Dáil debates
Tuesday, 25 June 2013
Topical Issue Debate
Ambulance Service Response Times
5:50 pm
Brendan Griffin (Kerry South, Fine Gael)
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I thank the Minister for attending the Chamber for this important matter. I am raising a matter arising from the recent death of a baby in Tralee. I express my sympathy to the family on their profound loss.
The HSE has confirmed that a 999 call was received in the early hours of 18 June from the family of a three-and-a-half-week-old child who was having breathing difficulties and subsequently suffered a suspected cot death in Tralee. However, the ambulance was sent to The Tennis Village, Model Farm Road, Cork, rather than The Tennis Village, Tralee. The first emergency vehicle arrived at the scene in Tralee 30 minutes after the initial call, which the Minister will agree is not an acceptable timeframe in such instances. This timeframe would have been much smaller had the call been co-ordinated from a local ambulance centre, as was the case before May.
Reports on this case have seriously dented public confidence in the new centralised ambulance system. Yesterday, Kerry media carried a report about how on 9 June it had take 75 minutes for an ambulance to take an elderly man having breathing difficulties to hospital after his daughter had called for it. Again, the ambulance was sent to the wrong address initially. It was meant to go to an address in Ballyvelly but was sent to Spa Road instead. My colleague Deputy Jerry Buttimer has raised similar incidents in Cork at the health committee.
The director of the National Ambulance Service, Mr. Robert Morton, has suggested that a postcode system would assist in despatching ambulances. If he believes this is important, why then was the national centralised system rolled out before a postcode system was established? This needs to be urgently reviewed because it is a matter of life and death and we cannot afford for it not to work.
Arthur Spring (Kerry North-West Limerick, Labour)
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I, too, thank the Minister for attending the Chamber to discuss this matter. The integrity of the ambulance despatch system has been undermined as a result of events in recent days in County Kerry. I have no aspiration to condemn the idea of a centralised despatch system, but the one we have is not working. In the recent awful and tragic death of a four-week-old baby in Tralee, it has been stated that even if an ambulance had arrived earlier, it would not have been able to prevent the child from dying. I understand there was a language barrier because the family involved did not have the capacity to speak fluent English and could not identify the area in which they were living to the ambulance service. However, Ballyvelly and Spa Road are very distinct areas in Tralee and for an ambulance to take 75 minutes to deliver a person to a hospital which is effectively over the road is a problem.
As the Minister will be aware, my father is a doctor. He has told me he has never come across anything like what is happening with the ambulance service. If a doctor rings for an ambulance, he or she must answer a list of questions to justify getting it. Could doctors be provided with an app similar to the Hailo taxi app in order that their name and location appears to the ambulance centre, meaning they do not have to answer the litany of questions that an average member of the public must go through?
The IP system for landline telephones means people’s locations can be quickly identified. Similarly, GPS works for mobile phones. The Garda can identify the locality of a phone used to call its service. These existing systems should be applied to the ambulance service. The people of Kerry are not happy with these recent events and people’s health is at stake.
James Reilly (Dublin North, Fine Gael)
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I thank the Deputies for raising this issue.
A tragic event occurred in County Kerry last week which was widely reported. First, I extend the Government’s deepest sympathy to the family of the child involved. The loss of a loved one is hard for family and friends at any time but the sudden and unexpected death of a young child is particularly difficult.
At 1.16 a.m. on 18 June 2013, an emergency call was received about a baby who was reported as not breathing. The NAS was initially unable to obtain sufficient details of where the family was, which led to a delay in responding to the call. The first emergency resource arrived at the scene 30 minutes after the initial 999 call. The baby was subsequently pronounced dead.
The incident has been the subject of a systems analysis, as is routine in cases in which a death occurs, to ascertain whether call-taking protocols were followed. Following an examination of the facts, the HSE is satisfied that systems and processes operated correctly and there are no plans to carry out any further review. However, interrogation has been strengthened to mitigate the impact of a call in which the incident location cannot be identified. In addition, the HSE communications service has been requested to run a publicity campaign to improve public awareness of the need to communicate precisely the location of incidents.
