Seanad debates

Wednesday, 31 October 2007

7:00 pm

Photo of Alan KellyAlan Kelly (Labour)
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I welcome the Minister of State, Deputy Devins, to the House. All emergency services should be given our fullest support. I am concerned, however, that inadequate resources are being allocated to the ambulance service. In recent weeks, several persons working in the ambulance service have contacted me to raise their concerns in this regard.

Since the imposition of an embargo on the recruitment of staff by the HSE and the associated cutbacks, a situation has arisen where the ambulance service is engaged in ferrying patients between hospitals. At Nenagh Hospital, for example, there is a cap of 75 on patient numbers and the 76th person is ferried into Limerick. The ambulance service is obliged to ferry patients in this way while also being available to deal with emergencies. Those operating the control room of the ambulance service are thus placed in a difficult situation.

The ambulance service is there to deal with emergencies but, because of the embargo, it is effectively functioning as a taxi service because patients are not being accepted in their regional hospital of choice. This is a serious and lamentable development. It could be a matter of life and death if ambulance service staff are unable to attend the scene of an accident in good time because they are engaged in taxi services.

The ambulance service is under great pressure. In Nenagh, one ambulance is available from 4 p.m. until 8 a.m. daily. This is simply not good enough. Likewise, only one ambulance is available to serve Roscrea and Thurles. If a serious accident were to occur in Nenagh, the cover is not there to cope because of the pressure on the ambulance service to ferry patients between hospitals.

The ambulance service is meant to carry two emergency medical technicians, EMTs, who operate the ambulances. A number of patrols do not have two of these EMTs and in two scenarios I know of in the mid-west, there is a nurse on board. These personnel are doing their best but the situation is unacceptable, as EMTs are specifically trained in protocols and techniques with regard to roadside emergency scenarios etc. Will the Minister of State explain why this is happening and what will be done about it?

Training programmes for advanced paramedics were promised, with one such paramedic operating in each ambulance station per shift. In reality, between 240 and 320 advanced paramedics are needed in the country, given there are 80 stations. Where are these located, as I understand the training programme is way behind schedule? As a result of the embargo, a number of these trained advanced paramedics are moving into private health care.

Ambulance personnel are working long hours. The chairman of the Ambulance Association of Ireland, Pat Hanafin, recently stated that many are tired and some ambulance services are not being manned because of issues relating to rosters, sick leave and working hours that are too long. It is dangerous for us not to have the required personnel to run the service.

Will the Minister of State clarify the matter of new ambulances being brought in by the HSE? I understand a quantity is on order, which I welcome. There is an EU directive on the standard of ambulance that should be used and I look forward to their introduction into service. An issue exists, however, and I hope it will not provide a "Port Tunnel" moment for the Government. The new ambulances are to be one-stretcher ambulances and because we have two-stretcher ambulances currently in operation we require twice the amount of ambulances to meet capacity. We also need twice the number of personnel to man those ambulances. Is the Government fully aware of this matter and if so, will it guarantee the required resources of ambulances and personnel will be available?

I also wish to raise the state of ambulance stations. In a number of cases these stations are in a very good state, with one in my own constituency in Roscrea being a state-of-the-art facility. In the same constituency there is a more ugly case, with the ambulance station in Thurles at times in a ridiculous state because of dampness and infestation. That is not good enough in this day and age.

Ambulance personnel need our full support and we are only too aware, as legislators, how important these people are in conjunction with other emergency services. The events in Bray in recent months confirm this. We should support these people fully and I ask the Minister of State to ensure the Government does this by answering the queries I have brought to the House.

The support given should not relate to the HSE being run by budget instead of demand. Such a system would take these people for granted, which should not happen because they provide such an important service to all of us.

Photo of Jimmy DevinsJimmy Devins (Minister of State, Department of Health and Children; Minister of State, Department of Education and Science; Minister of State, Department of Enterprise, Trade and Employment; Sligo-North Leitrim, Fianna Fail)
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I thank Senator Kelly for his kind wishes, although I have had the pleasure of being here on a previous Adjournment matter.

