Ciarán Cannon (Galway East, Fine Gael)

I am replying to this Adjournment matter on behalf of my colleague, the Minister for Health, Deputy James Reilly, and I thank the Senator for raising this matter.

The HSE has confirmed to the Minister, Deputy Reilly, that services are not being diminished. What is happening is that traditional work practices within the National Ambulance Service, NAS, are changing, as stations move to on-duty status and away from on-call. Being on-duty means highly trained paramedic crews will be in the stations to respond to calls rather than having to be called out to the station, which is inevitably slower in responding to emergency calls.

The Labour Court recommended that the HSE abolish on-call for all NAS staff in Cork and Kerry. The ambulance staff has sought the elimination of on-call working. It has already been reduced from 44 hours to 16 hours per week and that it will continue to decrease on a phased basis, as part of the improvement of services and response times in the region. There are ongoing discussions with staff on implementing the proposals, including in Caherciveen. The HSE and unions are committed to this process.

This change is to ensure that the needs of people in Cork and Kerry continue to be met in an integrated, safe and effective way by a modern service and within available resources. The focus of the HSE's current plans is to deliver a better service from the funds available rather than saving money. It also means that resources can be deployed dynamically based on need and demand patterns, rather than simply by location, giving greater flexibility and responsiveness. For example, an ambulance operating on a 24 hours a day, seven days a week basis in Killarney or Kenmare would be moving between areas to maintain spatially based emergency cover, based on predictive analysis, and then dispatched every time a rapid response vehicle is dispatched. Effectively, this means that the ambulance would be available to transport the patient by the time the paramedic or advanced paramedic has assessed and treated the patient. This will produce better response times for the people in the Cork and Kerry area and a better service.

The National Ambulance Service proposals are phased. In phase 1 stations in east Cork with night time on-call will have crews rostered on-duty 24 hours a day, 365 days a year. The more rural stations of Castletownbere, Kenmare, Bantry, Skibbereen and Caherciveen will be in later phases. The service will be evaluated after each phase.

Caherciveen will, under the new system, move from on-call at night to full 24 hour on-duty cover. Paramedics will be present at all times, with an on-duty ambulance during the day and an on-duty rapid response vehicle, staffed by advanced paramedics, at night. The dynamic delivery model means that an on-duty emergency ambulance will be available from within the region as required.

Current evidence suggests patient outcomes can be improved by better treatment and stabilisation at the scene, followed by ongoing treatment and transport to the most appropriate centre, even if that means longer transport times. On-duty service will enable a modern emergency response service involving paramedics, advanced paramedics, community first responders and GP out-of-hours services working together to respond to emergency situations. This approach is consistent with international best practice and will ensure compliance with HIQA response times and quality standards.

On-duty rostering is one of several service enhancements. Other developments include improved control and dispatch, practitioner deployment and inter-hospital transfers. All of these will allow the NAS to provide a better, safer, more comprehensive and more efficient emergency ambulance service to the people of Skibbereen and to the Cork and Kerry region as a whole.