Billy Timmins (Wicklow, Fine Gael)
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Question 108: To ask the Tánaiste and Minister for Health and Children her plans to allocate additional funding and human resources to the ambulance service in the old Eastern Region Health Authority area to assist it in the expansion of the first responders scheme; and if she will make a statement on the matter. [28949/05]

Liz McManus (Wicklow, Labour)
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Question 110: To ask the Tánaiste and Minister for Health and Children if her attention has been drawn to the review of the ambulance command and control centre in central Dublin that called for the establishment of a joint ambulance control in Dublin, to be staffed by the Dublin Fire Brigade and Health Service Executive staff; if her attention has further been drawn to the findings of the review that the current system represents a substantive, identifiable, measurable risk to the patient population in the greater Dublin area; and if she will make a statement on the matter. [28781/05]

Billy Timmins (Wicklow, Fine Gael)
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Question 176: To ask the Tánaiste and Minister for Health and Children if she will extend the first responders scheme, currently in progress in County Wicklow, to other regions; and if she will make a statement on the matter. [28948/05]

Mary Harney (Dublin Mid West, Progressive Democrats)
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I propose to take Questions Nos. 108, 110 and 176 together.

Deputy Timmins's questions relate to the management and delivery of health and personal social services, which are the responsibility of the Health Service Executive, HSE, under the Health Act 2004. As part of the reform of the health service a national ambulance office has been established under the auspices of the national hospitals office within the HSE. The office has responsibility for the provision of pre-hospital emergency care nationally, including the development of the "first responder" service where required.

The report of the Strategic Review of the Ambulance Services, 2001 has largely formed the basis for the development of pre-hospital emergency medical services in recent years. One of the recommendations in that report is that all ambulance services should consider setting up first responder programmes to support the ambulance service. Consistent with this recommendation, the HSE eastern region trained over 1,000 people last year in cardiopulmonary resuscitation in the community. My Department is advised that there are a number of community first responder schemes operating in County Wicklow. The Executive has advised that it intends to progress the further roll-out of the community first responder scheme, subject to the pre-hospital care needs of particular regions.

With regard to the question from Deputy McManus, ambulance services in the eastern region are provided by the HSE and Dublin City Council through Dublin Fire Brigade, DFB. The HSE eastern regional area provides services in counties Dublin, Kildare and Wicklow while the DFB largely operates in Dublin city under an arrangement with the executive. The HSE has overall responsibility for the provision of ambulance services and allocates funding annually to Dublin City Council.

In 2004, the former Eastern Regional Health Authority commissioned a review of an integration agreement relating to the operation of the command and control centre at Townsend Street, Dublin. The centre is staffed by ambulance personnel from the HSE and the DFB. The review was commissioned arising from difficulties which had arisen in operating the centre in a fully integrated fashion. The review was conducted by an independent management consultant.

The principal recommendation arising from the review was that discussions should take place at senior management level between Dublin City Council and the Health Service Executive. Among the issues to be considered are: the need to establish a fully integrated joint ambulance control based in Townsend Street staffed jointly by the HSE and DFB; the need to ensure that previously agreed protocols on the dispatch of emergency ambulance services are implemented and monitored; and the need for a single information and communication technology system to be introduced for the dispatch of emergency ambulances.

My Department is advised that the national hospitals office has since had preliminary discussions with Dublin City Council to discuss the implications of the report and with a view to setting up the senior management group as recommended. My Department is further advised that the composition of the group has been agreed and that it is scheduled to meet later this month. The review further recommended that in the absence of agreement to the resolution of difficulties which have arisen in the operation of a fully integrated centre, the HSE should commission a risk management audit to assess the risks to patients arising from a continuation of the existing arrangements at Townsend Street.

I strongly support the recommendations in the report. Furthermore, I consider that risk management-audit should form an integral part of any future arrangements governing the provision of ambulance services nationally.