Cathal Berry (Kildare South, Independent) | Oireachtas source

Táim fíorbhuíóch a bheith anseo inniu chun caint faoin ábhar seo. Tuigim cinnte go bhfuil sé ar cheann de na hábhair is tabachtaí in Éirinn faoi láthair. Before I speak to the motion, I would like to convey my deepest sympathies to the people of Greece following the tragic train accident there. More than 32 people have been confirmed dead. This accident underscores the importance of having a functioning, fit-for-purpose, pre-hospital emergency care system, which we clearly do not have in this country at the moment.

I agree with what my colleague, Deputy Denis Naughten, said. We need to improve the services. There are massive pressures due to the population increase and the age demographic going in the wrong direction. Our services need to be expanded bearing that in mind. Rather than dwelling on the bad stuff, I have four suggestions that might improve things perhaps not individually in isolation but in combination they would make things a bit better.

The first one addresses regulation. The Pre-Hospital Emergency Care Council, PHECC, is based in Naas, County Kildare. I have visited its premises a number of times. It is a great place with great people but they are hamstrung by the lack of legislation. Deputy Naughten touched on the need for a system in which the roles of emergency medical technician, paramedic and advanced paramedic are defined.

There are two reasons. First, from the point of view of retention, if we want people to have pride in their profession, there needs to be a defined role. In addition, when they show up at an incident, everybody recognises that the scope of practice of an EMT is utterly different from that of an advanced paramedic. The second reason relates to training. I am not convinced that the training output is being maximised. If we agree that the NAS, Dublin Fire Brigade, DFB, and all paramedic capability needs to be expanded, then, by extension, training pathways need to be improved. DFB works through the Royal College of Surgeons in Ireland while the NAS works through University College Cork, UCC. However, the NAS worked through University College Dublin, UCD, up to three years ago. A large dedicated paramedical school in UCD is not only being underutilised, it is not being utilised at all. There is spare capacity in the system that we should look to exploit and take full advantage of. A lot of people do not realise this, but there is also a paramedical course in the University of Limerick. The university is not even plugged into the Irish system. It has to send its trainee paramedics to the National Health Service, NHS, in the UK to get their on-the-road experience. We have work to do from a training point of view. If we want to increase the number of paramedics we should focus on training and maximising output from that perspective.

All the Members in my group represent regional and rural constituencies. There is a lot of work we can do from a community perspective. I acknowledge and welcome the fact that there are now a lot more defibrillators in the community, which is very good from the point of view of cardiac first responders. In the community, you are a long way from an acute hospital and you could be waiting a while for an ambulance. We could look at expanding that further. Instead of just having a defibrillator, we could put EpiPens, aspirin and salbutamol inhalers in the box as well. That would help with anaphylaxis, cardiac arrest and acute asthma attacks. For a start, public buildings should lead by example. We have defibrillators around Leinster House, which we could perhaps use as a pilot scheme. We could put those extra three medicines in and scale up from there. That is from a community perspective.

Finally, I want to address helicopter emergency medical services, HEMS. An excellent Air Corps helicopter is based permanently in Custume Barracks in Athlone, as the Minister of State knows well. There is an advanced paramedic on board from the NAS That is a good model and it works well. However, we do not have a dedicated HEMS helicopter in this jurisdiction. HEMS is a helicopter emergency medical scheme, and it has doctors on board. There is an anaesthetist, a nurse, or an emergency physician. It offers a lot of critical care at the point of impact in a road traffic accident. Northern Ireland, which is a smaller location with a smaller footprint and population, has two fully kitted out HEMS teams. In Wales, approximately 50 miles from here, there are six fully dedicated helicopters and teams. That is something we can look at, and it would take pressure from our road ambulances. In summary, I commend all the people working in the pre-hospital environment. They are doing their bit, and now we must do ours.

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