Dáil Éireann Debate, Thursday - 18 January 2024
8. Deputy Peadar Tóibín asked the Minister for Health the number of ambulance drivers recruited to the National Ambulance Service and the number of ambulance drivers who have left the National Ambulance Service in each of the past ten years; and if he will make a statement on the matter. [1894/24]
View answerThe average ambulance response time in this country has been increasing significantly in the past few years, so much so that one particular and heartbreaking statistic is the number of times a patient was dead when an ambulance reached the person. In 2019 that figure was 700 and in the past year that has increased to at least 900 deaths. This is a very serious statistic that shows lives are being put in danger as a result of late ambulance arrival.
I thank Deputy Tóibín for the question. We must endeavour to do everything we can to make sure the responses are properly triaged and then the response times are such that where they really do need to be there very quickly this is achieved.
I acknowledge the commitment of the national ambulance service and all of those working in it to delivering this on behalf of patients. We have invested more than €219 million in the National Ambulance Service since 2019. It represents a €50 million increase. It is has been a very significant investment to ensure we have the best possible ambulance service. The increase in staff has been important. If we look back to 2015, over the past eight years the number of staff has increased by more than one third. We have 600 more people working in the service than we had in 2015. To be clear, just last year 228 of those were added. There was a big increase in the number of people working in the national ambulance service last year. The majority of those were hired late in the year.
On the Deputy's points specifically on the response times, which I fully appreciate, the Deputy will be aware of the ECHO and the DELTA response times and the targets. The target for the ECHO calls, which includes cardiac, is 75% within the time period. To November of last year they were at about 73%, which is 2% off the target. The DELTA calls had a target of 45%. They were at 44.5%, so nearly there. They are not yet hitting those targets. I interrogated this matter further on the back of the question submitted by the Deputy. The good news is that the majority of those several 100 extra staff were hired very late last year and so the benefit of those extra staff for increased response times will not have been seen in the 2023 figures. We have, therefore, an ambition this year not just to meet the response time targets but to exceed them.
The figures quoted by the Minister are obviously from a baseline in 2015. The Minister will accept that 2015 was probably during the complete collapse of investment, post austerity, into the health service. The figures being taken as a baseline are from the lowest level of staffing within the National Ambulance Service, which obviously will make the Minister's figures improve. It is very important. In 2019 there were 750 people dead by the time the ambulance arrived. In 2022 that figure was 900. The average response time for an ambulance over that period of time in 2019 was 18 minutes. In 2022 it was 27 minutes. That is an incredible figure. In the western region in 2022 one individual waited 22 hours for an ambulance to arrive. This too is an incredible figure. In the first two months of last year one person in the south of the country waited 13 hours for an ambulance to arrive. The figures are getting worse, given the real life experience of patients, and it is having a material detrimental effect on their health and lives.
Neither I, the Deputy nor those working in our ambulance service would stand over or defend those individual cases where people clearly have waited far too long. Nobody would defend that. On the response times, the core targets the service works to are the ECHO and the DELTA times. They were very close to those times last year.
I hear the Deputy's point about going back to the 2015 figures. This is why I wanted to give the Deputy just last year's figures. Of the 600 new staff, 228 of them were just last year. I understand the Deputy's point. This is also why I wanted to say that most of these 228 were hired towards the end of last year. We do want to improve those figures.
The question tabled by the Deputy was about retention, the numbers joining and the numbers coming in. I will answer that directly in my next response.
If I may I will add some practical solutions on this. One of the big situations we see on a regular basis is that an ambulance arrives at the accident and emergency department with the patient but due to the jam in the accident and emergency department because of overcrowding, or simply because there are not enough trolleys there, the ambulance has to stay at the entrance to the accident and emergency department for one, two or three hours. We then have incredible situations such as in Drogheda hospital one year ago where ten ambulances had to wait for five hours because they could not off-load their patients. I have recently heard of another hospital in Mayo where eight ambulances were stuck there. When those ambulances are stuck they obviously cannot get to the rest of the region to pick up new patients. A very simple thing would be to have just enough trolleys so when the patient is moved into the accident and emergency department from the ambulance trolley there is another trolley there. The ambulance can then be freed up to travel. I am aware this is not the case in every situation and in many situations one needs the necessary medical staff to be able to deal with the patient for the patient to be accepted but that is one of the major pinch points where ambulances are stuck at the accident and emergency departments and are not free to go about their work.
I certainly know the ambulance service can take that under advisement and will do everything they can to increase the turnaround times. They have been innovating over the past few years. The clinical hub now has hear and treat and see and treat services they did not have previously. The Deputy will be aware of the pathfinder model, the medical assessment unit pathways, the community paramedic scheme, the ED in the home and various other issues. The ambulance services are to be commended for their innovation. I am not detracting from the fact there are still significant challenges.
On the Deputy's specific question about those joining versus leaving the service, I am very happy to say the ambulance service put in place a human resource plan two years ago in 2022. Their turnover rate is now 1%, which was for quarter 3 of last year versus 2.4% for the HSE. Essentially, twice as many have joined the service as have resigned or retired from the service in previous years. They are clearly doing something right. We in Government and in the Oireachtas need to continue to support them and to continue investing in them. They are showing that it is money very well spent on behalf of patients.
