David Stanton (Cork East, Fine Gael) | Oireachtas source

I have been told the Pre-Hospital Emergency Care Council, that is, the regulator for pre-hospital clinicians such as emergency medical technicians, EMTs, and general and advanced paramedics, requires that paramedics be privileged by each organisation for which they work or volunteer. If, therefore, an advanced paramedic who works full time for the National Ambulance Service wants also to volunteer for Civil Defence, he or she must be privileged separately by each organisation to work at the level of advanced paramedic. Part of achieving this privilege is being able to access medications that are within the relevant scope of practice. Some of these medications, such as morphine, fall under controlled drugs legislation. Each organisation typically stores these medications. Clinicians do not take them home and they are not issued for personal use. In order for an organisation such as a Civil Defence unit to store these controlled medications, it must acquire a licence and meet requirements under the legislation. Part of this requirement is to have a responsible officer, namely, the Civil Defence officer, an assistant Civil Defence officer or a Civil Defence unit. It is the responsibility of each local authority, I am told, to organise this for its respective Civil Defence unit. To date, just half of the Civil Defence units have submitted licence applications. The Civil Defence officers' association has concerns about some of the requirements, mainly relating to the role of responsible officers, and has raised these concerns with Fórsa. I am told some units have applied for a licence and that locally there is no issue, but that Civil Defence will not allow authorisation on a unit-by-unit basis. It is all or nothing. I am told this has been going on for three years and there is no sign of it progressing.

Civil Defence volunteers who are registered with the Pre-Hospital Emergency Care Council at the clinical level of general or advanced paramedic, particularly those who work full time for the National Ambulance Service, have informally withdrawn from training or attending medical units in some Civil Defence units due to an issue with privilege that has been ongoing since the summer of 2020. Naturally, these are some of the more experienced volunteers, who are usually in instructor or leadership-type roles. Their absence at training and active duties is felt by the rest of the volunteers. Some medical duties require the presence of general or advanced paramedics under health and safety guidance for event organisers, which means Civil Defence risks losing long-standing duties it covers annually or may have to request support from other organisations such as St. John Ambulance, the Order of Malta or the Red Cross, given this issue is unique to Civil Defence.

In summary, due to a privileging issue, Civil Defence does not stock the correct medications to allow general or advanced paramedics to deliver care to their scope of practice. Civil Defence will allow these clinicians to practise only to the level of EMT, a lesser capability, and I received a response to a parliamentary question last week that confirmed that. As a result, these clinicians feel they may be at risk of not fulfilling their duty of care to a patient under their professional registration and, therefore, put their jobs as full-time general or advanced paramedics with the National Ambulance Service at risk. This is extremely serious for them and has led to many having withdrawn their services as an instructor for training or as a volunteer at medical duties.

This is a serious issue. I am raising it now because, while I was going to try to prepare an amendment, it is difficult to prepare an amendment for this. I will re-examine the matter on Report Stage but I would like the Minister of State to respond now and tell me what he thinks of this provision being included as part of the section. Doing so means we will be at risk of losing very experienced people, who are putting their careers at risk because they cannot practise to the level of professionalism they have reached, and their duty of care to patients will be breached.