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

I welcome the opportunity to address the House and outline the changes proposed to ambulance services in Dublin.

First, I wish to clarify the position on statutory responsibility for the Dublin ambulance service. Historically, the Dublin ambulance service has been provided by Dublin Fire Brigade under fire services legislation. Statutory responsibility for this service, therefore, rests with Dublin City Council and consequently comes within the remit of my colleague, the Minister for the Environment and Local Government.

That being said, I am a huge supporter of the Dublin Fire Brigade ambulance service and its crew who provide an excellent service for the people of Dublin. Our paramedic fire fighters have a very long and proud tradition in the city and have rightly won a place in the hearts of Dubliners for that reason.

Response times are good. Training is excellent and clinical audits have been carried out for years. As my constituency is very well served by Blanchardstown fire station in Coolmine, I am well aware of the valuable services that Dublin Fire Brigade ambulances provide. Long may that continue and develop.

The National Ambulance Service is part of the HSE and statutory responsibility lies within the remit of my Department. In recent years staff at every level have put in a huge effort to transform the service. The service has evolved from being simply a transport service to a paramedic service, where advanced and often lifesaving treatment is provided at the scene and in the ambulance long before the patient gets to hospital. This is true throughout the country. A major programme of reform and modernisation of the service has been under way for some time and will continue this year. Response times for emergency Echo and Delta calls are improving, as are hospital turnaround times. I pay tribute to the staff and leadership of the service for these major advances in recent years.

Following the recent agreement between Dublin City Council and the HSE on changes in ambulance services, I want to be very clear that there is no question of any takeover by the National Ambulance Service of Dublin Fire Brigade. Dublin Fire Brigade will continue to provide ambulance services in Dublin, using its own vehicles and staff, and Dublin Fire Brigade vehicles will continue to support ambulance services, as needed. Only the structures around clinical governance of the service and call management will change. I have previously stated and I am happy to repeat today that I will not support a single fire brigade ambulance being taken out of service. However, the fact is that HIQA has identified serious patient safety concerns about the lack of co-ordination between the National Ambulance Service and the Dublin Fire Brigade. In its recent report HIQA highlighted the urgent need to address these issues. It is now proposed to establish a single point of contact and dispatch for all ambulance resources in the Dublin area and clinical governance of all Dublin ambulance services will be the responsibility of the National Ambulance Service medical director, Dr. Cathal O'Donnell.These changes will mean that emergency calls in the future will go to one call centre in Dublin and not two. The dispatcher in that centre will be able to see every available ambulance in the region. The nearest available ambulance, whether it is a National Ambulance Service ambulance or a Dublin Fire Brigade ambulance, will be sent to the incident, which is not currently the case. The people of Dublin can therefore look forward to a more responsive service as the nearest ambulance to the scene will be dispatched. The changes will also mean that there will be uniform clinical standards, training, equipment and procedures, so patients will receive exactly the same level of care no matter which type of ambulance arrives. These reforms make sense and are good for Dubliners.

There has to be a better system than the current one. Currently, if Dublin Fire Brigade has no ambulance available, the call may, or may not, be transferred to the National Ambulance Service. Passing calls between two centres poses potential difficulties and calls can be delayed or fall between the two services. A patient can fall between two stools. This has to change.

I know that firemen may be concerned about the future but they need not be. Dublin Fire Brigade will continue to provide emergency ambulance services in Dublin and the staff will be fully consulted before any changes are implemented. I understand that on Friday last, it was agreed to set up a joint Dublin City Council-union group, under an independent Chairman, to move the process forward. This is welcome and I am sure the House will support it.

Dublin Fire Brigade has provided very well for the emergency needs of Dublin since 1898. However, no service can afford to stand still. A single contact and dispatch point for emergency ambulance calls is needed to address the safety issues identified by HIQA. I ask this House to set aside any sectoral interests and to put the people of Dublin first. Members should ask themselves what is best for the people of Dublin. In my view, clearly what is best for Dublin is an integrated call-taking and dispatch service.

I am therefore pleased that following meetings between Dublin City Council and the unions, agreement in principle has now been reached on the integration of emergency ambulance call taking and dispatch. It has also been agreed that Dublin Fire Brigade will continue to be fully involved in emergency ambulance service delivery and there will be no diminution in such services. I very much welcome this development which will ensure that the people of Dublin get an even better ambulance service in the years to come.