Dáil Éireann Debate, Wednesday - 14 December 2016
143. Deputy Seán Haughey asked the Minister for Health if he will provide funding directly to the Department of Housing, Planning, Community and Local Government and Dublin City Council for the operation of the ambulance service provided by the Dublin Fire Brigade; if this funding can be increased to reflect the current costs of this service; and if he will make a statement on the matter. [40279/16]
View answer144. Deputy Seán Haughey asked the Minister for Health if he will commence immediately, by way of the new governance arrangements set out in the findings of the expert panel on the pre-hospital emergency care services Dublin published in December 2015, a process to eliminate the shortfall in the Dublin Fire Brigade available capacity to meet demand in order that the use of fire appliances to respond to ambulance calls is reserved for those calls that are clinically appropriate; and if he will make a statement on the matter. [40281/16]
View answer178. Deputy Seán Haughey asked the Minister for Health if he will implement as a matter of urgency the findings of the expert panel on the pre-hospital emergency care services Dublin published in December 2015; his views on whether this report provides a mechanism to address the operational inefficiencies and the issue of a fully integrated ambulance service in the Dublin area identified in the recommendations of the December 2014 HIQA report on pre-hospital emergency services; and if he will make a statement on the matter. [40282/16]
View answer179. Deputy Seán Haughey asked the Minister for Health if he will ensure that the national ambulance service and the Dublin Fire Brigade are provided equal status and equal treatment regarding the operation of ambulance services in Dublin; and if he will make a statement on the matter. [40284/16]
View answer180. Deputy Seán Haughey asked the Minister for Health his views on whether current dispatch functions should be retained by the Dublin Fire Brigade; and if he will make a statement on the matter. [40286/16]
View answer181. Deputy Seán Haughey asked the Minister for Health his views on whether the Dublin Fire Brigade should maintain control over its own clinical governance; and if he will make a statement on the matter. [40288/16]
View answerI propose to take Questions Nos. 143, 144, and 178 to 181, inclusive, together.
Dublin Fire Brigade (DFB) provide emergency ambulance services in Dublin city and county, by arrangement between Dublin City Council and the HSE. The HSE National Ambulance Service (NAS) provides some emergency capacity in the greater Dublin area, as well as non-emergency patient transport.
In recent years three comprehensive reviews of our ambulance services have been undertaken; the HIQA review, the independent Lightfoot Review of NAS capacity, and the review of Dublin ambulance services which was jointly commissioned by the HSE and Dublin City Council.
The Capacity Review, published earlier this year, examined overall ambulance resource levels, and distribution against demand and activity. The Review identified deficits in ambulance capacity, including in the Dublin area, which will require very significant investment to address. Implementation of the recommendations of the Capacity Review will require a multi-annual programme of phased investment in ambulance manpower, vehicles and technology. To this end, increased funding will be available for ambulance services in 2017.
The HIQA report on ambulance services, which was published in December 2014, highlighted significant public safety issues arising from two ambulance services operating in the same domain. The report identified concerns around the existence of two separate control and dispatch processes, and also highlighted the need for greater clinical governance of both services.
The HIQA report points, very clearly, to the need for enhanced integration of service provision in the greater Dublin area. In that context, the HSE is working closely with Dublin City Council, which is leading on this issue on behalf of the four Dublin local authorities, to devise and agree the elements of a safe, sustainable, integrated and quality ambulance service for the citizens of Dublin. I fully accept that, in the interest of patient safety, we need the DFB and the NAS to have a more coordinated and integrated approach to service delivery.
The Dublin ambulance services review, which was commissioned in 2014, is focused on identifying a service model for the optimal provision of emergency ambulance services and patient care in the Dublin region, including service quality, patient safety and value for money. The review's primary objectives are:
1. To determine the optimal model of ambulance provision which ensures that patients receive the highest standard of emergency response, and where the care provided meets all national safety and quality standards.
2. To determine the most cost effective model of provision going forward, which ensures optimal 'value for money' for the public purse.
I understand that the Review has recently been completed and is under consideration by the HSE and Dublin City Council, who as I mentioned earlier, commissioned the Review. While I have yet to be apprised of the detailed outcome of the Review, I can assure the Deputy that before any changes are implemented, a formal proposal for same will be required to be submitted to both myself and the Minister for Housing, Planning, Community and Local Government, for our consideration and approval. I therefore expect that my Department and the Dept of Housing, Planning, Community and Local Government will, in the coming weeks, continue to engage with the HSE and Dublin City Council, in relation to any changes in service provision which may be proposed.
I also expect that the report of the Expert Panel, referred to by the Deputy, which I understand was commissioned by Dublin City Council as part of its internal response to the HIQA report, will help inform the discussions which are currently taking place between the HSE and Dublin City Council in the context of the Dublin Ambulance Service Review, and will help with the development of an overall plan for a more integrated and safer ambulance service, in line with HIQA's recommendations.
