John Lahart (Dublin South West, Fianna Fail)
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We were expecting the Minister for Communications, Climate Action and the Environment to be present, but we will say more on that later. I speak on behalf of Deputies Haughey and O'Brien, myself, all Fianna Fáil Dublin Deputies and all Fianna Fáil public representatives in Dublin. As the Minister of State will know, Dublin Fire Brigade, DFB, has been providing an ambulance service to the citizens of the city and county since 1898. That is almost 150 years. Uniquely, all firefighters are also paramedics and rotate between fire and ambulance duties. The dual role they have of fire-based emergency medical service is internationally recognised. It is also recognised as best practice. It is replicated in cities such as Seattle, New York, Dusseldorf, Frankfurt etc. The beauty of it is that Dublin is recognised as having the second best survival rate for out-of-hospital cardiac arrests in the world after Seattle. This is because of the fire-based emergency medical system. My colleagues will take up the debate.

Seán Haughey (Dublin Bay North, Fianna Fail)
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I first raised this matter in the Dáil on 25 January and I stand over the remarks I made on that occasion. Yesterday was St. Valentine's Day, the anniversary of the Stardust tragedy in 1981. On that awful night we saw the efficiency and professionalism of the Dublin Fire Brigade and ambulance service at its best. International best practice indicates that combining fire rescue and emergency services greatly improves the response to a crisis. That was clearly seen in the case of the Stardust tragedy.

SIPTU is balloting for strike action at the moment. All indications are that the go-ahead will be given for strike action. The key issue is that the Dublin Fire Brigade is being starved of resources and support to do its job. The chief executive of Dublin City Council wants to transfer the call-taking and dispatching for ambulances to the national control centre in Tallaght. I oppose this. It is not in the interest of the citizens of Dublin. The expert panel published a report. That is the way forward to deal with this particular issue. I hope the Minister of State present will support it. It is a roadmap on how to deal with the problem and it was published in December 2015.

Darragh O'Brien (Dublin Fingal, Fianna Fail)
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The time we have is wholly insufficient to deal with this particular item. Over a number of years, I have been writing to the Minister of State's predecessor. The bottom line is that the DFB ambulance service and its structure work extremely well, as my colleagues have outlined. What Fianna Fáil as a party and the members of the DFB are really concerned about is the removal of the delivery of that service from the DFB. The reason they are so efficient is because they manage it themselves. They are all trained paramedics and can work with any of the appliances. We saw it with the terrible bus crash in Dublin. Everyone who is on that rig is a trained paramedic. It works.

Dublin City Council and Mr. Owen Keegan have an issue with funding and that is all it is. The HSE is looking to amalgamate this. The DFB complements the HSE ambulance service. This is not a turf war issue. I ask the Minister of State to give a commitment on behalf of the Government that there will be no changes to the operation of the DFB ambulance and to pledge and commit to that. I ask the Minister of State to do that and to raise it with her senior Minister. I believe that the Minister, Deputy Coveney, should be here to answer this because he has big role in telling Mr. Owen Keegan to get off the stage and take his hands off the DFB ambulance service.

Helen McEntee (Meath East, Fine Gael)
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I thank the three Deputies for raising this issue. I give my apologies for not being Deputy Coveney or Deputy Harris. I am taking this on behalf of the Minister, Deputy Harris, who gives his apologies. If there are commitments I cannot give, I will certainly take the requests of the Deputies back to both Ministers.

As the Deputies know, Dublin Fire Brigade provides emergency ambulance services in Dublin city and county by arrangement between Dublin City Council and the HSE. The HSE National Ambulance Service provides some emergency capacity in the greater Dublin area as well as non-emergency patient transport. I take this opportunity to commend the excellent work that is completed by the people that undertake that work for the Dublin Fire Brigade and the National Ambulance Service. In recent years, three comprehensive reviews of our ambulance services have been undertaken: the HIQA review, the independent Lightfoot review of National Ambulance Service capacity and the review of Dublin ambulance services that was jointly commissioned by the HSE and Dublin City Council.

The capacity review, published last year, examined overall ambulance resource levels and distribution against demand and activity. The review identified deficits in ambulance capacity, including in the Dublin area, which will require very significant investment to address, as the Deputies have pointed out. Implementation of the recommendations of the capacity review require a multi-annual programme of phased investment in ambulance manpower, vehicles and technology. To this end, increased funding has been made available for ambulance services in the HSE national service plan for this year.

The HIQA report on ambulance services, which was published in December 2014, highlighted significant public safety issues arising from two ambulance services operating in the same domain. The report identified concerns around the existence of two separate control and dispatch processes and also highlighted the need for greater clinical governance of both services. The HIQA report points very clearly to the need for enhanced integration of service provision in the greater Dublin area. The Dublin ambulance services review, which was commissioned in 2014, is focused on identifying a service model for the optimal provision of emergency ambulance services and patient care in the Dublin region, including service quality, patient safety, capacity and value for money for ambulance services.

