Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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To ask the Minister for Health if he will provide all details of cuts and changes to ambulance services across the country since his appointment, including the rationale for the areas chosen for implementing changes or cuts; the planned savings to his Department of these changes; the actual savings to his Department; and the resulting changes in the response time to ECHO and DELTA calls that resulted from these changes [7002/13]

James Reilly (Dublin North, Fine Gael)
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The HSE National Ambulance Service (NAS) is not a static service. It deploys its resources in a dynamic manner and works on a regional and national, not a local, basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource is mobilised to the location of any incident. In this context, any removal of overtime inefficiencies will be addressed through more efficient deployment and utilisation of resources.

The Deputy may be aware that, following a referral to the Labour Court under the Public Service Agreement, the NAS is progressing a number of efficiencies arising from the Court's decision. These operational efficiencies include the removal of on-call arrangements in rosters, where ambulance staff are not actually on duty in ambulance stations or vehicle but must be summoned for a 999 call. This means that it could take over 20 minutes for an emergency ambulance to leave its station after the crew has been tasked. All parties accept that, in accordance with a Labour Court recommendation, providing ambulance services under on-call arrangements should cease. As the Deputy's query relates to operational matters for the Health Service Executive, this question has been forwarded to the HSE to reply directly to the Deputy.

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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To ask the Minister for Health in view of the fact that there is no ambulance service in north Kildare between 7.00am and 7.00pm on a Thursday since September 2012, if ECHO and DELTA calls on Thursdays in this area are being responded to in the Health Information and Quality Authority recommended timeframe of 19 minutes [7003/13]

Richard Boyd Barrett (Dún Laoghaire, People Before Profit Alliance)
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To ask the Minister for Health the rationale for cutting the North Kildare Ambulance Service on Thursdays between 7.00am and 7.00pm; and if there is any other ambulance area in the country with a population of 100,000 that has a 12 hour period on a weekly basis in which there is no ambulance service [7004/13]

James Reilly (Dublin North, Fine Gael)
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I propose to take Questions Nos. 677 and 678 together.

The National Ambulance Service is not a static service. The NAS deploys its emergency resources in a dynamic manner and works on an area and national, rather than a local, basis. The dynamic deployment of ambulance resources ensures that the nearest appropriate resource within a region is mobilised to the an incident.

For dynamic deployment of emergency resources within a region to be effective, those resources must be available to be used as efficiently as possible. Following a referral to the Labour Court under the Public Service Agreement, the NAS is currently progressing a number of efficiencies arising from the Court's ruling, including more efficient rostering and the removal of overtime built in to rosters. New rosters are now in place, including in the greater Dublin area, and are operating successfully. The Health Information and Quality Authority (HIQA) has developed key performance indicators (KPIs) for pre-hospital emergency care, which classify 999 emergency calls by clinical status. Clinical Status 1 (Echo) calls involve life-threatening emergencies of cardiac or respiratory origin, while Clinical Status 1 (Delta) calls involve life-threatening emergencies other than cardiac or respiratory. The target times for responding to Echo and Delta calls are 7 minutes 59 seconds by a first responder (a person trained in minimum basic life support and use of a defibrillator) and 18 minutes 59 seconds for a patient-carrying vehicle. With effect from January 2012, HIQA set the standard at 75% within the target time for first responders and a target has been set at 80% within the target time for patient-carrying vehicles.

The NAS has been taking a number of steps to improve emergency responses. These include development of a Performance Improvement Action Plan, an Intermediate Care Service, the national control centre reconfiguration project and a trial emergency aeromedical service.

In light of the above, and following a review of the validity of time-based KPIs, it is considered, in line with international views, that clinical outcomes would be more appropriate as performance indicators. Accordingly, work has begun on their development.I also welcome the fact that use of clinical indicators will enable a focus on Clinical Status 1 (Echo and Delta) calls.

In relation to the specific queries raised by the Deputy, as these are service matters, they have been referred to the Health Service Executive for direct reply.