Leo Varadkar (Dublin West, Fine Gael) | Oireachtas source

I thank Senator Kelly for raising this matter and giving me the opportunity to update the House on our plans for ambulance service improvements this year. I am happy to confirm that those plans include providing more paramedic cover in the west of Ireland, although certainly not one at every crossroads. In 2015, a €5.4 million budget increase has been provided to the National Ambulance Service to help address service gaps. In that regard, provision is being made for 50 additional paramedic posts in the west. Some of these posts will be used to staff ambulance stations at Tuam and Mulranny and others will assist in the move from on-call to on-duty rostering. On-call rostering means paramedics remain at home and wait to be called out. This, on average, results in a 20 minute delay in despatching an ambulance. We are therefore moving from this to on-duty rostering where crews will be in their stations or vehicles ready to go immediately on despatch.

It is also intended to expand the number of community first-response teams, particularly in more rural and sparsely populated areas. These are volunteer groups in the community who are registered and trained to a certified standard. The National Ambulance Service calls out a local responder to a cardiac emergency in the area. This responder gets to the scene before the arrival of the ambulance crew, applies his or her cardiac training and increases the person's chance of survival. There are currently over 100 teams operating around the country at present but we need more and are working on this.

Of particular benefit to western counties is the emergency aeromedical support service. This service was established under this Government and is particularly targeted at the midlands and west. It provides rapid access to appropriate treatment for very seriously ill patients where this may be difficult to achieve by road. I am currently looking at proposals to examine the service on a permanent basis and I am in discussions with my colleague, the Minister for Defence on this matter.

Discussions around ambulance response times can become emotive. We only seem to ever hear about the delays. We do not hear about the high quality treatment being provided by our paramedics and how the service has improved so much in recent years. It is important to point out that response time performance is improving year on year in the face of increasing demands. Response-time targets only measure one aspect of ambulance performance. Ideally they would be part of a suite of assessments. Internationally, more and more ambulance services are moving towards patient outcomes as a better indicator of performance. The National Ambulance Service introduced a patient-outcome target for out-of-hospital cardiac arrests last year and more are being developed.

Currently there are three major reviews of the ambulance service under consideration, namely, the recently published HIQA review, the national capacity study and the Dublin ambulance service reviews.These three reviews, when taken together, will provide us with very good information to help drive further service improvement. I am working with the HSE to prepare an action plan on completion of all three reviews within the timelines to realise a new strategic vision for our ambulance services. I assure the House that the National Ambulance Service is focusing on addressing some of the service gaps in the west in 2015. Specifically, that will involve 50 new paramedics and a move from on-call to on-roster service, which is very important.

The Senator suggested that we should use fire crews in these circumstances. I certainly think there would be a strong case for training them up as community first responders. That makes a lot of sense. I cannot for the life of me see any reason that is not a good idea. It would be a little trickier to train them to emergency medical technician level. I would need to see a worked-up proposal on that. If a person who is trained to such a level does not use his or her skills regularly, he or she can become deskilled and that can actually be unsafe. That would have to be worked up and considered carefully in consultation with the pre-hospital emergency care council.