James Bannon (Fine Gael)
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I welcome the Minister of State. Given the time of year, an analogy between the story of Scrooge in A Christmas Carol and the Government's penny-pinching in the health services would not be out of place. These cutbacks are impacting on the lives of the ill and their carers. Following the post-election scandal of broken promises, the health services throughout the country are in a Dickensian state. Basic care is being jeopardised and we are returning to an era where the rights and needs of patients are no longer paramount; they have been sacrificed to dubious remedial action to cover the miscalculations of the Minister for Finance. For every progressive step taken we are taking two steps backwards.

My locality faces a Christmas during which only one ambulance crew will be on duty to cover the greater Longford and midlands area between 6 p.m. and 8 a.m. for the duration of the medical technicians' strike, which started last Monday. This dispute centres on current working arrangements and means the five midlands ambulance stations – Longford, Portlaoise, Tullamore, Athlone and Mullingar – are manned by one crew and an off-duty on call crew between 6 p.m. and 8 a.m. County Longford will be worst affected because, having no 24-hour casualty service, it is obliged to rely on the Midlands General Hospital in Mullingar.

The Midland Health Board has stated it is unable to meet the demands of the emergency medical technicians, EMTs, who are striking in pursuit of their claim in respect of the removal of the current on-call arrangements. EMTs provide a 24 hour ambulance service with up to three duty crews in each station. Between the hours of 6 p.m. and 8 a.m. there is only one duty crew per station plus an on-call off-duty crew who are paid only €2 an hour – Dickens did not know the half of it.

This industrial action is not about money or double time payments. The technicians merely want a commitment from the Midland Health Board to remove the on-call arrangement currently in place. It is unsatisfactory that a person must work a 32 hour shift – as in the case of EMTs in the midlands – working from 10 a.m. to 6 p.m., then on-call to 8 a.m. and having to turn up for work again the next day. That is ridiculous in this day and age. There is much concern among the public about what is happening in this regard in the midlands.

SIPTU, which represents the approximately 80 EMTs involved in strike action, recommended as far back as 1993 that the on-call service should be removed from the rota system. Of the 75 technicians polled on the elimination of the on-call service, 67 returned papers. A total of 64 voted in favour, two voted against and there was one spoiled vote.

The level of activity covered by the on-call service as estimated by the Midland Health Board is 6% between the hours of 6 p.m. and 8 a.m. Under an alternative roster system crews would be brought in on an overtime basis in the short term, but in the long term it would necessitate the recruitment and training of eight additional EMTs, which would reduce dependence on overtime and give a continuous service. It comes as no surprise to hear that the Midland Health Board cannot afford to finance these changes from its current budgets. The elimination of the on-call arrangement would require the provision of additional funding of approximately €1.4 million.

This strike comes at a bad time for the Midland Health Board. It has overspent on this year's budget by almost €3.5 million, as outlined by the financial review for the first nine months of this year, with under-funding, the medical card scheme, the winter vomiting bug and the settlement of the national accident and emergency dispute responsible for its financial losses. Ambulance crews provide an essential life saving service. Without their rapid intervention patients will die or, at the very least, suffer undue delay in receiving treatment.

Ivor Callely (Dublin North Central, Fianna Fail)
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I thank the Senator for giving me the opportunity to clarify the position in relation to non-co-operation by emergency medical technicians with on-call pre-hospital emergency care rostering arrangements at ambulance stations in the Midland Health Board region. It would be remiss of me not to respond to some of the points raised by him. He said morale of health workers was at an all-time low. I wish to mention a few figures which will put the position in perspective.

When the Senator party's was in Government five years ago, the annual spend on the provision and delivery of health services the length and breadth of the country was shy of £3 billion. The Government recognised that money was required to ensure an adequate level of service. We have done a lot and recognise there is a lot more to be done. We have put approximately three times that amount –€9 billion – into the health service. We have extended services—

James Bannon (Fine Gael)
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None of the money has been spent in the Midland Health Board area.

