Seán Haughey (Dublin Bay North, Fianna Fail)
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Dublin Fire Brigade provides emergency ambulance services in Dublin by arrangement between Dublin City Council, the National Ambulance Service and the HSE. In short, Dublin Fire Brigade provides a fire-based ambulance service. International best practice indicates that combining fire rescue and emergency services greatly improves the response to a crisis, particularly in this age of international terrorism. 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 control centre in Tallaght. This would be a major mistake.

Problems were identified in the HIQA report published in December 2014, and there were concerns about the existence of two separate control and dispatch processes. We are now at an impasse on this issue. The 2015 report of the expert panel on pre-hospital emergency care services in Dublin provides the solution. Moving the call and dispatch service to Tallaght from Townsend Street is not acceptable to Dublin Fire Brigade. A technical solution to bring about the required co-ordination is possible. This would cost only approximately €10,000 to €20,000 and should be trialled. A transfer to Tallaght would end the fire-based emergency ambulance service and benefits of such a service. The practical solution is to provide terminals in both call centres. This would replace the existing telephone contact arrangements. It would show both emergency services the location and availability of ambulances and would ensure the nearest available ambulance is identified.

There is another issue. Dublin Fire Brigade has not been provided with the necessary ambulance capacity to respond to the 36,000 emergency calls it received in 2016. Dublin Fire Brigade has only 12 ambulances and this needs to be addressed.

Darragh O'Brien (Dublin Fingal, Fianna Fail)
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My colleague has outlined the reason both of us and our party firmly support Dublin Fire Brigade's provision of ambulance services for Dublin. It is because it works, and it works very well. There was a 99% satisfaction rating in the last survey.

The external review in the report carried out by HIQA is fundamentally flawed because one of the members of the external review team did not declare a conflict of interest in carrying out this report. The conflict of interest is that individual is also a board member of the Association of Ambulance Chief Executives, AACE, which is a UK firm contracted to the HSE and which provided advice to the National Ambulance Service. All of this leads in this direction.

I also want to specifically state to the Minister for State, on the day we are discussing parliamentary questions not being answered, that on 17 October I tabled three parliamentary questions to the Minister for Health asking him to outline the procurement process entered into by the HSE and the granting of this contract to AACE UK Limited. I also asked about the conflict of interest and what references it sought regarding the individuals and, in particular, one individual, Mr. Ken Wenman, who was a board member and a member of the external review team. I also asked the Minister for Health about payments made to an organisation each year in respect of its engagement by the HSE. This was put forward on 17 October. On that date, I received a reply from the Minister stating the issues raised are operational and he had referred them to the HSE for a response. I have had no response since. The external review is absolutely flawed because it was teed up to give Dublin City Council and the HSE the answers they wanted to undermine the work of Dublin Fire Brigade.

Catherine Byrne (Dublin South Central, Fine Gael)
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I thank the Deputies for giving me the opportunity, on behalf of the Minister for Health, Deputy Simon Harris, to address this issue and the concerns they have raised.

Dublin Fire Brigade provides emergency ambulance services in Dublin city and county by arrangement between Dublin City Council and the HSE. The National Ambulance Service provides non-emergency patient transfers in the greater Dublin area and also some emergency capacity in this area. I understand that in the last year, in response to increased service pressures, the National Ambulance Service has provided additional emergency capacity in Dublin.

In recent years three comprehensive reviews of ambulance services have been undertaken: the Health Information and Quality Authority, HIQA, review, the capacity review and the review of Dublin ambulance services which was jointly commissioned by the HSE and Dublin City Council. The capacity review which was published last year examined overall ambulance resource levels and distribution against demand and activity. It identified a requirement for additional emergency resources, primarily comprising rapid response vehicles in the eastern region, including Dublin. As I mentioned, the National Ambulance Service has put in place additional emergency resources in Dublin, including rapid response vehicles, to address this capacity deficit.

