Ms Laverne McGuinness:

Apologies, the north east. The response to emergency calls is slower in Ireland compared to the UK. The capacity review shows that the rate of call out of our ambulance service is 40% that of the UK.

We are looking through that and Dr. Cathal O'Donnell will speak about it in more detail. It signifies that we have wide access to our GP services, including out-of-hours access. Our GP services are accessible on a 24-hour basis. It is very unlikely that a person would go to a GP and not be seen. The situation in the UK is not the same. At the moment we transport 100% of our patients to hospital and HIQA has said that we need to look at alternative models of care. However, given that only 40% of people are actually ringing the ambulance service in the first instance, we have less of an opportunity to divert patients elsewhere. We are looking at "treat and discharge" and "hear and treat" as part of alternative models of care. We need to do that in collaboration with GPs. Dr. O'Donnell will elaborate on that further.

There is an ongoing working relationship between the Dublin fire brigade and the national ambulance service. In the briefing document I outlined some of the legal constraints regarding service level arrangements which the European Court of Justice ruled on. We could not enter into a formal service level arrangement but we do have a memorandum of understanding in place under which we transfer funding. It is not the optimum working arrangement that two service providers are providing different models of care across Dublin city. The Dublin fire brigade does not use a separate call taker and dispatcher, which is the model we have moved towards.

We are working towards enhancing our working relationship. We have met Dublin fire brigade again and there are ongoing meetings between the Chief Fire Officer and the director of the national ambulance service and at the highest levels of the organisation, the Director General and the City Manager have agreed a joint implementation plan in response to HIQA. However, there are areas that need to be streamlined in the interests of patients and that is why we commissioned the capacity review for Dublin city and county. That review will be publicly available in February 2015. It took a little longer than anticipated because there was a very wide consultation process involving unions, service users and various stakeholders, including HIQA.

Regarding Rooskey and Monaghan, my colleague Mr. Martin Dunne will address the issues raised.