Duncan Smith (Dublin Fingal, Labour) | Oireachtas source

I thank Deputy Cullinane and Sinn Féin for bringing this motion and this issue for discussion before the Dáil again in their Private Members' time.

Before I get into the motion itself, I would like to pick up on what the Minister said about the many things that are being delivered, including a national "modern network of primary care centres". When will we get a primary care centre in Swords in Fingal? It is the largest town in Ireland without one. It serves a growing population of more than 60,000. We are no closer to having a primary care centre than we were when a former Fine Gael Minister for Health put up posters all over the constituency saying he was going to deliver one. We are the largest town in Ireland without one, to add to us being the largest town in Ireland without a rail link. We need it. There are children's disability network teams, CDNTs, that need to be housed in modern facilities. Our primary care centre is Beaumont Hospital, and that is not appropriate. It puts undue pressure on an already stressed accident and emergency unit and hospital in Beaumont.

I welcome the equity the Minister showed at the beginning of his contribution when he said his comments this evening apply to both NAS workers and DFB workers. It is important to acknowledge, at least in a Dublin context, that we have both services and that they have quality workers and workforces. However, both are under massive pressure. Both require the investment and the resources this motion speaks to, although the NAS is the focus of this motion. While the Minister's response to the motion was robust, it still did not speak to the main charge of the motion, which is that we do not have a workforce plan for the NAS that will deliver the 1,300 additional paramedics who are needed by the end of 2024. They will just not be delivered. We need to double the staffing composition to more than 4,000 by 2026, which is a very short period of time. The NAS needs more than 3,000 paramedics in only four years. That is just not going to happen if we maintain the current recruitment levels associated with current recruitment drives.

We have seen reports on this issue and it has been discussed before the health committee. Every local newspaper all over the country and all the national media have highlighted on many occasions the wait times that are being experienced. The trolley crisis still has not ended because there are between 550 and 600 people on trolleys each day. At the peak of the crisis, in early January, one ambulance crew spent its entire shift at the accident and emergency unit of a Dublin hospital. That is something that nobody could stand over. These are the realities faced by this workforce, which is under intense pressure and is under-resourced. The investments and resources that are coming its way are not meeting the demands of an ever-growing population.

Today, SIPTU has unequivocally called for support for this motion, as well as the motion that will be before the Dáil tomorrow. While we can all articulate political support in this Chamber, SIPTU has said that the appropriate first step would be the implementation of the independent review of NAS roles and responsibilities, which dates back to 2018. Its members and HSE management have called for the implementation of the review in order to assist with alleviating the crisis in ambulance services. These are the practical things that the unions are calling for in this area.

The Minister mentioned the echo and delta calls in his response to the motion, but they are still not meeting the targets. We have the figures that have been reported and the Minister has come back with figures that are slightly higher. However, they are still not meeting the target and we are still not confident that is the trend. We hope it is, and we hope it meets and exceeds the target. However, given what we are seeing in terms of the throughput of people going into training and coming into the workforce in this area, we are not confident that meeting and exceeding the target will be a trend. It gives us in opposition no joy whatsoever to say that.

In relation to the Dublin Fire Brigade, we really need to get a handle on this. Most people in politics speak in support of the DFB. The support at local authority level from local authority members is incredible, and that is where the majority of the funding for the DFB service comes from.

Nevertheless, a recent report by Dublin City Council stated no additional funding had been secured from the HSE towards the cost of the Dublin Fire Brigade EMS in 2022 or 2023. The Department of Housing, Local Government and Heritage has made €8 million available towards the cost of the service in 2022, in addition to €1.9 million, or just over 50% of the unfunded cost of the service, towards payroll costs, and there is no commitment to maintaining this funding in 2023. There is agreement between the two agencies and the two Departments to establish an HSE-DCC joint ambulance service delivery task and finish group, to be chaired by the chief executive of DCC and the national director of acute operations in the HSE, to see whether the outstanding service delivery and funding issues can be resolved.

They need to be resolved. Successive Ministers for Health and HSE management continue to express public support for the involvement of DFB in the provision of emergency ambulance services but continue to starve that very service of the funding it requires. When we speak of why we need a strong Dublin Fire Brigade as well as a strong National Ambulance Service, it is because we need a strong paramedic service. The end users of these services are people who are sick, and in many circumstances, critically ill. They do not really care who turns up, whether that is a NAS or DFB ambulance. They just want one to turn up quickly and for the paramedics in those vehicles to have been trained and be skilled, as they are. There are not enough them, however. We are not bringing enough of them onstream and they are not being supported.

We cannot allow this continued uncertainty in the provision of the service by Dublin Fire Brigade to continue. We need certainty. The fire brigade is a trusted service the people of Dublin value and hold dear to their hearts. We need proper action to ensure that service will be sustained and that the investment needed in the NAS, as set out in the motion, will be delivered.

See this speech in context