacity review and another was to implement the response times improvement framework. When one looks at the situation in relation to each of these - I refer, in particular, to the national capacity review - Ms McGuinness stated that these reviews are already under way. This is the end of 2014. These were signalled as objectives back in 2012. In fact, an indication was that the NAS had commenced a significant change programme back then. It is two years plus since then and it would not give me confidence. What Ms McGuinness said is that the national capacity review is to independently determine the resource requirements. At what point is that review? It seems like an inordinate delay.

Number four of the four updates in relation to these is an independent review of the NAS fleet. We already know from the information provided to this committee that 20% of the fleet is more than eight years old, with more than 500,000 km on the clock, and of a standard that could let people down in circumstances where emergencies present. How long will the independent review of the fleet and the independent review of the resource requirement, in its broader sense, take? These are urgent requirements not only in relation to ambulances and personnel but to how effectively the network of ambulance centres across the country are placed. Ms McGuinness actually indicated three of them in the course of her address. How many ambulance centres are there currently? Are they all in service on a 24-7 basis? Does Ms McGuinness have the figures for each of the HSE areas? If she does not have them to hand, maybe she could provide them. If she has them, I would welcome that, in particular in relation to the north east, where there is a belief and anecdotal evidence that there are serious delays. I have already recounted here personal experience of that, including in this year.

Lightfoot highlighted in its summary of recommendations that the national ambulance service should undertake further investigation into why emergency calls per head are so low in Ireland by comparison to England. It is something to which Ms McGuinness referred also. She said that this difference cannot be fully explained. There is a serious differential here of 40% in terms of the difference in ambulance calls per head of the population. It would suggest to me that Irish people are reluctant to call an ambulance when perhaps that would be what they should do. Is it consequential on previous experience and a lack of confidence? These are important and serious questions and it is not enough to park the differential. It would appear that calls for ambulance support and service in the neighbouring island are significantly greater.

Ms McGuinness talked about the Dublin fire brigade and made the reference to the NAS and the DFB having statutory powers for the provision of emergency ambulance services and that work was completed to develop and put in place a service level arrangement but she did not reflect was what actually said to this committee a short time ago. The notation by HIQA was that the Dublin fire brigade - I mean no disrespect to the representatives of the NAS here today - had a more acutely refined response time and performance. It drew a clear distinction between the NAS and the Dublin fire brigade. Are there lessons for the NAS to learn from the Dublin fire brigade? These are not my words. I am asking the question certainly, but the evidence that is at the backdrop to the question is presented by a body entrusted to carry out these assessments and give of its expert and professional opinion. I am not drawing a distinction between the two. In fact, I have no experience at all of the Dublin fire brigade service and only have an excellent experience of the personnel working in the NAS. However, what I do not have is an excellent experience in terms of call out time.

Ms McGuinness may be aware that I have personal experience. My family never had occasion to call an ambulance but in the past 12 months, we have had three occasions. Two of them were cardiac and the other was a collapsed state of an elderly member of my family. The first cardiac resulted in the death of the victim while the second was myself and I was more fortunate. Each of the three addresses where the events took place are half a mile from an ambulance station in our town. Two other stations are located close to us. The ambulances all came from 45 miles away. I instance it only because I was present at all three events. I say it as no criticism of the personnel who presented in all cases and to whom I take my cap off. However, it has to ring alarm bells.

I do not believe for one moment that in the three incidents, each of the other three stations were completely out of service or already in service, whatever was the case. I am really anxious to know what is the status of the station in Monaghan at Rooskey and the situation at Castleblayney and at Cavan General Hospital. Why was it that on each of those three occasions, ambulances to present in Monaghan town had to come from Virginia in the south east of the neighbouring county of Cavan?