Photo of Alan KellyAlan Kelly (Labour)
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I apologise, I did not realise.

Photo of Jimmy DevinsJimmy Devins (Minister of State, Department of Health and Children; Minister of State, Department of Education and Science; Minister of State, Department of Enterprise, Trade and Employment; Sligo-North Leitrim, Fianna Fail)
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I will be taking this matter on behalf of my colleague, Deputy Mary Harney, Minister for Health and Children.

As part of the development of the Health Service Executive a national ambulance service was established in 2005. This new organisation replaced the eight regional ambulance services that existed under the former health board structure. The objective is to provide clinically appropriate and timely pre-hospital emergency care and patient or client transport services. This includes working closely with other health-care professionals in order to achieve the most suitable integrated health-care service. As part of the process, modern technology and clinical practice guidance are used and this will continue to be a feature as the service develops.

The service operates from 94 stations located throughout the country and is controlled from 14 command and control centres. There are approximately 1,350 staff involved in the provision of services. A wide range of vehicles is used and their suitability is constantly being reviewed both in terms of European standards and developing models of pre-hospital emergency care and patient transport in line with identified international models of best practice.

Expenditure on the pre-hospital and ambulance service has increased significantly in recent years. In 1991 expenditure was €25.8 million, with this figure increasing to €48.6 million in 1997. In 2007, the allocation to the national ambulance service has increased to over €122 million.

There is a full commitment to the expansion and development of the national ambulance service, which to date has seen investment both in revenue and capital funding. This has realised the purchase of 67 new ambulance vehicles in 2006 and 65 new vehicles in 2007. There has also been refurbishment and development of new ambulance stations; continued education and training for advanced paramedics; introduction of rapid response vehicles; development of services as part of emergency care networks; and the development of a national partnership which is effectively dealing with the change agenda required to develop the service in a manner which will deliver high quality mobile health care.

The Health Service Executive is aware of the continued increased demands placed on the service and is currently conducting a national spatial analysis identifying the demands across the country. The analysis has already provided a draft report for the north-west and will have the north-east finished within the next month. The service is prioritising the next areas to be analysed. This analysis will identify the optimum shift patterns which historically have been developed in line with historical demands within the former health board areas. The analysis will also identify optimum ambulance station locations and identify the appropriate skill mix of staff.

The inception of the Health Service Executive has removed the former operational boundaries throughout the country and therefore resources can be deployed based on demands. In some areas, as a consequence of spikes in demand and staff absences, this can impact on resources and mean that staff will be asked to cover these additional shifts on overtime.

The service is prioritising workload and is increasing its capacity to deal with demands. It is in the final stages of contracting private ambulance companies to assist where necessary. In addition, following a selection and recruitment process that commenced in July of this year, 37 staff have been offered employment subject to Garda clearance and former employer references. The Health Service Executive is continuing to examine the issue of staff recruitment and is currently considering a number of options. The Minister has every confidence the measures being taken to improve the ambulance service are on track to achieve this effect as speedily as possible.

Photo of Alan KellyAlan Kelly (Labour)
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I have some short questions and I thank the Minister of State for his response. Are the 37 staff being offered employment advanced paramedics or EMTs? Is there any information on the training programme in place, such as the numbers involved? Is there any information on the number of ambulances being purchased? Are they to go to areas replacing two-stretcher or one-stretcher ambulances?

Photo of Jimmy DevinsJimmy Devins (Minister of State, Department of Health and Children; Minister of State, Department of Education and Science; Minister of State, Department of Enterprise, Trade and Employment; Sligo-North Leitrim, Fianna Fail)
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I will come back to the Senator with the answers.

Photo of Paddy BurkePaddy Burke (Fine Gael)
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Is the Minister of State taking all the Adjournment matters tonight?

Photo of Jimmy DevinsJimmy Devins (Minister of State, Department of Health and Children; Minister of State, Department of Education and Science; Minister of State, Department of Enterprise, Trade and Employment; Sligo-North Leitrim, Fianna Fail)
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No, but I will be taking the next one.