The 2014 HIQA report on ambulance services highlighted some operational inefficiencies between the National Ambulance Service and Dublin Fire Brigade and recommended a number of measures to improve operations. I am pleased to draw the attention of the House to a follow-up review by HIQA earlier this year which noted that communication, co-operation and co-ordination between the National Ambulance Service and Dublin Fire Brigade had improved significantly since 2014.

A review of Dublin ambulance services was commissioned by Dublin County Council and the HSE some time ago and focused on identifying a service model for the most effective and efficient provision of emergency ambulance services and patient care in the Dublin region. Its primary objectives were to determine the optimal model of ambulance service provision which would ensure patients received the highest standard of emergency response and to determine the most cost effective service which would ensure optimal value for money for the public purse. However, the issue of Dublin ambulance service provision is the subject of a mediation process between Dublin City Council and staff associations. In these circumstances, I am not in a position, nor would it be appropriate, to make any comment on funding arrangements that are in place, or should be in place, between Dublin City Council and the HSE. I can, however, confirm that additional funding will be made available for the continued development of pre-hospital emergency care services in 2018. The allocation of the additional funding by the HSE for specific service developments throughout the country must await the finalisation of the national service plan. This process is under way.

I note that the National Ambulance Service recently won an ESAI sustainable energy award for the energy efficiency of its new vehicles. The vehicles include features such as solar panels and other energy saving mechanisms. I am advised that five of the new vehicles have been assigned to Dublin Fire Brigade.

Seán Haughey (Dublin Bay North, Fianna Fail)
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The Government must provide a minimum of four additional ambulances and the consequent funding for Dublin Fire Brigade immediately in order that it can respond to the ever increasing number of emergencies and incidents in Dublin. Dublin Fire Brigade personnel are also trained paramedics. If the Minister goes along with the changes proposed by the chief executive officer of Dublin City Council, a skill set will be lost forever. A fire brigade can also be sent with an ambulance with trained paramedics on board. This is a safety issue and in the best interests of the public and patient safety generally. Sadly, terrorist attacks are now a major threat in EU member states. Other member states are moving towards the concept of a fire brigade based ambulance service. It would be a shame, therefore, if we were to break up something that is working well. Will the Minister of State ask the Minister to give the local authority the appropriate funding and resources in order that it can continue to provide this service? The issue has dragged on for long enough. It must be resolved once and for all.

Darragh O'Brien (Dublin Fingal, Fianna Fail)
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I am disappointed that although this is the second time we have raised the issue, on neither occasion has the Minister for Health, Deputy Simon Harris, attended the House to discuss it. In our initial statements we outlined our full support for Dublin Fire Brigade and its ambulances. The work of the National Ambulance Service is also exceptional. However, the HIQA report mentioned by the Minister of State is absolutely flawed. The individuals who undertook the work to complete the report had a clear conflict of interest. As I mentioned, they are employed by the HSE to provide other services and that fact was not declared.

Why can I not get answers to the three parliamentary questions I tabled on 17 October about the public procurement process and the company AACE UK Limited? In six weeks I have not received answers to the three questions. I believe the company was appointed to give the HSE, the National Ambulance Service and Dublin City Council the answers they wanted, which is unacceptable. The Minister of State is a Dublin Deputy and aware of the work Dublin Fire Brigade and its ambulances do. This is an absolute divvy-up which should not be accepted. I ask the Minister of State to give a commitment that the Minister, Deputy Simon Harris, will come to the House to address the issue at least once. This is the second time we have raised it in six months.

Catherine Byrne (Dublin South Central, Fine Gael)
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I am fully aware of the service Dublin Fire Brigade provides in the city through the council. I am a long-standing fan of Dublin Fire Brigade and the service it provides since my term as Lord Mayor. It provided a service for the Lord Mayor at the time also. I will bring the issues that have been raised by the Deputies to the Minister's attention. Unfortunately, he cannot be present, but it is not his fault as he had to leave for another engagement. I will raise the procurement issue with him and the three parliamentary questions tabled on 17 October and ask him to reply personally to both Deputies.