Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I very much welcome the HIQA report on the ambulance service, which was requested by my predecessor, the former Minister, Deputy Reilly, some time ago. The report provides us with an opportunity to reflect on the progress made in pre-hospital emergency services and to acknowledge the challenges and opportunities ahead.

I am aware there are shortcomings in the current service provision. However, I assure the House that I am committed to improving services and performance.

The National Ambulance Service is modernising and reconfiguring its services so they are delivered in an appropriate and timely manner. A significant reform programme is under way for a clinically driven, nationally co-ordinated system supported by improved technology.

The emergency services have come a long way in recent years, from providing basic care and transport to advanced and sophisticated treatment for people in crisis. While the report confirms that we are on the right path in terms of service reform, it also sets out much of what remains to be done. Many issues identified in the report have been dealt with or are prioritised to be dealt with in 2015. A key component of reform of the ambulance service is the single national control centre in Tallaght, with backup in Ballyshannon. This will be completed in 2015 and, with the single computer aided dispatch system, provide the opportunity to further improve call taking and dispatching.

With the recent transfer of the Limerick control centre to the national platform, call taking and dispatch functions are now separated in all National Ambulance Service control rooms. The ambulance turnaround framework, to address ambulance delays at hospitals, is being implemented. The national service plan provides for 47 new ambulances next year. In addition, the 50 plus intermediate care vehicles are doing a lot of the work that previously fell to be done by the emergency fleet.

The HIQA report highlights a lack of clinical audit in the National Ambulance Service and this is of great concern. However, I am pleased that funding is provided in the 2015 service plan to initiate effective clinical auditing for the first time. Funding is also provided to expand the number of community first responders and to go a long way towards ending on call in the west.

While an extra €5.4 million has been provided for the National Ambulance Service in 2015, it is not all about resources. One of the most valuable matters identified in the HIQA report is how much more could be done with current resources. An example is dynamic dispatch. Too many ambulances spend too much time waiting in fire stations, ambulance control centres or at hospitals when they could be dynamically dispatched like so many other fleets. From where ambulance calls are going to come is predictable; they rarely come from next door to the ambulance station. We must examine alternative models of care, given that every patient who calls an ambulance does not need one and certainly does not need to go to an accident and emergency unit. In many countries, as little as 60% of the people who call an ambulance are taken to an accident and emergency unit.

The report is particularly critical of the relationship between the National Ambulance Service and Dublin Fire Brigade. This is a long-standing issue which has not been addressed to date. The HIQA report, with the awaited capacity and Dublin ambulance review, will give us a clear evidence base to finally establish a fully integrated service in the Dublin area. When we have the reports, I will consider them and request the HSE to prepare an action plan which I will bring to the Government. Taking the findings of the three reviews together, we will develop a comprehensive and coherent response. My Department will work with the HSE to ensure the development of an action plan, with timelines, to realise a new vision for ambulance services in Ireland.

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