Wednesday, 9 October 2013
Ambulance Service Provision
I thank the Minister of State, Deputy Lynch, for taking this Adjournment debate. The issue I raise is the ambulance service in County Kerry, in particular in south Kerry where, as of last Tuesday, the service has been changed significantly in a way I believe will have detrimental consequences for patient safety. The issue is simple. Killarney town, which services a huge catchment area, has a population of 20,000. In summer the many visitors swell that population to 40,000 and, at weekends, to 80,000. One of the town's two emergency ambulances has been withdrawn and Killarney and its surrounding areas have emergency cover that is far from satisfactory. After a significant campaign in the Kenmare area we managed to retain that town's ambulance. The ambulance in Caherciveen was also retained. I refer to emergency ambulances. Due to the policy of "dynamic deployment", which means ambulances will be moved as soon as they are activated in other areas, we can see a situation coming about that has happened in other areas such as Midleton, as the Minister of State is well aware, where ambulances are not available when needed.
The loss of an emergency ambulance, namely, the reduction of 25% of cover in the south Kerry area, will have life-threatening consequences. Unfortunately, I may be back in this Chamber to report on incidents and calling for the restoration of the second emergency ambulance in Killarney, as I do now. It services the entire south Kerry area.
I thank the Senator for raising this matter, which I am taking on behalf of the Minister for Health, Deputy James Reilly. A significant reform programme has been under way in pre-hospital emergency services in recent years. The objective is to ensure that the best clinical care is provided for the people in each region served by the national ambulance service, NAS, through the provision of a clinically driven, nationally co-ordinated system, supported by improved technology.
As part of this process, the NAS has implemented a new model of pre-hospital care services for the people of south Kerry. This new model is for a region-wide service to replace the former local delivery structure, allowing for dynamic deployment and optimal use of emergency resources. It arose out of an analysis of the needs of the south Kerry area and the best use of emergency resources, including paramedics and advanced paramedics. The modernisation of service delivery in south Kerry followed a consultation process with interested groups in the region, including GPs, local public representatives and community groups. The plan was also informed by the modernisation that has already taken place in Cork.
The new structure, agreed between Health Service Executive management, union representatives and staff, provides numerous benefits for patients. The replacement of on-call with on-duty rostering brings service delivery in south Kerry in line with the majority of the region. On-duty rostering means that, during a shift, paramedic staff are at their bases or in their vehicles, ready to be dispatched immediately to answer 112 and 999 calls rather than waiting at home to be notified, with the delays that involves. Regional deployment of emergency vehicles and emergency personnel offers a wider availability of ambulance resources, to best serve the people of south Kerry. An intermediate care service for routine transfers of patients between acute and community hospitals, in line with best clinical practice, will free emergency vehicles in south Kerry for emergency work. Killarney, Caherciveen and Kenmare ambulance stations will be retained as the locations for deployment in the south Kerry area.
In a modern emergency service, treatment begins when emergency staff arrive at the scene of an incident. Patients are assessed, treated and stabilised, before being transported to the most appropriate facility. The NAS has highly trained health professionals in south Kerry, at paramedic and advanced paramedic level, who can perform life-saving interventions and other skilled treatment at the scene, before moving the patient safely to an acute facility for further treatment. While some concerns have been raised regarding levels of cover at certain ambulance stations, I am assured by the NAS that the plan will greatly improve response times, as emergency ambulances will be available straight away and, where necessary, ambulances from adjacent stations will provide dynamic cover by moving to areas where cover is required.
The new arrangements I have outlined provide an extra 126 resource hours each week between Killarney, Kenmare and Caherciveen stations. The move to on-duty services means the entire south Kerry area will have a 24 hours a day, seven days a week emergency ambulance service. This will ensure the people of the region have timely access to highly-skilled paramedic and advanced paramedic staff, day or night.
I thank the Minister of State for her reply. We in south Kerry are facing death by geography and death by PowerPoint. Hidden within the PowerPoint presentation delivered to us by the national ambulance service was the information that the second emergency ambulance in Killarney town would be lost, which simply beggars belief. People in rural areas will now be waiting one to two hours for a response, including in cases of heart attack and stroke. Patients could well end up requiring weeks of hospital treatment rather than days, because of delays in administering emergency care.
The national ambulance service and Health Service Executive management have made their decision and it is the people of Killarney who are at a loss. Notwithstanding the promises of an improved service, I fear there will be fatal consequences for people in Kerry.
Thank you, a Leas-Chathaoirligh. I know well what Opposition Members are obliged to do, because I was in that position for long enough. However, I would urge Senator Daly to give the service a chance. It is not helpful simply to assume we will have the worst possible outcome. This, after all, is a service which the experts in the area assure us is an improvement on what went before. I have seen paramedics in operation and they are incredible people, able to perform tasks at the side of the road that are normally done in a very high-tech hospital environment. Frightening people into believing the new service will be worse than the old, before it is even tested, is somewhat irresponsible.