Michael Lowry (Tipperary, Independent) | Oireachtas source

I support the motion. I raised this matter with the Taoiseach last week. I requested an urgent independent review of the ambulance service. Since I highlighted the issue, I have been contacted by paramedics, patients and medical professionals from every corner of the country. Story after story has been relayed to me, some through anger and others through tears, but all of them through frustration and desperation.

This service is in crisis and I am not sure that the Minister, the HSE or those who are responsible for delivering the service are fully aware of the extent of the problem. This service is failing those who strive every hour of every day to provide emergency care. This service is failing men, women and children throughout the country. This service is failing full stop.

I could quote stories of the anguish and suffering being experienced by patients, and it would be a long list. We have all heard them. Every public representative here has heard the stories emanating from paramedics, ambulance crews and the public who have been affected by this problem. Most of these stories we hear are heart-rending. Each one is a catalogue of human suffering. The realities of our flawed National Ambulance Service cannot be allowed to become a vote-catching opportunity for any elected representative, including me.

We have a duty to demand that this be put right. This is our duty, in the first instance as human beings and in the second as elected representatives.

We cannot fail on this issue. It is too important, and failure is not an option. We must start to improve what is a substandard service, which is being experienced every day by people everywhere. We must tackle this national crisis by engaging with and listening to the front-line staff. We must ensure those who are doing the job have the means, structures, conditions, support and co-operation to do it safely and effectively.

The words "health and safety" have become so much a part of everyday life that one wonders if they are now simply taken for granted. It is ironic that health and safety regulations in the case of paramedics, who are recognised globally as being among the most highly skilled medical professionals, are constantly ignored or sidelined. If an individual has a licence to drive a heavy goods vehicle, he or she is obliged to obey the Road Safety Authority rules. These rules require a maximum of four and a half hours driving which must be followed by a 45-minute break. The driver's working day must be no longer than nine or ten hours, with weekly and fortnightly limits to be observed. Weekend breaks are also enforced.

A paramedic is expected to work 15-hour or 16-hour shifts, without rest periods and with no enforced weekly breaks. Meal breaks can be requested but cannot be guaranteed. Eating food in an ambulance in the current Covid environment is not exactly a healthy practice, yet this is the only option for paramedics as they travel the motorways. As they travel the motorways they pass numerous big glowing road signs that state, "Tiredness kills". A good work-life balance is long recognised as essential for healthy living. Some 57% of all paramedics' shifts do not finish on time. Nobody can predict which ones will be part of the 43% that might get home on time. This puts massive stress on families and on the well-being of the paramedics who are trying to do their best to be all things to all people.

When I raised the current ambulance service debacle with the Taoiseach last week, he referred in his response to pre-hospital emergency care. This is the primary function of paramedics, who are licensed to practise by the Pre-Hospital Emergency Care Council, PHECC. Countless lives have been saved because of their interventions. We owe them a huge debt of gratitude. Their job should be complete when they arrive with a patient at the emergency department. The hospital staff should take over responsibility at that stage. However, the reality is very different. In recent years, the ambulance has become an extension of the emergency department. Crews are caring for patients in ambulances for up to five and six hours because the receiving hospital staff have no place for the patients. This is not pre-hospital care.

Three things must happen immediately, and they are just three of many actions that are battling for priority. Front-line paramedics must be taken off Covid testing. The ambulance service is already grossly understaffed. Highly skilled paramedics should not be diverted to Covid testing. The deployment of the new interns due out of training schools must be monitored carefully. My request is that interns be placed as close as is practical to their homes or localities. Interns are on very poor wages. They get no travel or accommodation allowance. I know several interns based in Tipperary who are travelling daily because it is cheaper for them to travel to west Cork. They could leave Tipperary at 10 p.m. or 11 p.m. and report back for duty again the morning after at 8 a.m. It is simply unfair and unjust to treat young people like that, and it is happening regularly.

I also agree that paramedics must have NASRA recognised as their union of choice. This group was formed by paramedics to be their independent voice. It was initially recognised, but the HSE withdrew the recognition. Will the Minister enlighten us as to why this recognition was granted and then withdrawn? Paramedics and ambulance crew feel very strongly that their views are not represented adequately, and they believe there is a conflict in the fact the union that is currently representing them is also representing the management of the HSE. This should be recognised and reflected in the decision of the Minister.

The lid has been blown off the pathetic state of the ambulance service. That lid can never be allowed to close again until the voices of those who work in and depend on the National Ambulance Service are both heard and heeded. The problems in the ambulance service are compounded and exacerbated by a general malaise in the healthcare system. The Minister mentioned the lack of acute beds. There is an urgent need for a significant increase in bed capacity. For example, last week the Taoiseach received a very warm welcome on his visit to open a new 40-bed unit in South Tipperary General Hospital. His visit was well received by the management and staff and, indeed, patients across Tipperary. I do not see the Deputy tonight and I wish him well, but the only note of hostility was from Deputy Mattie McGrath, who did not want to see the Taoiseach in the hospital or in the constituency. The Taoiseach in his tour of that hospital saw a 39-bed unit on which €2 million has already been spent. An additional €5 million would make 39 additional beds available. I ask that this gets priority.

See this speech in context