Séamus Kirk (Louth, Fianna Fail) | Oireachtas source

I thank the office of the Ceann Comhairle for selecting this most important topical issue. Yesterday, the Health Information and Quality Authority, HIQA, review of pre-hospital care emergency services was published. While there have been many positive developments in our ambulance services in the past ten years, the HIQA review of pre-hospital care emergency services is a cause for great concern. It found that the National Ambulance Service, and many hospitals, struggle to routinely meet their targets. Additionally, it found a lack of effective leadership, clear strategic planning and ongoing constructive co-operation between management and staff in the National Ambulance Service. This must be acted on with the greatest urgency.

Alarmingly, the report tells us that a number of staff reported that they did not have appropriate technical knowledge for their positions. HIQA also says it is unacceptable that, owing to the lack of clinical audit in the National Ambulance Service, quality assurance of clinical care is very limited, especially for staff who have completed training.

The review also highlights the deficiencies in dispatch and response. Three different computer-aided dispatch systems were in use at the time of HIQA's review. Those systems are not integrated, which means the National Ambulance Service continues to operate as six different services within defined geographical areas rather than as one national entity. That means there appears to be limited visibility of ambulance resources outside the geographically defined areas.

The most disquieting finding is that there is a lack of effective leadership, clear strategic planning and ongoing constructive co-operation between the management and staff of the National Ambulance Service.

This must be acted on with the greatest urgency. It is alarming that a number of staff reported that they did not have the appropriate training knowledge.

The disjointed relationship between the National Ambulance Service and the Dublin Fire Brigade is also highlighted in the review. Both bodies should move swiftly to publish the joint action plans that HIQA is recommending.

It is clear there is a need for more resources in our ambulance services, just as it is clear that there is a need to better manage those resources. The Government must act on the former and the National Ambulance Service must act on the latter. It seems from the reports today that the HSE has admitted that urgently needed improvements to the ambulance service will have to be delayed because of a lack of resources. The HSE is indicating now that longer target response times may be introduced for ambulances in rural areas compared to those operating in cities.

With regard to first responders, the National Ambulance Service seeks to have one on the scene of an emergency call within seven minutes and 59 seconds in at least 75% of cases. The best monthly results for ECHO calls involving immediately life-threatening cardiac and respiratory arrest was 58%. The best result for DELTA calls involving other life-threatening situations was 34%, just over one in three.

HIQA says that the National Ambulance Service demonstrated consistent underperformance in the efficiency of call taking and the processing of emergency calls. That has contributed to poor response times to ECHO and DELTA calls.

I am glad the Minister for Health is in the House to take this important item. What action does the Government plan to take in light of this report?

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