Joan Collins (Dublin South Central, Independent) | Oireachtas source

I support the motion. I thank Fianna Fáil for tabling it. I support it because of the men and women here tonight and their colleagues throughout the fire service and the ambulance service. I am here tonight to state that intention about the motion. I accept the motion and I will talk to the firefighters between now and any vote taking place on Thursday in order to discover what they think. While the Government is accepting the motion in general, there are parts of the response relating to the NEOC with which I am not happy. I reckon the firefighters are not happy with them either. The Joint Committee on Health could possibly set up a subgroup to work with the firefighters and the ambulance service to look at the report from HIQA in order to ensure that the resources the firefighters need are provided. The matter could then be referred back to the Dáil. It should not be placed on the long finger over a period. There should be a time limit of two or three months; whatever is negotiated with the firefighters and the National Ambulance Service workers. That might work. I would like to hear what the firefighters and ambulance service workers have to say about that but the committee could work to move this matter on. I do not think there would be general agreement with the Government's proposals.

In 2017, 233 people were rescued by Dublin Fire Brigade. Some 43 persons were rescued from fires, 70 river rescues were attended and there were 79 road traffic collision rescues. All full-time firefighters are trained as paramedics and rotate continuously between firefighting and providing emergency medical services. Dublin Fire Brigade's 12 emergency ambulances, of which it needs more, are staffed by paramedics who are available to respond 24 hours a day, 365 days per year. In addition, there are 21 front-line fire appliances, of which more are needed, with up to 120 paramedics available to respond on a daily basis. All full-time firefighters are trained to paramedic standard and are required to maintain Pre-Hospital Emergency Care Council, PHECC, registration as paramedic practitioners. All trained firefighters are trained to an emergency first responder level. Tangible clinical outcomes in 2017, illustrating the work of fire brigade emergency medical service, include: 61,462 patients treated and transported to hospital - that is a huge number; 3,527 critical medical incidents managed; and 435 cardiac arrests manage. Also in 2017, Dublin Fire Brigade assisted in the delivery of 12 pre-hospital childbirths and mobilised in 86,405 emergency ambulance instances. That is a tremendous response from the men and women of these services.

I want to make particular reference to Dublin City Council because it has already been alluded to here. In 2014, the HSE had been attempting to take control of the Dublin ambulance service from Dublin Fire Brigade. In March 2014, the director of the HSE's National Ambulance Service was called before Dublin City Council councillors to answer questions about his intentions towards Dublin Fire Brigade's ambulance service. The decision to do this was taken amid growing controversy at the time about a HSE plan - drawn up in 2013 - to take control of Dublin ambulance service from Dublin Fire Brigade by the end of 2015. The plan in question was drawn up in advance of the HSE-Dublin City Council review of the capital's ambulance service, which was announced in February 2014.

In the same month and year, at a meeting of the council's environment committee, the chief fire officer gave a presentation where he said the major issue for the fire brigade was funding. He said the fire brigade had provided the ambulance service in Dublin since 1898 on behalf of the city council, while the HSE provides for services outside Dublin. The council agrees a figure annually with the HSE. In that year it was approximately €9.8 million. The chief fire officer stated that the fire brigade's 12 ambulances were working at full capacity and even with the backup of 22 fire tenders, which often responded to 999 emergency ambulance call-outs, the brigade was not able to meet HIQA targets due to factors outside its control. Those factors were resources in areas that included ambulances and personnel. The chief fire officer stated that it had been impossible to reach an agreement on a sustainable funding model with the HSE over the years. That was in 2014.

Members from all parties and none across the council support the fire brigade service. It appears to me that the chief executive officer of Dublin City Council, Owen Keegan, and the HSE are intent on breaking an effective, efficient, state-of-the-art model of service developed over 120 years by removing Dublin Fire Brigade's ability to maintain a full fire-based emergency medical service, EMS. As other speakers have said, the model is working, so why change it? Why not expand it? Why not resource it? Why not satisfy HIQA standards and support the service?

In the time remaining I will read an email I received from a firefighter in recent days. He gives a sense of the pride the workers have in the service.

[The Dublin Fire Brigade service which] we in the service are extremely proud of, and have provided to the city for 120 years, is now under a very real threat of been removed from us and the citizens of Dublin. The HSE has proposed the removal of the delivery of this fire/EMS service from the DFB and instead merge the service with the National Ambulance Service. I know first hand the value of Dublin File Brigade providing an ambulance service and having the back up of every firefighter being highly trained in fire, rescue and paramedic or advanced paramedic skills. From a personal point of view, the comfort that I take from knowing that any of the crew members responding to an incident with me, are capable of performing life saving interventions at the scene of an emergency, makes my response a lot easier.

In today's world, where there is a constant threat of a large scale terrorist attack or even a small scale attack with high casualty numbers, running alongside the normal everyday emergencies, Dublin Fire Brigade is capable of providing in excess of 100 paramedics on-scene within a very short time frame.

Last year Dublin Fire Brigade Emergency Regional Control Centre processed in excess of 114,000 ambulance calls and 23,576 fire calls. This year to-date the figures are 56,029 for ambulance calls and 9,033 for fire calls. Dublin Fire Brigade has 12 emergency ambulances strategically located throughout the city and county. Our service is at capacity, so not only is full retention of the service an urgent matter but an increase in capacity is also required as a matter of urgency.

He goes on to state:

The National Ambulance Service, NAS, provides an emergency ambulance service to the whole of the country. At times where Dublin Fire Brigade are at capacity a request is made to the NAS for resources and vice versa, [obviously when needed]. Last year the response from NAS to [the Dublin Fire Brigade] requests for resources was 75% negative, i.e., they could not provide us with an ambulance. The opposite response, where NAS requested resources from the DFB was met with 80% positive response. [That is down to resources and that must be addressed. That is the point the writer of the email is making.]

Ambulance calls are categorised in accordance with the priority of the emergency, the most urgent calls are designated Echo calls, with Delta being urgent but not life threatening. Within the DFB response protocols, a fire appliance, staffed by an officer and 4 firefighters-paramedics is automatically dispatched to all Echo calls. Delta calls may also have a fire appliance attached if the situation warrants one. This dual response capability is a key component to our strength as an emergency service and cannot be mimicked by the NAS.

That point must be taken on board. I would like to hear the response of the workers involved in the direct front line. They are the people who save lives and they are putting their lives at risk. I think we should respect them and resource them properly. I wish to emphasise that point. We should link in with the committee to see whether we can move the issue on and bring the proper services into Dublin and across the country.

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