Stephen Donnelly (Wicklow, Fianna Fail) | Oireachtas source

I welcome this important and timely debate tabled by the Regional Group on the future of our National Ambulance Service. I commend the sponsors of the motion on what is a fair and constructive approach to improving these services. This contrasts starkly with yesterday's Sinn Féin motion on the same topic, which was littered with spin and failed to acknowledge the progress being made by the women and men who work throughout Ireland in the NAS. Deputies will be aware that in parts of Dublin, ambulance services are delivered by Dublin Fire Brigade, and the comments I am making today apply to both these groups of healthcare professionals.

The motion rightly calls for more funding, an expansion of the workforce, not least in terms of the highly trained ambulance crews we have, and better response times, especially in certain regions and parts of the country. Colleagues are right to call for these and the Government will not oppose the motion. There are parts of the country where response times need to be a lot better, where there remain too few paramedics and where those paramedics who are there are being asked to work under sustained pressure. There are parts of the country where the ambulance bases are either outdated or simply not fit for purpose. For these reasons, we have been investing, over the past three years, at record levels in our National Ambulance Service. To the great credit of our ambulance teams, they have been turning this funding into better response times, new fleet, more paramedics and more services for patients.

With the motion being a notable and worthy exception, debate in the Oireachtas and more widely on our ambulance service tends to focus on what is not working. The debate rarely acknowledges the progress that is being made. If this narrative were to be believed, one would be forgiven for thinking the women and men working in our ambulance service were failing in their drive to make things better for patients. Of course, not only is this relentlessly negative narrative not true and not only is it deeply demoralising for our healthcare professionals, but this narrative of failure is, in fact, the opposite of the truth. Last year, the average response time was 25 minutes. This January, it was 22 minutes. In January 2022, of 30,000 incoming calls, 35 people had waited more than two hours, whereas this year, that figure fell to 30. In January 2022, 114 people waited more than one hour, while this January, that fell to 81, and our ambulance crews and management are determined to keep driving down that figure. The target for echo calls, that is, cardiac and respiratory emergency response, is 80% to be responded to within 19 minutes. Last year, crews hit 71%, while this January, they increased that to 77%. The target for delta calls, that is, all other emergencies, is 50% to be responded to within 19 minutes. Last year, crews hit 43%, whereas this January, they increased that to 48%, and they are determined to meet those targets.

Deputy Cullinane earlier described as “disgraceful” my putting on record the progress being made by our healthcare professionals. The truth may not suit the Deputy's narrative, or that of Sinn Féin, that Ireland is somehow a failed State. It may not suit the Sinn Féin narrative to see the ambulance response times getting better or new services being rolled out. It may not suit the Sinn Féin narrative to see waiting lists, for the first time in many years, falling last year and again this year, but that does not make any of those things less true. I and the Government commend our healthcare professionals on the progress they most definitely are making.

Last year, the Government invested a record €200 million in the NAS. This represented an overall increase in funding of approximately €30 million on 2019 and there is another significant investment this year. Staffing has increased by one fifth since 2016 and needs to go further. Additional clinical capacity in the NEOC in Tallaght has introduced new care pathways, including see and treat and hear and treat, which have been successful. Since October 2020, almost 50,000 patients have been treated through these new pathways, with nearly 19,000 of them as a result not needing to be brought into an emergency department.

The pathfinder model has been rolled out in Tallaght, Limerick and Waterford, and additional sites are being identified for this year. Another recent initiative has been the medical assessment unit pathway, which was first trialled in Cork last year and has been rolled out in Ennis, Roscommon, Nenagh and Loughlinstown, with additional sites being identified for expansion later this year. Substantial funding has been allocated to increase the number of student paramedics training in the NAS college. The NAS recruitment programme is very successful, with 175 students enrolled in its bachelor of science, BSc, programme in paramedic studies.

None of this is to detract from the significant challenges for patients and ambulance crews, particularly in certain parts of the country. More funding and more paramedics are needed. The service needs to continue to evolve from an emergency response service to a mobile medical service. To that end, I asked the director of the National Ambulance Service to develop a new strategy. The HSE board reviewed the draft plan in recent weeks and it is now with my Department. It addresses many of the issues the Deputies raised through the motion. This evolution of the NAS is just one part of a fundamental reform and reshaping of our health service towards community- and home-based care where possible, freeing up hospitals to do the most complex work for patients.

A total of 165 primary care centres are now fully operational, while a further 14 are under construction, with 12 of them due to be completed this year. The construction of ten community nursing units was completed last year and 13 more are being built this year. Last year, the contract for the community nursing unit, CNU, public-private partnership project was awarded. This will deliver 530 beds on sites at Ardee, Athlone, Clonmel, Killarney, Midleton, St. Finbarr's Hospital in Cork and Thomastown. For older persons with care needs, 426 public intermediate beds have been delivered to date, with 31 more coming on line in the coming months. Some 539 private intermediate care beds are contracted weekly, while 132 private beds are managed locally.

We are in the middle of creating 96 new primary care teams in every part of the country, as well as 60 specialist teams for older people and chronic disease management. Ninety-four of those 96 primary care teams are in place. A total of 2,500 of the 3,500 staff sanctioned have been hired and are now working in every part of the country. There are 18,000 more healthcare professionals working in the HSE now than there were at the start of 2020, and an additional 6,000 are going to be hired this year. We are aiming to hire more than 300 of those into the National Ambulance Service, including more EMTs and more general and advanced paramedics. Critically, as colleagues will be aware, the Government recently sanctioned a new rapid response team of 200, which is going to be put in place this year as well.

I acknowledge the extraordinary efforts of our ambulance crews and those working in our NAS throughout the country. When Covid arrived, they were often the first on scene, with testing and tracing, treatment and vaccinations. Since Covid, they have turned State funding into better response times, new services and an expanded and highly trained workforce. When they say they need further investment, modern bases and more paramedics, I and the Government hear them, agree with them and will continue to invest in them.

I thank the Deputies for a constructive motion, full of excellent ideas, which I will discuss with the Department in the context of the new strategy we are looking to launch shortly.

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