Ivor Callely (Dublin North Central, Fianna Fail)
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—where possible, increased the number of professional and support personnel, extended the medical card scheme to all persons over the age of 70 years, reduced waiting lists and improved the procedures for elective surgery.

James Bannon (Fine Gael)
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There is no evidence of that now.

Ivor Callely (Dublin North Central, Fianna Fail)
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Those are only some of the improvements that have been made in the health service. I could spend a good deal of time outlining all the improvements that have been made and would be happy to focus on the improvements that have been made in the Midland Health Board area, if the Senator would like me to do so.

James Bannon (Fine Gael)
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The Minister of State should deal with the reality.

Ivor Callely (Dublin North Central, Fianna Fail)
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The Senator asked about the position regarding the EMTs. It is important that he should have factual information. I invite him to avail of this information from my office at any time on any health issue.

James Bannon (Fine Gael)
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What aspects of the information I gave does the Minister of State dispute?

An Leas-Chathaoirleach:

Please allow the Minister of State to continue without interruption.

Ivor Callely (Dublin North Central, Fianna Fail)
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I will try to outline the correct position regarding some of the inaccuracies outlined by the Senator. Responsibility for the provision of pre-hospital emergency care rests with the Midland Health Board. A number of the Senator's political colleagues represent the board—

James Bannon (Fine Gael)
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I represent it myself.

Ivor Callely (Dublin North Central, Fianna Fail)
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The Senator is also a member. It is a matter for the board to meet the pre-hospital emergency care needs of its functional area.

James Bannon (Fine Gael)
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It needs adequate funding.

Ivor Callely (Dublin North Central, Fianna Fail)
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Let us consider the reason the EMTs have withdrawn from the provision of the board's on-call service. They are represented by SIPTU. The dispute centres around SIPTU's demands for the elimination of the on-call arrangement through the provision of additional duty crews. The board's emergency ambulance service, which is in place from 6 p.m. each evening until 8 a.m. the following morning, consists of normal duty attendances and on-call emergency rosters. The effect of the withdrawal of on-call emergency roster arrangements by EMTs is being met by arrangements with the Department of Defence to provide the necessary backup cover to duty crews each night for the duration of the industrial action

James Bannon (Fine Gael)
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It is a sad day for Ireland when the Department has to bring in another semi-State body to deal with the problem.

Ivor Callely (Dublin North Central, Fianna Fail)
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The board has advised the public that there is no change in existing practices regarding contact with, and availability of, emergency services.

Conciliation talks were held under the auspices of the Labour Relations Commission on Thursday last, 5 December 2002. I understand that at those talks the EMTs' representatives declined a request from Midland Health Board management and the Labour Relations Commission to agree to suspend their industrial action in advance of the intervention of the director of industrial relations. I understand the Midland Health Board continues to be available for further talks. Is the Senator indicating it is not?

James Bannon (Fine Gael)
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It is, as are EMT personnel.

Ivor Callely (Dublin North Central, Fianna Fail)
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Good. I am delighted to know that. The Minister and I—

James Bannon (Fine Gael)
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The EMT staff have requested meetings with the board and its staff since 1993 to no avail.

An Leas-Chathaoirleach:

The Minister of State to continue without interruption, please.

Ivor Callely (Dublin North Central, Fianna Fail)
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The Minister and I are satisfied that the arrangements in place are sufficient to ensure the pre-hospital emergency care service in the region can respond to any demands placed upon it and that there will be no diminution of emergency service provision in the region. However, we are concerned that the action by the EMT staff has taken place. I urge an early resolution to the difficulties which have arisen between the board and its EMT staff.

The Government will continue to pursue a policy of investment aimed at improving key aspects of emergency medical services to ensure those calling on the service continue to receive timely and appropriate care.

The Seanad adjourned at 8.35 p.m. until 10.30 a.m. on Thursday, 12 December 2002.