Dáil Éireann debate -
Wednesday, 4 Apr 2001

Vol. 534 No. 1

Adjournment Debate. - Ambulance Service.

Mrs. B. Moynihan-Cronin

I thank you, a Cheann Comhairle, for the opportunity to raise this very important matter on the Adjournment. I would like to outline the situation in regard to the ambulance service from Killarney Community Hospital. The service from the hospital serves Killarney and a huge surrounding area, including Rathmore, Barraduff, Carrow and up to Ballydesmond in County Cork. This service is too restrictive. On three days per week, the full service available is between 8 a.m. and 7 p.m. On two days per week, the full service available is between 8 a.m. and 6 p.m. On weekends, the full service is only available from 9 a.m. to 6 p.m. Outside these hours, there is an on-call service which is not satisfactory. In fact, it is a disgrace for a town the size of Killarney and the surrounding area.

The staff on the ambulance have been negotiating an improved cover for the past 18 months. They have gone through all the normal channels but, unfortunately, they have not been successful. This is not their fault but that of the Southern Health Board and the Department of Health and Children.

The objective of the ambulance service, according to the Southern Health Board, "is to develop our ambulance service so that our patients receive an efficient service, irrespective of where they are located." Unfortunately, the Minister, who is from the Southern Health Board area, is not here tonight but I am sure the Minister of State, Deputy Hanafin, will deliver the message. Would the Minister agree that the present situation is far removed from the objective outlined by the Southern Health Board? It is unbelievable in this day and age that if somebody becomes very ill during the night or if there is an accident, the ambulance is not immediately available but must wait to call the staff from their homes. They have then to travel to Killarney Community Hospital, which is the ambulance centre, pick up the ambulance and then proceed to the location of the ill person or the accident. The location could be 25 miles away from the Killarney Community Hospital and the journey could take anything up to 20 minutes to 25 minutes. That amount of time, in certain cases, is vital.

The Southern Health Board has admitted that Killarney is one of the busiest stations in its area. Some 18 months ago it stated that it would reduce the on-call service but it literally had to be dragged to this position by both the Labour Court and the unions. Improvements were to have been made by June 2000 but, unfortunately, nothing has been done to date. This is a despicable way to treat the people of Killarney and the surrounding areas and the staff who are doing a tremendous job under very difficult circumstances.

I understand the Minister of State, Deputy Hanafin, will have a prepared speech but I want the answers to two questions. What happened to the funding provided in 2000 for the improvement of emergency cover and the reduction of on-call cover? Money was provided but nothing was done. When will Killarney enter the modern age and be provided with a full 24 hour ambulance service? I am sure everybody in this House is aware that Killarney town and the surrounding area swells with many thousands of visitors during the summer months. I am sure visitors to the most scenic and beautiful town in this country would be appalled if they realised that a town such as ours had such an inadequate service and who would blame them in this day and age.

Ms Hanafin

I thank Deputy Moynihan-Cronin for raising this issue. I will bring the questions she asked to the attention of the Minister on whose behalf I am replying. Significant developments have taken place and will continue to take place to enhance this service which is very important to the whole Killarney area. Before doing so, however, I would like, as the Minister, Deputy Martin, did in the course of a similar debate on the ambulance service last week, to pay tribute to all of those in the ambulance service who work so hard to provide life-saving care in circumstances which can very often be difficult and unpleasant.

Government policy on the development of emergency medical services in Ireland is as set out in a number of policy documents, most notably the report of the Review Group on the Ambulance Service, which was published in 1993 and "Building Healthier Hearts", the Government's cardiovascular health strategy.

The report of the review group, which contained wide-ranging recommendations, set out an ambitious programme of developments which were needed to align standards in emergency medical care in Ireland with best international practice in this area of medical care. The report, inter alia, addressed the issue of the level of cover currently being provided by ambulance crews and made the recommendations on how improvements might be made.

Significant progress has been made by the Southern Health Board on the implementation of the recommendations of the report of the review group. This progress has been facilitated by special development funding from the Department of Health and Children to the board of in excess of £3 million in recent years. Much of this investment funding has been directed by the board towards improvements, on a phased basis, in the level of duty hours cover in all of the board's ambulance stations. The board's service plans continue to address the issue of increasing the level of in-station duty hours cover with a subsequent reduction of on-call cover.

The board's five year development plan for its ambulance service, 1997-2002, identifies the need to improve the level of emergency ambulance cover in a number of areas. I am pleased to report that the board has now fully implemented the objective of all emergency ambulances being crewed by professionally qualified emergency medical technicians and the full integration of part-time temporary ambulance nursing posts into the service. The Killarney station was the first of the 16 stations to have this improvement implemented in 1998.

In 2000 the board embarked on a phased plan to further extend the on-duty cover in the 16 stations outside the Cork and Tralee area and again Killarney was prioritised for this development to take place this year with the addition of an ambulance and an extra crew. The additional resources to effect this improvement on the service in Killarney will enable the board to extend the level of an in-station duty cover to 1 a.m. each day. The other stations identified are Mallow and Middleton.

Negotiations are at an advanced stage between the board and the staff side to agree the early implementation of the new roster in Killarney and this has involved a joint union-management committee being formed. Ongoing discussions are taking place with the staff members in Killarney with a view to implementing the necessary improvements to the service there and in addressing the concerns of the staff with the issue of reducing the level of on-call cover and ensuring that a period of on-call duty at night is not followed by the duty the next day.

The board is fully satisfied that the new rostering arrangements currently being discussed will ensure the service in the Killarney area will be improved in the most effective way, directing the additional resources to where they are most needed, to serve the community of Killarney.

The reduction of on-call cover and the increase of duty cover to 24 hours is but one of the many aspects of the ambulance service that requires development. The chief executive officer of the Southern Health Board last year established a strategic review group to review the implementation of the recommendations of the 1993 report in the board's area and, in particular, to address the issue of the appropriate level of ambulance stations and hours of cover in those stations with the costed implementation plan for all the board's area. This strategic review will include a costing analysis for 24-hour cover in all the board's ambulance stations. I am informed by the board that this strategic review will be completed before the end of this year and we look forward to its outcome.