In the interest of respecting the dignity and grief of the family, I wish to make no further comment on the specific incident. However, Ireland is now a multicultural society. An individual who has language issues and is emotionally traumatised at having found her baby dead can have great difficulty in communicating. I have heard what Deputy Arthur Spring said about GPS for physicians, and I will mention this in the second part of my answer.
A significant reform programme has been under way 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 control centre reconfiguration project which is endorsed by HIQA and represents international best practice will reduce the number of ambulance control centres to a single national control system, with significant investment in new voice, data and mapping technologies. The project is also a key element of Future Health: A Strategic Framework for Health Reform in Ireland 2012-2015.
Both HIQA and the national ambulance service had concerns over control and despatch structures at some control centres leading up to the development of the national control system. Accordingly, the national ambulance service moved the Cork and Tralee centres to its Townsend Street centre on an interim basis in May to mitigate such concerns pending completion of the national centre. Detailed preparations took place to ensure the safety of services during the move of the Cork and Kerry operations. The national ambulance service provided additional staff, training, technology and equipment to assist this process - 112/999 calls from these areas are now answered in Dublin using improved technology. The national ambulance service is satisfied that the Townsend Street centre, while not appropriate to the needs of the overall reconfiguration project, is nevertheless suitable and infrastructurally sound for the interim accommodation of these centres.
6:00 pm
Brendan Griffin (Kerry South, Fine Gael)
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I thank the Minister for his response, but I need to emphasise that this reform is not like the SUSI grants system or the medical card system in respect of which there have been teething problems. There can be no scope for teething problems in the change of this system. The consequences of a failure in the system are a matter of life or death. Therefore, it needs to work 100% correctly all of the time.
As a public representative, I am not 100% confident, as a result of the recent cases in Tralee, that the system is working properly. I live in a little place called Keel on the Dingle Peninsula. One will not find it on any map and if a person from Keel called for an ambulance, I would be concerned it might be sent to Achill Island in County Mayo. What is to prevent this from happening? The local knowledge in the local centres would have helped to prevent what happened in Tralee recently. Perhaps as Deputy Arthur Spring suggested, we need to embrace technology more and explore that option.
If the director of the national ambulance service is saying the absence of postcodes is a problem, why was this change proceeded with and why was addressing the problem of postcodes not a prerequisite in making this change? I want to ensure that what happened in both cases in Tralee recently will never happen again to anybody else. We cannot afford for mistakes to be made in this crucial area.
Arthur Spring (Kerry North-West Limerick, Labour)
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The core issue is that the people of County Kerry are worried about whether the emergency services can provide them with an adequate ambulance service. From what we have seen in recent weeks, there is no evidence to suggest people's lives are not in jeopardy. We have a problem, but it is not one that cannot be solved; however, it needs the attention of Department of Health. There are technological issues, but there are also core values and principles that need to be adhered to.
It is unacceptable that there is a language barrier when so many foreigners have come to live here and that language may pose a problem when a person seeks help. Language is even more of a problem for people living in rural areas in that different placenames can be duplicated in different regions and provinces and an ambulance may be sent to the wrong county. This is unacceptable and it needs to be rectified. We need to hear a response on how it will be done. We will keep the Minister informed if there are further infringements and we may have to return to the old system. If he wants some of his people to deal with us at local level, we would be happy to meet them, but I also suggest technology needs to be advanced in his Department.
James Reilly (Dublin North, Fine Gael)
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I thank the Deputies for raising this matter. Given the circumstances of what happened in the tragic case mentioned, I do not know if moving back to the old system would have addressed the problem. Both Deputies have made the point that we have a serious problem in terms of communication. Proper communication is essential in delivering any service. The centralisation of this service will allow for translation facilities to be put in place. I will aggressively pursue the issue of technology in terms of the use of GPS, given that most people have mobile phones. I am given to understand from early inquiries, however, that the technology is not at a level in the country to do this in a rapid way, which is very important. I accept that we should be looking to make such an investment to give the people the assurance they need that the service will be as efficient as possible and that we will remove, as much as possible, the room for human error, particularly when it comes to issue of communication. It is utterly understandable people are completely traumatised in situations where a loved one is in terrible danger and if there is also a language issue, that complicates the matter. I reiterate that we will certainly have this issue further interrogated and have a solution put in place to provide further reassurance. I again express my deepest sympathy to the family in question on their terrible loss.