Mattie McGrath (Tipperary South, Independent)
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73. To ask the Minister for Health to review the current situation within the National Ambulance Service where emergency response vehicles have been removed from off-duty paramedics as such vehicles are perceived to be a benefit-in-kind and the impact this decision will have on response times to an emergency; and if she will make a statement on the matter. [9144/25]

Mattie McGrath (Tipperary South, Independent)
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I ask the Minister for Health to review the current situation within the National Ambulance Service where emergency response vehicles have been removed from the off-duty paramedics. Such vehicles are now perceived to be a benefit-in-kind, which is a strange situation that will have a huge impact on response times. As they are bad enough at the moment, I ask the Minister to make a statement on the matter.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy. I have been informed in recent weeks that a benefit-in-kind liability was identified by the HSE for staff using the NAS response vehicles when travelling from home to work. A review is under way in the National Ambulance Service, which it is hoped will be concluded in April. The National Ambulance Service took the prudent step of informing relevant staff members of a potential benefit-in-kind liability that may exist in 2025.

The Deputy will appreciate that the HSE must comply with Revenue Commissioner regulations, like everybody else, in relation to what may be considered a potential personal use of a publicly-owned vehicle. The National Ambulance Service is also preparing to seek a ruling from the Revenue Commissioners in the matter.

It is important to clarify that the response vehicles highlighted by the Deputy are not patient-carrying vehicles and that is a really important distinction. The vehicles in question are rapid response vehicles for authorised NAS staff to respond to an incident in support of an emergency ambulance while on duty but they are not patient-carrying ambulances or patient-carrying vehicles.

The decision taken by the National Ambulance Service, pending the ruling by the Revenue Commissioners that has been sought, does not impact on the National Ambulance Service emergency ambulance provision. I emphasise the Government's commitment to investing in our National Ambulance Service, with an allocation of €285 million in 2025. That includes €8 million new service development funding, with a full year investment of €16 million in 2026, to deliver up to 180 additional posts this year.

Mattie McGrath (Tipperary South, Independent)
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The National Ambulance Service is badly broken and the Government must intervene here to try to ameliorate this situation. It has been doing a wonderful job. The paramedics are not, as the Minister said, driving an ambulance or patient-carrying vehicle - we know that - but they are normally the first people to arrive to an accident or incident. In many cases now, when they are driving their cars, they have to pass the scene of the accident or emergency to pick up the ambulance and come back. That valuable time is lost. Often there are only minutes to spare - seconds, in some cases - to revive or stabilise a patient. This is a farcical situation.

We know there are huge issues with ambulances and burnout of the staff but this is something that came in a few years ago in a blaze of glory. It has been successful. How come it was not benefit-in-kind until now? In my own area and areas I know where they have them at home, they are not a huge benefit but they are there and they do not have to go to the hospital or ambulance base to pick them up, which could be 20 miles away. It makes no sense whatsoever. Surely, it can be dealt with in some other way so they have the fastest response time. That is what they are meant to be; a lead response before the other ambulances arrive.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I thank the Deputy and of course, I clarify for the benefit of others watching and not for him in respect of the patient-carrying vehicle. I know that he knows this but perhaps others have not been as involved in this issue as his good self.

This review was prompted by the National Ambulance Service itself. It undertook a review in September 2024 of the procedures governing the out of hours use of official response vehicles. It identified a potential benefit-in-kind liability. It is much better and more prudent to have taken that approach rather than to find out after the fact that it had been done wrongly and a liability had accrued. It is a precautionary measure and it has sought a ruling from the Revenue Commissioners.

We all have to comply with the rulings of the Revenue Commissioners. The NAS has sought such a ruling and the review of the scale of the use of response vehicles for out-of-hours incidents is being examined. The results of that review will be presented to the HSE in April 2025. I agree about the good work done but it has to comply with the rules as well.

Mattie McGrath (Tipperary South, Independent)
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I would accept this if it was about some other group of employees but these are dedicated, vital, fast responders. I salute the first responder groups - there is one in my own community - that do excellent work here. They do the work of the HSE and in some cases, they are supported by these particular paramedics who have these cars. They train with them and support them every which way. It is a reassurance that they are in an area. They have the blue lights so they can travel quickly to an incident or accident. If they go in their own car, they have to observe the rules of the road and they do not have blue lights which results in delays.

We are already crucified with delays and some people must wait three, four, five or six hours for ambulances, which come from Sligo to Clonmel and from Clonmel up to Roscommon. The whole thing is badly broken. This is the one area that was not broken; it was ag obair go hiontach, doing great work and working. Why change it? It was changed because Revenue may be an issue. Why do we not wait and see if it has an issue? We literally have taken these vital paramedics off the road. This is penny-pinching on a vital service. There are plenty of other areas to sort out the waste and issues in the HSE but not for these angels of mercy who can come so swiftly to an accident or incident.

Jennifer Carroll MacNeill (Dún Laoghaire, Fine Gael)
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I do not disagree with the Deputy one bit about the value of the service they are providing. The National Ambulance Service prudently is seeking a ruling on whether there is a benefit-in-kind liability and has informed people there may be a liability to put them on notice of that. We await a determination.

The review is useful more broadly because it will look at the scale of use of response vehicles for out-of-hours, as I said, but it will also determine the benefit and balance of the use of those vehicles out of hours compared to others existing out-of-hours or voluntary responses including, as we all know, the community first responder schemes. We have 300 of those schemes and 4,000 community first responder volunteers nationwide, which is extraordinary. We also have the NAS off-duty responder scheme, where we have 682 National Ambulance Service staff involved.

Pending the results of the review, the National Ambulance Service took it upon itself to inform people there may be a benefit-in-kind liability. Had it not done that, it would have been rightly criticised for being aware there may be a liability that would accrue to people and not having informed them. We await a ruling of the Revenue Commissioners on it.