Phil Hogan (Carlow-Kilkenny, Fine Gael)

I am taking the Adjournment matter on behalf of my colleague, the Minister for Health, Deputy James Reilly.

The HSE has confirmed that services are not being diminished in Iveragh or Dingle. However, traditional work practices within the National Ambulance Service are changing, as stations move from on-call to on-duty status.

Being on-duty means our highly trained paramedic crews are in ambulance stations and vehicles to respond to calls, rather than being called out to stations, which is inevitably slower in responding to emergency calls. It also means resources can be deployed dynamically, based on need and demand patterns, not location, producing more flexibility and responsiveness and giving better response times for people in Kerry and a better service.

Under the new system, Caherciveen will have 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 at night. With dynamic delivery, an on-duty emergency ambulance will be available from within the region as required.

I note that ambulance staff sought to eliminate on-call working, that it has been reduced from 44 to 16 hours a week and that this will continue as part of the improvement of regional services and response times. The HSE and unions are committed to ongoing discussions with staff on implementing the proposals, including Caherciveen and Dingle.

In phase 1 of the proposals, east Cork stations with night time on-call will move to on-duty 24/7, 365 days a year. The more rural stations, such as Castletownbere, Kenmare, Bantry, Skibbereen, and Caherciveen, are next, with the service evaluated after each phase. As Dingle will be considered in Phase 3, no decisions have yet been made. With the unique geography of the peninsulas, they will continue to be serviced primarily by emergency ambulance, with an emphasis on on-duty rather than on-call arrangements. In the event of the ambulance being away from the area for a period, existing resources, either rapid response cars or emergency ambulances, will be dynamically deployed close to or on the peninsula to maintain an emergency response.

Finalising the proposal depends on the work practice process, the national service plan and realignment of existing HSE resources to support reconfiguration of ambulance services in Cork and Kerry.

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 it means longer transport times. Having an on-duty service enables a modern emergency response service, with paramedics, advanced paramedics, community first responders and GP out-of-hour services working together to respond to emergencies. This is consistent with international best practice and will ensure compliance with HIQA response standards. On-duty rostering is one of several service enhancements. Others include improved arrangements for control and despatch, practitioner deployment and inter-hospital transfers, all of which will allow the national ambulance service to provide a better, safer, more comprehensive and efficient emergency service for the people of Caherciveen and the Kerry region as a whole.