Pat Upton
Ceist:114 Dr. Upton asked the Minister for Health his views on the provision of mobile services for the treatment of drug addicts. [13007/96]
Written Answers. - Drug Treatment Services.
Limerick East): I understand international experience has shown that mobile clinics can be a successful part of treatment programmes for drug misusers. The services offered by such clinics can range from methadone maintenance programmes for stabilised drug misusers to harm reduction programmes, including low threshold methadone doses for chaotic drug misusers. The important consideration in the type of programme to be provided is that clear operational policies be drawn up for the clinic and that, in addition clear objectives, which would be subject to review, be defined.
Pat Upton
Ceist:115 Dr. Upton asked the Minister for Health the number of clinics and treatment centres that are available for the treatment of drug addicts; and the number of persons attending each clinic. [13008/96]
Limerick East): Methadone treatment is provided to drug misusers in the Eastern Health Board at community drug centres at Amiens Street, Baggot Street and Ballyfermot, and at the Drug Treatment Centre, Pearse Street. The number of persons attending each clinic and centre are as follows: City Clinic, Amiens Street, 150; Baggot Street, 67; Aisling Clinic, Ballyfermot, 145; Drug Treatment Centre, Trinity Court, 350. In addition, approximately 700 addicts are being treated by general practitioners.
The Eastern Health Board is in the process of implementing its service plan, which, when implemented, will provide additional treatment for 1,100 patients. The service plan includes involving more general practitioners in the prescribing of methadone, the extension of existing health board treatment facilities and a mobile methadone treatment service. It is intended that this plan will be implemented by the end of the year.
Hugh Byrne
Ceist:116 Mr. H. Byrne asked the Minister for Health if his attention has been drawn to the review of the ambulance service, 1993, when the status of the service changed from essential to emergency; when the appropriate rate of pay will be paid to those involved in this emergency service such as ambulance drivers and others; and if he will make a statement on the matter. [13019/96]
Mary Wallace
Ceist:119 Miss M. Wallace asked the Minister for Health if his attention has been drawn to the current position regarding the rate of pay for ambulance personnel and to the negotiations which have been taking place with the Local Government Staff Negotiations Board during the past three years; the reason the negotiations are so protracted; if he will ensure an early decision with regard to the claim by the ambulance personnel which is well justified in view of the weekly pay of £220 compared with £227 for a lorry driver, £353 for a fire engine attendant and £350 for members of the gardaí; and if he will make a statement on the matter. [12449/96]
Mary Wallace
Ceist:120 Miss M. Wallace asked the Minister for Health the reason ambulance attendants in metropolitan areas are paid £248 per week plus £14.44 eating-on-site allowances with an hourly rate of £6.35 whereas their counterparts in provincial areas are paid £220 basic, no eating-on-site allowance and an hourly rate of £5.64; the difference between the work carried out by the ambulance attendants in provincial areas compared with those in metropolitan areas; if he will intervene to ensure that the ambulance attendants in the provincial areas are put on a parity with those in metropolitan areas with regard to pay; and if he will make a statement on the matter. [12450/96]
Mary Wallace
Ceist:121 Miss M. Wallace asked the Minister for Health if his attention has been drawn to the injustice which is being meted out to ambulance attendants throughout the country who are involved in a three part emergency service with their counterparts in the fire service and the gardaí and are being paid £130 per week less than their colleagues in the fire service and in the gardaí; if his attention has further been drawn to the fact that nursing staff no longer attend in the ambulance with the ambulance staff resulting in the ambulance staff being in full control of not just the driving of the vehicle but the attendance to the patient at the scene of the accident and throughout the drive to the hospital; and if he will make a statement on the matter to clarify his position with regard to the need to place the ambulance attendants on a parity with their counterparts in the other emergency services. [12451/96]
Mary Wallace
Ceist:122 Miss M. Wallace asked the Minister for Health the reason ambulance attendants in the metropolitan area are paid an eating-on-site allowance of £14.44 per week whereas ambulance attendants in provincial areas are paid no eating-on-site allowance; the reason this differential exists; when the provincial ambulance attendants will be put on a par with their metropolitan counterparts with regard to the eating-on-site allowance; and if he will make a statement on the matter. [12453/96]
Mary Wallace
Ceist:123 Miss M. Wallace asked the Minister for Health the reason ambulance attendants in the metropolitan area are paid an hourly rate of £6.35 whereas ambulance attendants in the provincial areas are paid an hourly rate of £5.64; the reason this differential exists; whether he will ensure that there is parity of pay between the provincial and metropolitan areas with regard to ambulance attendants; and if he will make a statement on the matter. [12454/
Limerick East): I propose to take Questions Nos. 116, 119, 120, 121, 122 and 123 together. As I see it, four main issues are raised: classification as an “emergency service”, rate of pay, “eating-on-site” allowance and manning of ambulance vehicles.
