Róisín Shortall (Dublin North West, Labour)

I thank the Deputies for giving me the opportunity to address this issue. I am responding on behalf of the Minister for Health, Deputy Reilly.

The HSE's national ambulance service, NAS, has been progressively improving and modernising emergency ambulance services in Cork and Kerry. As part of this process, stations and crews are changing from being on call to having on-duty rostering. Being on duty means our highly trained paramedic crews will be on-site in their stations or in their vehicles to respond to dispatches, rather than being alerted and then having to make their way to the station when called out. This drastically reduces deployment times for emergency vehicles. On-duty status means resources can be deployed dynamically. This means that vehicle location during a shift is based on need and demand patterns such that vehicles will not just be sitting at a station. This produces greater flexibility and responsiveness. Under the dynamic model, on-duty emergency ambulances are available from within a region as required. This will produce better response times for the people in Cork and Kerry and a better service.

Current evidence suggests patient outcomes are improved by better treatment and stabilisation of the patient at the scene, followed by ongoing treatment and transport to the most appropriate centre, even if that means longer transport times. On-duty rostering of ambulance staff will, therefore, support a modern emergency response service involving paramedics, advanced paramedics, community first responders and GP out-of-hours services working together to respond to emergencies. This approach is consistent with international best practice and will assist with compliance with HIQA response times and quality standards.

I note that ambulance staff themselves sought the elimination of on-call working, that the relevant period has already been reduced from 44 hours to 16 hours per week in the region and that it will continue to decrease on a phased basis as part of the improvement of services and response times. There are ongoing discussions with staff on implementing the proposals, and both the HSE and unions are committed to this process.

The HSE's NAS is engaged with union representatives, through the Labour Court, regarding on-call arrangements for ambulance services in the south west. All parties have accepted that, in accordance with a Labour Court recommendation, providing ambulance services under on-call arrangements should cease. The National Ambulance Service has begun removing on-call arrangements by focusing on east Cork in the first instance. It has been agreed that the arrangements for the removal of on-call in east Cork will be reviewed after six months with a view to implementing similar arrangements in west Cork by mid-2013.

It is important to note that emergency ambulances are staffed by paramedics working in pairs. Where an individual paramedic does not report for duty, the other paramedic on that shift is available to respond to emergency calls. While an individual paramedic cannot transport patients to hospital, support is provided through strategic deployment of available resources. This ensures a patient transporting vehicle is available. The HSE national ambulance service is committed to implementation of the HSE attendance management policy and continues to manage absenteeism on this basis. I thank the Deputies for raising the matter.

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