Helen McEntee (Meath East, Fine Gael) | Oireachtas source

I wish to pass on the apologies of the Minister for Health, Deputy Harris, who cannot be here. I thank Deputy Nolan for raising this matter and for giving me the opportunity to inform the House of the position relating to it.

The main role of the National Ambulance Service is to respond to emergency 999 or 112 calls, as the Deputy knows. On average, the National Ambulance Service responds to 21,500 emergency calls per month. There is, of course, a significant requirement for transfers of non-urgent patients for various clinical reasons outlined, including transfers between hospitals, transfers between residential and acute settings and transfers for diagnostic tests at other hospitals. The National Ambulance Service provides such inter-hospital transfers through the intermediate care service. By providing this service for lower acuity hospital transfers, emergency ambulances are freed up for the more urgent calls. On average, the National Ambulance Service undertakes 3,800 inter-hospital transfers per month.

In the context of the continued increase in demand for emergency ambulance services in recent years, there is a need to avail of private ambulance services to secure additional capacity for such patient transfers where required. To this end, the HSE has put in place arrangements under a framework agreement that provides for the utilisation of private ambulance providers. In circumstances where providers included in the agreement are not in a position to provide the service required hospitals are permitted to seek patient transport services from other providers recognised by the Pre-Hospital Emergency Care Council. The reality is that there is ongoing need for hospitals to have the flexibility to be able to access private ambulance services where necessary and appropriate. However, the Deputy may be interested to note that the HSE has commissioned a review of public and private ambulance service provision. The purpose is to assess the costs of both services, ascertain the appropriate use of those services and clearly define the parameters for use of public and private providers.

Intermediate care services for the north Leinster area, which encompasses the former midlands area, operate from the Mullingar, Cavan, Cherry Orchard, Castleblayney and Ardee bases. On average, the service based at Mullingar undertakes 41 routine inter-hospital calls per month. Emergency ambulances in the midlands area undertake a similar number of journeys monthly. Where additional services are required, hospitals may directly request private ambulance services.

The National Ambulance Service has undergone a significant process of modernisation in recent years. This ambulance reform programme is taking place against the backdrop of the HIQA review of ambulance services and the National Ambulance Service capacity review, which was published last year. The review examined overall ambulance resource levels and distribution against demand and activity. Implementation of the recommendations of the capacity review will require a multi-annual programme of phased investment in ambulance manpower, vehicles and technology.

In 2017, an additional sum of €3.6 million has been made available to the National Ambulance Service. This includes €1 million for new fund developments. Development funding will be used to increase the number of paramedics and intermediate care operatives in line with the capacity review recommendations.

There is always a need for the public and private sectors to work together to be able to cater for gaps in the system and improvements we are trying to make. Again, the increased number of people accessing and in need of our services will automatically result in increased demand in the public and private sectors. That is possibly another reason why the numbers are increasing.

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