asked the Minister for Health the number of cardiac ambulances attached to each health board; the number serving the Dublin area; and if he has any proposals to increase the number.
14.
Ceisteanna—Questions. Oral Answers. - Ambulance Services.
13.
asked the Minister for Health if he is aware of the concern of people in the Dublin area regarding the availability of cardiac ambulances; and if he will make a statement on the matter.
15.
asked the Minister for Health the categories of persons entitled to free ambulance services; and if he will arrange that the various schemes of medical insurance be extended to include cover for ambulance charges.
16.
asked the Minister for Health the cost of putting a fully equipped cardiac ambulance into service.
I propose, with the permission of the Ceann Comhairle, to answer Questions Nos. 13, 14, 15 and 16 together.
Health boards do not operate special cardiac ambulances but provide an accident and emergency ambulance service which caters for emergency cardiac cases as well as other emergency cases. The ambulance personnel are specially trained in the resuscitation of cardiac emergency cases.
In the Dublin area there is a private cardiac ambulance service which is run independently of the Eastern Health Board's ambulance service. The health board pay £8.95 per call on this cardiac ambulance service in Dublin city and county, and somewhat more for calls to Counties Kildare and Wicklow, in the case of persons eligible for hospital services under the Health Act, 1970, if the cardiac ambulance is requested by a doctor or by the Dublin Fire Brigade, who operate the accident and emergency ambulance service in the Dublin area on behalf of the Eastern Health Board.
I have received a number of complaints from people who have been charged for using the cardiac ambulance service but my Department are not aware of any widespread concern about the availability of cardiac ambulances. This matter is, however, being further considered in the Department.
Health boards are not legally obliged to provide ambulances but, in fact, they all do so. They have discretion whether to make a charge for ambulance services or to provide them free of charge. The actual position is that an accident and emergency ambulance service is provided free of charge to everybody except in one area where persons not eligible for hospital services under the Health Acts may be charged. The routine non-accident ambulance service for conveying patients to or from hospitals and clinics is provided free for persons with medical cards. Persons with limited eligibility may be charged for this routine ambulance service in most areas, and ineligible persons are charged for it in all areas.
The cost of putting a fully-equipped cardiac ambulance into service is estimated at £23,000, made up of the cost of the ambulance and equipment, approximately £7,000, and the annual cost of ambulance personnel to provide cover for 24 hours every day. The staffing costs would probably be less if the cardiac ambulance service were integrated with the existing accident and emergency ambulance service.
With regard to the suggestion that medical insurance schemes be extended to include ambulance charges. I understand that the Voluntary Health Insurance Board's ordinary scheme covers conveyance by ambulances between hospitals. The board's supplementary scheme provides cover for the major portion of the cost of ambulance charges in excess of £25.
I take it that the health authorities do not provide cardiac ambulances and that the only such ambulances available in Dublin are those operated by a private firm?
That is right.
The Minister has said that while he has received a number of complaints from people who have been charged for using the cardiac ambulance service, the Department are not aware of any widespread concern about the availability of this service. Surely it is the duty of the health authorities to provide a service of this nature. I am aware of many public representatives, including myself, to whom representations have been made in this regard.
May we have a brief question, please?
Is it not the responsibility of the Minister to examine this matter further?
As I indicated, I am at present investigating the whole ambulance service.
The Minister will recall that I raised this matter with him some time ago. Is he aware that frequently in Dublin city there are cases in which the unfortunate relatives of persons who suffer heart attacks are asked for money before the ambulance will move to take the patient to hospital although the patient has already been transferred to the ambulance? These are cases in which all that is standing between the patient and death is the cardiac ambulance. Can the Minister do anything about that situation?
I share the Deputy's concern. This matter was raised recently by Deputy Walsh as well. It is deplorable that anybody should demand payment.
Would the Minister recognise that the ordinary man in the street is not concerned whether it is the Eastern Health Board or the Voluntary Health Insurance Board? He is concerned only with getting the patient as quickly as possible to safety, and the cardiac ambulance means the difference between life and death. Would the Minister agree that it is an appalling situation that we do not have this service in Dublin city, free of charge, or at least provided on a basis of subsequent recoupment of the cost?
Question No. 17.
While these investigations are taking place would the Minister give an undertaking to come to some suitable arrangement with this firm under which people will not be delayed while the question of money is discussed or the cost of the fare to the hospital is under discussion? Surely it is possible to come to some arrangement?
A brief question, please, Deputy. We must move on from this question.
In respect of the Dublin service, with which Deputies are concerned, there have been complaints about the charges made. There has been pressure exerted to provide a free cardiac ambulance service. It is intended that the officials of my Department will discuss the whole subject with cardiologists and with the Eastern Health Board to ascertain whether there is a real need for cardiac ambulances. Therefore, so far as Dublin city and county are concerned, this matter is under consideration, and I trust something satisfactory will come out of that.
One final supplementary——
Please, Deputy Walsh; we must make some progress. I have allowed a lot of latitude on this question. The Chair is in command at Question Time. A brief supplementary, please.
With regard to the number of complaints received by the Minister, might I ask if he has had these investigated regarding the cost of ambulances and delays involved?
I said that, in respect of complaints made by certain people, these are being considered.