The report of the Review Group on the Ambulance Service was published in November 1993. The group stated in their report that the ambulance service is an emergency service similar to the Garda and fire service. The report of the review group has been accepted by Government and forms the basis of Government policy in relation to the ambulance service.
While it is accepted that the ambulance service acts as an emergency service in respect of its accident and emergency work, it must also be accepted that approximately half of all ambulance calls are not of an emergency nature but are related to the routine transport of patients. In addition, classification as an emergency service does not suggest that ambulance personnel are being asked to carry out the same duties as either the fire service personnel or indeed the Garda.
A claim was lodged by SIPTU on behalf of ambulance personnel and controllers in provincial locations in 1993. The claim sought parity of basic pay with their counterpart grades in the Dublin ambulance service where agreement had already been reached. In February 1994, during the pay talks which formed part of theProgramme for Competitiveness and Work discussions, agreement was reached to restore basic pay parity with Dublin, payment conditional on agreement to a range of productivity-efficiency measures, with referral for binding third party decision in the event of disagreement on any of the proposed measures.
Negotiations have been taking place since then to try to reach agreement on a number of productivity-flexibility measures. This has been a complex set of discussions in the context of the publication, in December 1993, of the report of the Review Group on the Ambulance Service which heralded a new strategy for dealing with the major policy issues which had arisen in the ambulance service and which had not been addressed in a comprehensive way by the health service.
A number of outstanding issues were referred to the Labour Relations Commission in January 1995. Arising from these conferences a set of proposals were agreed and put to a ballot of the membership. In July 1995 SIPTU advised that the proposals had been rejected. A number of meetings have been held since then to try to progress these talks to a satisfactory conclusion. Two meetings have already been held in the last fortnight at the LRC and a further meeting is scheduled for next week.
It is my hope that this issue can be resolved at a very early date. With the monetary aspects of this deal already agreed, the Department is anxious, at this stage, to finalise the details of the productivity and flexibility measures as soon as possible.
The monetary sum quoted in the questions would seem to refer to the "travel" allowance as opposed to the "eating-on-site" allowance. Both of these allowances emerged originally from their introduction in the local authority Dublin metropolitan and were subsequently extended to the Eastern Health Board — Dublin area. It should be noted that ambulance personnel in the Dublin area are not in receipt of the "eating-on-site" allowance.
These allowances have been the subject of a number of Labour Court cases for the non-nursing group of employees as a whole. Consistently, the court has recommended that allowances such as these, should not be extended to employees working outside the Dublin area. Particular emphasis has been laid on the origins of the allowances and the fact it would be "neither practical or desirable that these payments should be extended." [LRC 10319].
It should also be noted that this issue represents a cost-increasing claim. This group are entitled to only one such claim in the lifetime of the current agreement on pay as incorporated in theProgramme for Competitiveness and Work. The claim for pay parity represents their claim under this agreement.
Ambulance vehicles are manned by a two person crew. This crew may incorporate a driver and an attendant, two interchangeable qualified drivers; or a driver and an ambulance nurse. The report of the Review Group on the Ambulance Service recommends that each emergency ambulance should be staffed by two trained personnel, with at least one having successfully completed the advanced training programme. Where a nurse is employed as part of the ambulance service she/he will act as an ambulance person and perform the duties as set out in the report of the review group. The recommendations regarding the training of ambulance personnel are currently being addressed by all health boards.