Claire Kerrane (Roscommon-Galway, Sinn Fein) | Oireachtas source

First, by way of background, the accident and emergency department in Roscommon was closed in 2011. On the back of that, a commitment was made that there would need to be much better ambulance cover for Roscommon because we are farther away from the next nearest emergency department. Both Fine Gael, which was in office at the time, and the HSE committed to ensure there would be advanced life support. It would always be provided given the accident and emergency was no longer there. At that time, a separate roster for advanced paramedics on the rapid response vehicle was put in place. Until 2023, that had been in place for 12 years. In 2015, Leo Varadkar, the then health Minister, restated that a rapid response vehicle crewed by an advanced paramedic providing 24-7 cover in Roscommon was one of the significant improvements made in Roscommon because of the closure of the accident and emergency department. He went on to state his intention that there would be further improvements because we had no accident and emergency department and we were farther away from the next emergency department.

Instead what has happened, and I have been raising this for about a year, is that the advanced paramedic roster on the rapid response vehicle has been filled by a paramedic instead of an advanced paramedic. On the roster that was full with advanced paramedics, one advanced paramedic is missing, meaning that when calls are made, sometimes there is no advanced paramedic when there should be.

I recall last year a further reply from the HSE telling me that paramedics and advanced paramedics were the same thing, and that paramedics had been upskilled and could carry out duties similar to that of advanced paramedics. Of course, that simply is not true. Advanced paramedics can administer an additional 23 medications for acute emergency medical and traumatic conditions like a cardiac arrest. They are the only paramedics in the National Ambulance Service who provide the advanced life support that is needed quickly in very urgent cases.

We started with the use of a paramedic filling the AP roster and now, in the past week, it has been said that the rapid response vehicle – I have confirmed this with management in the National Ambulance Service – is being taken off the road in Roscommon on Thursdays, further downgrading that commitment and breaking that promise to the people of Roscommon. That shift had been filled by overtime. I understand it is a saving to the National Ambulance Service of about €350 a week. It is detrimental to the people of Roscommon should an urgent call come in and there is no advanced paramedic.

We have also had the situation in Roscommon where the air ambulance was relocated to Dublin in November arising from works in Athlone. It was due to come back in January. It is March now, and we are still waiting. I note the majority of calls for the air ambulance come from County Roscommon. We are without the advanced paramedic 24-7 cover, the promised rapid response vehicle and now the air ambulance.

I wish to make a point I have made a number of times in the House. I am concerned with the direction in which the National Ambulance Service is taking the service. It appears to be dismantling entirely the role of the advanced paramedic. It is the policy of the director to go in a different direction. It is looking at establishing something else, which is not even up and running yet. It has not been and is not training advanced paramedics anymore. It also has not been doing the privileging courses. We have about 14 or 15 people in the National Ambulance Service working as paramedics who are fully qualified APs but did not qualify here. The privileging course to make them APs and allow them to work here has been suspended. It is said it will be rolled out in May, but there is no guarantee they will manage to do a privileging course for 14 to 15 people, which is ridiculous.

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