I want to assure the House that the Minister, Deputy Harris, is fully aware and appreciative of the excellent historical tradition of service provided to the citizens of Dublin by the Dublin Fire Brigade. However, at the same time, it is fully accepted that in the interest of patient safety we need the DFB and the NAS to have a more co-ordinated and integrated approach to service delivery. It is important that we optimise and maximise all available resources to ensure the citizens of Dublin have the most responsive and safest ambulance service possible, which I know we all agree on.

The Minister, Deputy Harris, has not as yet received a copy of the final report on the review of Dublin ambulance services, which, as I mentioned, was commissioned by Dublin City Council and the HSE. However, to be clear, if any change to the model of service delivery is required, a formal proposal for those changes will have to be submitted to both the Minister, Deputy Harris, and the Minister for Housing, Planning, Community and Local Government, for their consideration and approval. To that end, discussions are taking place between officials in the Department of Health and the Department of Housing, Planning, Community and Local Government. The Departments have requested a joint action plan from the HSE and DCC with regard to service and governance issues.

John Lahart (Dublin South West, Fianna Fail)
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I have seven points to make in 60 seconds. The Dublin Fire Brigade gets 7% of the national ambulance budget but takes on 40% of the ambulance calls nationally. It is simple maths. Dublin City Council actually has the legal authority to run the Dublin Fire Brigade and ambulance service. It is not necessarily a moral obligation, but I believe that obligation has been well established after 150 years. The fire-emergency medical service model is the best model for an urban area. All expert reports point to that. The dual qualification makes the Dublin Fire Brigade ambulance service very efficient on the public purse. The Dublin Fire Brigade is very used to emergencies. It deals with emergencies every hour of every day. It is never off service. This is not a competition with the National Ambulance Service.

Darragh O'Brien (Dublin Fingal, Fianna Fail)
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Not at all.

John Lahart (Dublin South West, Fianna Fail)
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Dublin Fire Brigade is never off service. This practice has been well established for 150 years. The Minister of State's reply, particularly with regard to a decision not having been made, is very disheartening. We want to serve notice on the Minister that we are going to continue to press this issue and highlight it on behalf of Dubliners and on behalf of the national fire and ambulance service in Dublin.

Seán Haughey (Dublin Bay North, Fianna Fail)
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I mentioned that the chief executive of Dublin City Council, Owen Keegan, wants to see a transfer of all call taking and dispatching for ambulances to the national central control centre in Tallaght. The Dublin Fire Brigade call centre is in Townsend Street. Technology and IT solutions are available to co-ordinate the ambulance service between Tallaght and Townsend Street. The national ambulance service has centres in Tallaght and Ballyshannon in County Donegal, so this is possible. Unions and staff must be consulted on any proposed changes. So far, everything that has been done in that regard has been done unilaterally. That is no way to do business. The unions and the staff must be consulted. Councillors in the local authorities have passed motions along the lines of what we are suggesting here this evening. As I mentioned, the pre-hospital emergency care services Dublin report was published in 2015. That is the roadmap with which to proceed, and I hope the Minister of State and her colleagues will take it on board.

Darragh O'Brien (Dublin Fingal, Fianna Fail)
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I appreciate the Minister of State coming into the House to give the response but the second and third last paragraph in the reply was written by Health Service Executive, HSE, senior management. One can read in the answer that the divvy-up has already been done but we are putting the Government on notice that Fianna Fáil will not accept these changes in Dublin. The local authorities will not accept them.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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We will not accept them.

Darragh O'Brien (Dublin Fingal, Fianna Fail)
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It is a cross-party issue. Anyone with a brain will understand that if it is working extremely well, which is the case, it should not be changed. If anything, the combined emergency medical service, EMS, should be replicated in Galway, Cork and Limerick. It can and should be done. This is a case of Owen Keegan in Dublin City Council not wanting to fund it. We need to sort it out because we will not accept any changes to this service. It is a very serious issue for us and for all other parties which care about this service. I ask the Minister of State to take on board the comments we have raised, which I know she will do.

Finally, there has been no consultation whatsoever with Dublin Fire Brigade, DFB, ambulance or their employee representatives. The HSE making the decisions with the Minister is not acceptable at all.

Helen McEntee (Meath East, Fine Gael)
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I thank the Deputies. Many statements have been made that I will not disagree with because a fantastic service has been provided over the past number of years. However, the Deputies must accept best practice when it is put forward. The objectives of the review were to determine a cost effective model of provision going forward, ensure optimum value for money for the public purse but, importantly, determine the optimum model of ambulance provision which ensures that patients receive the highest standard of emergency response and that the care provided meets all national safety and quality standards. That is what we must aim to achieve.

John Lahart (Dublin South West, Fianna Fail)
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The Dublin Fire Brigade ambulance achieves that.

Helen McEntee (Meath East, Fine Gael)
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It is my understanding that the review was originally scheduled for completion in 2014. However, it was not possible to finalise it prior to the conclusion of the national ambulance service, NAS, capacity review. Where funding is needed, it has been allocated in additional funding and this year's service plan has been allocated for our ambulance service through the HSE national service plan. This is about best practice and ensuring that we have the best service possible for the people who need it. I am sure that when recommendations are made and the report is given to the Minister he will discuss this issue and engage with the relevant bodies before any decision is taken. I will certainly bring the Deputies' comments to the Minister and raise their concerns with him.