Gerald Nash (Louth, Labour)
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I am glad to have the opportunity to raise the proposed interim move of the Navan, Cork and Kerry ambulance control centres into one unit to be housed at the facility at Townsend Street in Dublin. The plans to create two new state-of-the-art control centres in Tallaght and Ballyshannon to manage all national emergency calls is very laudable and it is in accordance with international best practice. As the Minister of State knows, change is difficult and must be handled very carefully, especially when concerned with such a critical service as this. I doubt if anybody in the Chamber can point to such a critical service from a life-saving perspective as the ambulance service. The ability and capacity of the ambulance service to respond to emergencies should never even be tinkered with at the edges until we can all be confident that what comes after represents an enhancement.

Centralising the system in Tallaght and Ballyshannon, supported by the best personnel, technology and systems available, is a good move. However, it is bizarre in the extreme and, frankly, suspicious that the national ambulance service has unilaterally decided to centralise ambulance control from Navan, for example, and the other centres to a facility in Dublin 2 that will be shared with the Dublin fire brigade service for the moment. This begs the question of why two changes should be implemented over a short period when we only need one. This leads to the final resolution of the issue, which is the development of the facilities at Tallaght and Ballyshannon.

Surely this adds to the cost of change and risk of errors and accidents, as not all the existing control centres operate to the exact same procedures, which is a critical point. They do not have the same systems or formats. Additionally, there are practical concerns held by workers in the ambulance service that the control centre at Townsend Street is not physically capable of facilitating the extra staff and equipment required. This leads me to suspect that the proposed move to a new five-storey state-of-the-art facility in Tallaght may not go ahead at all.

It is important that the Minister of State should use the opportunity today to clarify the matter. When will this move ultimately take place, as there are suspicions that as a result of this interim measure, the ultimate move may not happen, at least in the timeframe laid out? In the meantime, I have yet to hear health and safety concerns around this proposed move being adequately addressed. I have yet to hear a solid rationale or any real justification for the interim measure or be convinced that this move will not potentially adversely impact the ambulance service and its ability to respond in a timely and efficient manner.

If no arguments exist, the ambulance service should ensure that the existing centres in Navan, which covers my area of Louth, and Cork and Kerry should be permitted to continue to operate ahead of the moving of the control aspect to the new national centres in Tallaght and Ballyshannon.

Alex White (Dublin South, Labour)
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I thank Deputy Nash for raising the issue. A significant reform programme has been under way in recent years to totally reconfigure the way the HSE manages and delivers pre-hospital care services to ensure a clinically driven, nationally co-ordinated system, supported by improved technology. The national ambulance service, NAS, is not a static service and it deploys its emergency resources in a dynamic manner and works on an area and national, rather than a local, basis. The NAS has been addressing response times through a number of measures, including the performance improvement action plan, the development of the intermediate care service, the trial emergency aeromedical service, and the national ambulance service control centre reconfiguration project.

The national control centre will consist of one national control system on two sites - Tallaght and Ballyshannon - and it is intended to improve dispatch and response times, with regional, rather than local, deployment and better use of first responder schemes. The NAS control and dispatch system is currently operating within eight ambulance service regions with no interconnectivity of radio systems, thus restricting the service response flexibility. The service control centre reconfiguration project and associated ICT enabling projects aim to reduce the number of ambulance control centres from eight to one, operating over two sites - Tallaght and Ballyshannon - and transition communications from analogue to digital, including voice and data. The total value of this project, which commenced in late 2010, is €23 million.

The national ambulance service control centre reconfiguration project represents one of the most critical and complex pieces of the State's emergency infrastructure ever undertaken. The HSE's intention to reconfigure the existing ambulance control centres is consistent with international best practice and endorsed by the Health Information and Quality Authority, HIQA, as the most appropriate approach to improve the quality of services to patients and facilitate investment in technologically enabled service delivery.

This project is also a key element of Future Health: A Strategic Framework for Health Reform in Ireland 2012-2015.

Based on current known variables, the expected timescale for full commissioning, including the migration of all NAS ambulance control centres, is the end of 2014. Both the NAS and HIQA have a number of concerns about the control and dispatch structures at some existing control centres. In this context, the NAS intends to migrate a number of these centres to our existing facility in Townsend Street with a view to mitigating these concerns ahead of the completion of the national centre. The NAS is satisfied that Townsend Street is suitable and infrastructurally sound to facilitate the interim migration of Cork, Tralee and Navan control centres and it is providing additional staff, training, technology and equipment to facilitate this process. The migration of these control centres in the short-term will also improve the optimum and dynamic utilisation of all available resources in those areas, and peripheral areas, such as rapid response vehicles, intermediate care vehicles and emergency ambulances.

There can be no question of any compromise of patient safety and safety generally in the system in respect of any decision that is taken. That is paramount in respect of all considerations.

Gerald Nash (Louth, Labour)
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I thank the Minister of State for his reply; we are on the same page on this. Those who represent staff in the ambulance control centres, particularly SIPTU, are very concerned about patient safety. They have raised concerns about the move to this interim facility in recent days.

The Minister of State remarked that based on current known variables, the moves to the Tallaght and Ballyshannon centres will be complete by the end of 2014. That is welcome and those who represent staff have bought into that process. It complies with international best practice.

The Minister of State also mentioned that the National Ambulance Service and HIQA have some concerns about the control and dispatch structures at some of the existing control centres. It is my experience that the centres operate in a very effective fashion and comply with HIQA regulations and other aspects of the regulatory environment, as they are required to do. In this context, however, concerns have been raised by SIPTU that have been referenced with HIQA and the Health and Safety Authority related to the working environment at Townsend Street. As I understand it, the National Ambulance Service has refused to engage with the trade union concerned on an independent risk assessment of the site. These are experienced people working in the ambulance control sector and this is an experienced health sector trade union. If there are legitimate concerns, they should be pursued with the National Ambulance Service and should be taken seriously by HIQA and the HSA.

There is also a concern about the technology that is being used at the site. The move will not permit a single use system for call taking and dispatching, which can lead to confusion. We are all concerned about patient safety and efficiency in the ambulance service in terms of responding to emergencies and supporting staff to play a critical role in our health service. It is a concern for the Minister of State and the House and we must all ensure we do the right thing not just on behalf of the workers involved in the service but, specifically, the people who depend upon it.

Alex White (Dublin South, Labour)
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I thank Deputy Nash and I agree with him; the input of staff and their representatives, including SIPTU, is vital. I expect and believe any concerns raised by SIPTU or any trade union should be taken seriously. I will not comment on the specific question of a specific risk assessment but I would expect there would be engagement with the trade unions on the proposals for Townsend Street. In fairness to the union in its press release, it acknowledged the National Ambulance Service is providing additional staff, training, technology and equipment to facilitate the process. I hear what the Deputy is saying about remaining concerns and I hope there would be positive engagement between management in the National Ambulance Service, SIPTU and other unions and the staff to ensure those issues can be addressed.