Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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6. To ask the Minister for Health the position regarding the review of ambulance services; and if he will make a statement on the matter. [27041/14]

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I seek to establish if the review of the ambulance service currently under way will be comprehensive, including address of the capacity of the service to fulfil its obligations to the public properly.

James Reilly (Dublin North, Fine Gael)
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As the Deputy is aware, three reviews of the national ambulance service are currently under way.

The national ambulance service has commissioned a national capacity review to determine the level and use of resourcing required for a safe and effective service. This independent review is being undertaken by the UK Association of Ambulance Chief Executives, an organisation with considerable international experience in operational and strategic reviews of this kind.

In the context of the development of the single national control and dispatch system, a review of the Dublin Fire Brigade emergency ambulance service is also under way. This review was commissioned by the Dublin city manager and the HSE’s chief operating officer, and is considering all aspects of Dublin Fire Brigade ambulance operations, including the capacity and capability of current ambulance services. The review will inform consideration of the best model for provision of emergency medical services in the greater Dublin area.

HIQA is undertaking a scheduled review of the national ambulance service, examining the governance arrangements for pre-hospital emergency care services, to ensure the timely assessment, diagnosis, initial management and transport of acutely ill patients to appropriate health-care facilities.

The three reviews are being conducted in parallel, in a concerted effort to examine our pre-hospital emergency care services throughout the country, with a view to identifying the best way to enable them to meet the challenges of the future. I am confident the recommendations will guide us in the provision of a modern, forward-looking service, capable of delivering the best possible outcomes for the public.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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I note from the Minister's reply that one of the reviews under way is addressing the capacity of the current service. Without questioning the industry of the people entrusted to deliver the review, I must ask whether they are looking honestly at the capacity of the ambulance service to deliver on a day-to-day basis. Does the Minister agree with the National Ambulance Service Representative Association's statement that targets are not being met because of a shortage of personnel, infrastructure, including an ambulance fleet, and funding? Has he, independent of the reviews, brought to an end the scandal of the misuse of rapid response vehicles as personal cars for managers, an issue that was highlighted some time past? Has he undertaken a comparison between the provision for the ambulance service in the State and the experience north of the Border and in Scotland, statistics for which I have cited to him on the floor of the House? Will he seek to establish a truly national ambulance service that would initially encompass cross-Border co-operation and ultimately provide for integration under an all-island ambulance authority?

James Reilly (Dublin North, Fine Gael)
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The use of response cars by ambulance service officers is making a real difference in improving response times for patients. Between 1 January and 1 April this year, officer vehicles responded to more than 630 incidents, over 250 outside working hours. On average, the cars responded to seven incidents a day, almost three of which occurred outside working hours. The vehicles can be tracked by control centres. For example, an officer working in Wexford but with a vehicle in Limerick after hours is available to respond to incidents in Limerick for that period. The response cars are a valuable additional response resource and the officers provide an emergency service in their communities outside normal working hours. They are not paid an on-call allowance and respond to these calls pro bono. Officers using the cars also attend and manage complex incident scenes such as multiple-casualty road accidents during and after hours. Examples include the recent chemical incident in Maynooth and the national ambulance service's response to the Altnagelvin hospital fire.

Caoimhghín Ó Caoláin (Cavan-Monaghan, Sinn Fein)
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The Minister chose to focus on only one of the points I raised. I again ask for his view on the case made by the National Ambulance Service Representative Association, the members of which are front-line service providers, on the shortage of personnel, infrastructure and funding. In my own region which comprises counties Cavan, Monaghan, Louth and Meath ambulance service staff are expected to deliver the service with only 12 ambulances functioning and available at any one time. I know from direct personal experience both in December last year and January this year, which I have shared with the Minister, that the current provision is absolutely inadequate. I have appealed to him before and do so again to recognise that my experience is not unique to the region from which I come but is replicated across the State. How can this be acceptable? Will he undertake to deliver a truly State-wide audit of ambulance services with a view to increasing the number of front-line personnel and the level of infrastructure, including the ambulance fleet, in order to bring the service across the country up to a safe and efficient level? When will the reviews under way be concluded and when does the Minister expect to take possession of the relevant reports? In each of the cases he cited, will the report be published?

James Reilly (Dublin North, Fine Gael)
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On the last point, it is, of course, my intention that the reports will be published. The HIQA review of the national ambulance service will be a very comprehensive analysis of how to make the best use of the resources available to us. Response time requirements have been in place since 2011 - no such criteria applied before then - and everybody will agree that the people providing the service are very committed to it. However, there is no service so good that it cannot be improved. The Deputy referred to the position in Scotland which has a similar dispersed population. We will learn from our neighbours in any way we can. The objective of the three reviews to which I referred is to improve the service to the patient. The most important point, as the Deputy reminded me when he spoke about his own experience, is that the patient should receive the right treatment as quickly as possible. The ambulance that takes a patient to hospital is very important, but having rapid access to a skilled advanced paramedic who can administer care is the critical consideration.